Abstract:
BACKGROUND:Low dialysate calcium (LdCa) concentration is used to prevent or treat hemodialysis (HD)-induced hypercalcemia, but its use has been complicated by intradialytic hypotension in some patients. Our goal was to explore the possibility that dialysis calcium profiling (dCaP) can ameliorate intradialytic hypotension in HD patients who need to have dialysis performed with LdCa. METHODS:In a randomized crossover design, eighteen HD patients underwent one four-hour HD session with LdCa of 1.25 mmol/L (LdCa group) and one four-hour HD session with LdCa of 1.25 mmol/L during the first two hours and high dCa of 1.75 mmol/L during the remaining two hours (dCaP group). After that, they underwent another four-hour HD session with medium dCa of 1.5 mmol/L (MdCa group). Before HD and at four 60-minute intervals during the HD sessions, blood pressure (BP), heart rate (HR) and noninvasive measurements of cardiac index (CI), using bioelectrical impedance, were obtained. Ionized serum calcium (iCa) also was measured before HD and at 120 and 240 minutes into the HD session. In a separate study, eight HD patients were treated for three weeks with 1.25 mmol/L dCa and three weeks with the dCaP technique described above, in random order. A three-week treatment with MdCa followed. BP and symptoms were recorded during each HD session. RESULTS:During the LdCa treatment the iCa values remained unchanged, whereas mean arterial pressure (MAP) and CI decreased by 16.5 +/- 8.3% and 14.2 +/- 14.6%, respectively, at the end of HD. During the first half of the dCaP treatment, iCa, MAP and CI decreased by 2.2 +/- 4.1%, 12.6 +/- 12.3%, and 9.6 +/- 13.4%, respectively, whereas during the second half of the same treatment, iCa, MAP and CI values increased by 10.2 +/- 3.3%, 7.8 +/- 7.2% and 10.8 +/- 9.1%, respectively, from the middle HD values. ANOVA showed that the time x treatment effect was significant for iCa, MAP and CI. Total peripheral resistance and HR changes were insignificant and similar among treatments. Hemodynamic effects were comparable between LdCa and MdCa treatments. Intradialytic events were reduced (P < 0.05) only with the dCaP treatment. CONCLUSIONS:The drop in BP observed during the last two hours of HD in both the LdCa and MdCa groups was abolished in the dCaP group. The latter was accomplished via an increase in cardiac output, due to an iCa-induced increase in myocardial contractility. Therefore, dCaP, by individualizing the dCa concentrations used and timing the switching between them, may improve intradialytic BP instability and simultaneously minimize the risk for HD patients to develop hypercalcemia.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Kyriazis J,Glotsos J,Bilirakis L,Smirnioudis N,Tripolitou M,Georgiakodis F,Grimani Idoi
10.1046/j.1523-1755.2002.00100.xsubject
Has Abstractpub_date
2002-01-01 00:00:00pages
276-87issue
1eissn
0085-2538issn
1523-1755pii
S0085-2538(15)48177-3journal_volume
61pub_type
临床试验,杂志文章,随机对照试验abstract::Transepithelial fluid secretion promotes the progressive enlargement of cysts in autosomal dominant polycystic kidney disease (ADPKD). Recent indirect evidence indicated that active chloride transport may drive net fluid secretion in cultures of epithelia derived from ADPKD cysts. We now report that forskolin, which s...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1996.304
更新日期:1996-07-01 00:00:00
abstract::Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the g...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2020.04.031
更新日期:2020-07-01 00:00:00
abstract::Urinary exosomes containing apical membrane and intracellular fluid are normally secreted into the urine from all nephron segments, and may carry protein markers of renal dysfunction and structural injury. We studied methods for collection, storage, and preservation of urinary exosomal proteins. We collected urine fro...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5000273
更新日期:2006-04-01 00:00:00
abstract::Accurate measurement of glomerular filtration rate (GFR) is complicated and costly; therefore, GFR is commonly estimated by assessing creatinine or cystatin C concentrations. Because estimates based on cystatin C predict cardiovascular disease better than creatinine, these estimates have been hypothesized to be superi...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2010.321
更新日期:2010-12-01 00:00:00
abstract::We evaluated the effects of the bisphosphonate pamidronate on bone histomorphometry, structure and strength in male rats with uninephrectomy or with chronic renal disease induced by 5/6 nephrectomy. In rats with chronic renal disease the plasma urea, phosphate and parathyroid hormone levels were significantly increase...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2008.180
更新日期:2008-08-01 00:00:00
abstract::The study by Rieg et al. is the first to examine potassium handling in BK(-/-) mice, thereby addressing many unanswered questions regarding the separate roles of BK and ROMK channels in renal potassium secretion. This Commentary is an interpretation and opinion of their results, by two researchers who have been studyi...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/sj.ki.5002438
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Hypertriglyceridemia is a result of reduced triglyceride (TG)-rich lipoprotein (TRL) catabolism and occurs in rats with nephrotic syndrome (NS) and in Nagase analbuminemic rats (NARs). While the heparin-releasable lipoprotein lipase (LpL) pool in NAR and in NS is similar, TG levels are significantly greater ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2001.00478.x
更新日期:2001-01-01 00:00:00
abstract::A novel variant of the LLC-PK1 cell line was used to examine directly the mechanism whereby PGF2 alpha and TPA inhibit renal ammoniagenesis. The variant cells, which exhibit a growth pattern and morphology similar to the parent cell line, were isolated by a self selection process utilizing long-term cultures of parent...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1994.368
更新日期:1994-10-01 00:00:00
abstract::Calcitonin secretion is stimulated by acute hypercalcemia. Furthermore, in the rat, the calcemic response to parathyroid hormone (PTH) is decreased by calcitonin stimulation. However, in renal failure, it is not known if an increase in the serum calcium concentration within the physiologic range of serum calcium stimu...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1991.263
更新日期:1991-10-01 00:00:00
abstract::Many approaches to blocking profibrotic TGFbeta overexpression are under way. Therapeutic targeting of TGFbeta-Smad signaling holds promise for slowing or halting progressive renal disease. In this issue, Fukasawa et al., using the unilateral ureteral obstruction model, provide a new target for therapeutic interventio...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/sj.ki.5000260
更新日期:2006-05-01 00:00:00
abstract::Protein and mRNA expression of TGF-beta isoforms, TGF-beta 1, -beta 2 and -beta 3, and deposition of fibronectin containing extra domain A (fibronectin EDA+) and plasminogen activator inhibitor-1 (PAI-1) were studied in human chronic glomerulonephritis and diabetic nephropathy. Normal kidneys showed similar, weak immu...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1996.65
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND:Hyperphagic obese Zucker rats develop glomerular injury and die of renal disease, an outcome prevented by food restriction at an early age. We examined the effects of food restriction imposed at different ages on systemic, renal hemodynamic, and hormonal changes to gain insight into the mechanisms of obesity...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00412.x
更新日期:2002-07-01 00:00:00
abstract::The renal growth hormone--insulin-like growth factor-I system in acute ischemic renal failure. Recovery from acute tubular necrosis (ATN) is accelerated by IGF-I therapy. Furthermore, the local renal growth hormone-IGF-I system may participate in the natural repair. We examined the IGF-I system in rat kidneys subjecte...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1995.230
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND:Intrauterine growth retardation (IUGR) is associated with higher morbidity and mortality not only in perinatal life but also in later life. The purpose of our study was to determine whether IUGR has any effect on the course of minimal change nephrotic syndrome (MCNS) in children. METHODS:Forty children who ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1998.00121.x
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:While an understanding of the epidemiology and clinical course of HIV-associated nephropathy (HIVAN) is growing, little is known about the risk factors and clinical course of the other renal diseases that may also occur as a complication of HIV infection. This study was undertaken to compare HIVAN to the spe...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2004.00865.x
更新日期:2004-09-01 00:00:00
abstract::When the endotoxin-lipopolysaccharide (LPS) derived from the cell wall of gram-negative bacteria is given to the rat in vivo, there are prompt, marked decreases in glomerular filtration rate (GFR), renal blood flow (RBF) and % Na+ reabsorption (%T-Na+). However, it has not been determined whether the endotoxin itself ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1990.105
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:In renal cells, hyperosmolarity has been shown to induce the accumulation of myo-inositol, via the Na+/myo-inositol cotransporter (SMIT). Previously we showed that SMIT mRNA in the kidney is localized in the medullary thick ascending limb of Henle (TALH). Here we used renal cells derived from the rabbit oute...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1999.00235.x
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Only few noninvasive methods have the potential to quantitate renal blood flow (RBF) in humans. Positron emission tomography (PET) is a clinical imaging method that can be used to measure the tissue blood flow noninvasively. The purpose of this study was to validate PET measurement of RBF using 15O-labeled w...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2000.00110.x
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Acute renal allograft rejection with intimal arteritis is designated by the widely used Banff 97 classification as type 2A or 2B depending on the extent of arteritis, without regard to interstitial inflammation or tubulitis. We examined whether the distinction between type 2A and 2B is relevant to short- and...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00254.x
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Heparins are currently the anticoagulants of choice in long-term hemodialysis (HD). Because of their shortcomings, including the increasing incidence of heparin-induced thrombocytopenia (HIT II), alternative anticoagulation is necessary. The study objectives were to provide safe and effective HD by investiga...
journal_title:Kidney international
pub_type: 临床试验,杂志文章
doi:10.1111/j.1523-1755.2004.00433.x
更新日期:2004-02-01 00:00:00
abstract::To maintain nitrogen equilibrium when prescribed a low protein diet (LPD), metabolic adaptations occur involving a reduction protein turnover, principally decreased muscle protein degradation. Studies suggest that in patients with chronic renal failure (CRF) uncomplicated by metabolic acidosis (MA), these adaptive res...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1991.275
更新日期:1991-10-01 00:00:00
abstract::Cardiac surgery associated-acute kidney injury (CS-AKI) occurs in 30-50% of patients undergoing surgery for congenital heart disease. Here we determine if CS-AKI is associated with chronic kidney disease (CKD) in patients with congenital heart disease. Using Danish regional population-based registries, our cohort stud...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2017.02.021
更新日期:2017-09-01 00:00:00
abstract::How much dialysis is required for optimal well-being and long-term survival? The Frequent Hemodialysis Network completed two prospective trials examining the effect of more frequent, short hours and, now, of nocturnal hemodialysis compared with standard thrice-weekly treatments. Whereas the short-hours trial reported ...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2011.267
更新日期:2011-11-01 00:00:00
abstract::Previous studies have shown that nonsteroidal anti-inflammatory drug (NSAID) use might be associated with a lower risk of developing cancer in the general population. Patients on dialysis have increased risk for cancer, but there are no studies to determine the relationship between NSAID use and cancer risk in these p...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2013.79
更新日期:2013-07-01 00:00:00
abstract::Lipid abnormalities have been suggested as a major cause of the accelerated atherosclerosis and the high incidence of coronary heart disease in chronic renal failure patients. In the present work the postprandial lipoprotein metabolism was studied in chronic dialysis patients with or without fasting hypertriglyceridem...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1992.411
更新日期:1992-11-01 00:00:00
abstract::The parathyroid hormone response to hypocalcemia was investigated in hemodialysis patients with osteomalacia and compared to those with osteitis fibrosa. Hypocalcemia was induced during hemodialysis by employing a dialysate devoid of calcium. Patients with osteomalacia had a blunted maximum amino terminal parathyroid ...
journal_title:Kidney international
pub_type: 临床试验,杂志文章
doi:10.1038/ki.1983.168
更新日期:1983-09-01 00:00:00
abstract::Gene expression differs substantially among individual cells of the same type. We speculate that genes that are expressed in all but a portion of cells of a given cell type would be likely essential and required for either the cell survival (housekeeping) or for the cell type's unique structure and function, enabling ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2017.04.022
更新日期:2017-11-01 00:00:00
abstract::Metabolic acidosis is common in patients with chronic kidney disease, which is known to affect bone metabolism. We examined the effect of metabolic acidosis on the development of vascular and other soft-tissue calcifications in uremic rats treated with calcitriol. Extraskeletal calcification was measured in vivo, in c...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5002646
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Advanced glycation of proteins and their attendant advanced glycation end products (AGEs) contribute to the complications associated with diabetes mellitus or uremia. Regulatory mechanisms of AGE formation in vivo remain an issue of particular interest. We investigated a role of the glyoxalase detoxification...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2001.00051.x
更新日期:2001-12-01 00:00:00
abstract::The vascular endothelium normally is maintained in a quiescent state, but under certain conditions it is induced to undergo marked changes in behavior and form new vascular structures. A complex interaction among various growth and differentiation factors and the extracellular milieu regulates this behavior. One serie...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.1993.5
更新日期:1993-01-01 00:00:00