Abstract：
BACKGROUND:The use of renal Kt/V (r-Kt/V) as an indicator for the need of dialysis initiation has been recommended in the NKF-DOQI guidelines. In analogy to clinical practice in peritoneal dialysis, a fall of r-Kt/V below a threshold of 2.0 per week may indicate inadequate renal toxin elimination. However, there are no studies linking r-Kt/V with other parameters of glomerular filtration rate (GFR) in predialysis patients, and the validity of r-Kt/V as parameter for timing of dialysis initiation is unknown. METHODS:Renal function was assessed repeatedly in 125 patients (N = 465 measurements). In predialysis patients (r-Kt/V <2.5 per week) r-Kt/V was compared with creatinine [CCr], urea [CUr], averaged creatinine/urea clearance [CCr/Ur], Cockcroft-Gault formula [CCG], and MDRD prediction equation 6 (MDRD6-GFR). The diagnostic performance of r-Kt/V as a parameter for timing the initiation of dialysis was evaluated. RESULTS:Renal Kt/V <2.5 was prevalent in 24.9% of cases (N = 116, mean 1.92 +/- 0.34). In this group mean CCr was 13.8 +/- 4.9, mean CUr 6.7 +/- 1.3, and CCr/Ur 10.2 +/- 2.9 mL/min/1.73 m2. There was no correlation of r-Kt/V with serum creatinine and MDRD6-GFR, but a significantly positive correlation with CCr/Ur (r2 = 0.3382, P < 0.001). Sensitivity of r-Kt/V to detect CCr/Ur < 10.5 mL/min/1.73 m2, defined as the threshold for dialysis initiation, was 73.6% with a specificity of 91.9%. CONCLUSIONS:These results suggest that r-Kt/V is a parameter of acceptable specificity but poor sensitivity for the timing of dialysis initiation. Additional measures of renal function, such as the average of measured creatinine and urea clearance, also should be taken into consideration when deciding on the timing of dialysis initiation prior to the development of clinical signs of uremia and malnutrition.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Kuhlmann MK,Heckmann M,Riegel W,Köhler Hdoi
10.1046/j.1523-1755.2001.00957.xsubject
Has Abstractpub_date
2001-10-01 00:00:00pages
1540-6issue
4eissn
0085-2538issn
1523-1755pii
S0085-2538(15)48024-Xjournal_volume
60pub_type
杂志文章abstract：:Tubular function studies have shown that nephrectomy leads to a sharp increase in potassium secretion by initial collecting tubules. The aim of this study was to examine the relationship between potassium transport and the cellular morphology of the distal nephron. Clearance and ultrastructural studies were conducted ...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1985.58
更新日期：1985-04-01 00:00:00
abstract：BACKGROUND:Middle molecules such as beta2-microglobulin (beta2M) and advanced glycation end products (AGE)-modified proteins contribute to inflammation in uremia. The BetaSorb column is a new adsorptive device, which contains copolymeric beads, suitable for removal of beta2M and other middle molecules. We assessed the ...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1046/j.1523-1755.2003.00839.x
更新日期：2003-03-01 00:00:00
abstract：:IgG4-related disease is a recently recognized multi-organ disorder characterized by high levels of serum IgG4 and dense infiltration of IgG4-positive cells into several organs. Although the pancreas was the first organ recognized to be affected by IgG4-related disorder in the syndrome of autoimmune pancreatitis, we pr...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.2010.271
更新日期：2010-11-01 00:00:00
abstract：:Diabetes mellitus is associated with natriuresis, whereas estrogen has been shown to be renoprotective in diabetic nephropathy and may independently regulate renal sodium reabsorption. The aim of this study was to determine the effects of 17-beta estradiol (E(2)) replacement to diabetic, ovariectomized (OVX) female ra...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/sj.ki.5000140
更新日期：2006-02-01 00:00:00
abstract：:Renal cell carcinoma (RCC) is the most common kidney malignancy and has a poor prognosis owing to its resistance to chemotherapy. RCC cells overexpress the transcription factor, PAX2, normally expressed in fetal kidney but downregulated at birth. Since Pax2 suppresses apoptosis during renal development, we reasoned th...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/sj.ki.5000136
更新日期：2006-04-01 00:00:00
abstract：:In studying the metabolic effects of diet potassium (K+) variation in normal humans, we noted that varying diet K+ within its normal range influenced inorganic phosphorus (Pi) homeostasis and serum calcitriol (1,25-dihydroxyvitamin D) levels. In six men who ingested a constant whole-foods diet containing (per 70 kg bo...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1990.120
更新日期：1990-05-01 00:00:00
abstract：BACKGROUND:In uremic patients with secondary hyperparathyroidism (2HPT), nodular hyperplasia of parathyroid gland shows a monoclonal pattern of cell proliferation, in which a decreased density of vitamin D receptor (VDR) also is demonstrated. The present study aimed at elucidating the mechanism of parathyroid cell prol...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1111/j.1523-1755.2002.kid585.x
更新日期：2002-10-01 00:00:00
abstract：BACKGROUND:Human mesothelial cells (HMCs) have an important role in maintaining an adequately functioning fibrinolytic system in the peritoneal cavity by secreting the fibrinolytic enzymes tissue-type and urokinase-type plasminogen activator (t-PA and u-PA), as well as a specific PA inhibitor, PA inhibitor type 1 (PAI-...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1046/j.1523-1755.1999.00244.x
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:The next phase of the molecular revolution will bring functional genomics down to the level of individual cells in a tissue. Laser capture microdissection (LCM) coupled with reverse transcription-polymerase chain reaction (RT-PCR) can measure gene expression in normal, cancerous, injured, or fibrotic tissue....
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1046/j.1523-1755.2000.00295.x
更新日期：2000-09-01 00:00:00
abstract：BACKGROUND:We examined the effect of kidney disease (KD) on mortality in nondiabetic and diabetic Pima Indians aged > or = 45 years old. METHODS:Deaths and person-years of follow-up were stratified in a time-dependent fashion into categories of (1) no proteinuria and normal serum creatinine (SCr); (2) proteinuria and ...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1111/j.1523-1755.2005.00523.x
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND:Nitric oxide inactivation by superoxide impairs endothelium-dependent vasodilation and plays a role in various forms of hypertension. Almost no data exist regarding hypertension secondary to chronic renal failure. Previous studies have shown that endothelium-related relaxations, secondary to decreased nitric...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1046/j.1523-1755.2002.00166.x
更新日期：2002-02-01 00:00:00
abstract：:This study examined the consequences of nephrectomy in United States Army personnel who lost a kidney due to trauma during World War II (WWII). Records of 62 servicemen who underwent nephrectomy at an average age of 25 years were obtained. Mortality was compared with that of WWII servicemen of the same age. Medical re...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1993.156
更新日期：1993-05-01 00:00:00
abstract：:Hyperinsulinemia can contribute to hypertension through effects on sodium transport. To test whether the stimulatory effect of insulin on renal proximal tubule sodium transport is preserved in insulin resistance, we compared the effects of insulin on abdominal adipocytes and proximal tubules in rats and humans. Insuli...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.2014.351
更新日期：2015-03-01 00:00:00
abstract：:Ambulatory blood pressure monitoring (ABPM) remains a reference standard, but the minimal number of ABPM readings required to diagnose hypertension has not been empirically validated. Among 360 patients with chronic kidney disease and 38 healthy controls, 24-hour blood pressure was recorded 2 times per hour during the...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1016/j.kint.2018.08.021
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:Strict glycemic control and antihypertensive treatment may decrease but not eliminate the risk of progressive nephropathy in diabetic patients. C-peptide has been shown to exert beneficial effects on complications, including incipient nephropathy, in type 1 diabetes. METHODS:Renal effects of 14 days of intr...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1046/j.1523-1755.2001.00964.x
更新日期：2001-10-01 00:00:00
abstract：:Transient renal tubular acidosis may complicate acute renal failure (ARF). To clarify this phenomenon, the present study examined tubular H+ ion secretory capacity in an ischemic model of ARF. Clearance studies were performed in dogs subjected to 60 minutes, unilateral renal artery clamping. The contralateral kidney s...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1986.271
更新日期：1986-12-01 00:00:00
abstract：:In organ transplantation, ischemia/reperfusion (I/R) results in damage that may affect cell viability and lead to organ failure. I/R injury involves a complex cascade of events, including loss of energy, derangement of the ionic hemostasis, production of reactive oxygen species, and cell death. In this context, mitoch...
journal_title：Kidney international
pub_type： 杂志文章,评审
doi：10.1111/j.1523-1755.2004.761_9.x
更新日期：2004-08-01 00:00:00
abstract：:Kinetic parameters were studied to determine the effectiveness of hemoperfusion in removing ethychlorvynol from the plasma and red blood cells (RBC) of intoxicated dogs. Perfusion columns contained polystyrene/divinyl benzene resin (XAD-4 Amberlite. Column clearances of ethchlorvynol averaged 96.5 +/- 0.4% of the plas...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1980.36
更新日期：1980-03-01 00:00:00
abstract：:Proximal tubular (PT) epithelial cells express MHC class II (Ia) antigens in immunologically-mediated renal injury. To study the role of PT as accessory cells, we generated several murine PT-like epithelial cell lines by transformation with origin-defective SV40 DNA. These transformed cell lines display typical alkali...
journal_title：Kidney international
pub_type： 杂志文章,评审
doi：10.1038/ki.1990.46
更新日期：1990-02-01 00:00:00
abstract：:To determine whether acute renal failure (ARF) increases the long-term risk of progressive chronic kidney disease (CKD), we studied the outcome of patients whose initial kidney function was normal or near normal but who had an episode of dialysis-requiring ARF and did not develop end-stage renal disease within 30 days...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.2009.289
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Urine is supersaturated in calcium oxalate, which means that it will contain calcium oxalate crystals that form spontaneously. Their size must be controlled to prevent retention in ducts and the eventual development of a lithiasis. This is achieved, in part, by specific inhibitors of crystal growth. We inves...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1046/j.1523-1755.1999.00426.x
更新日期：1999-05-01 00:00:00
abstract：:Carefully age-matched, purebred male beagle dogs that underwent uninephrectomy one month after they were made diabetic with alloxan were used to establish a model of rapidly developing diabetic nephropathy in a large animal. The diabetic animals, all requiring insulin, were divided into two groups: one group with cont...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1982.88
更新日期：1982-05-01 00:00:00
abstract：:Dialysis patients have a high risk of cardiovascular disease. Cardiac rehabilitation is recommended in the general population as a standard component of care and covered by Medicare for those who have undergone coronary artery bypass grafting (CABG). Here we determined the impact of cardiac rehabilitation on Medicare ...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.2008.381
更新日期：2008-10-01 00:00:00
abstract：:Peptides representing potential antigenic regions of the NC-1 and 7-S domains of the human alpha 1 and alpha 2, and bovine alpha 3 chains of type IV collagen were synthesized either chemically or by the recombinant DNA technique and tested by ELISA using antibodies raised in rabbits against the whole type IV collagen ...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1993.16
更新日期：1993-01-01 00:00:00
abstract：:The acutely injured mammalian kidney mounts a cellular and molecular response to repair itself. However, in patchy regions such intrinsic processes are impaired and dysregulated leading to chronic kidney disease. Currently, no therapy exists to treat established acute kidney injury per se. Strategies to augment human ...
journal_title：Kidney international
pub_type： 杂志文章,评审
doi：10.1016/j.kint.2017.07.030
更新日期：2018-01-01 00:00:00
abstract：:Recent decades have witnessed the revelation of expanding roles of the vitamin D endocrine system beyond calcium and phosphorus metabolism. Along with these non-calcemic or non-classic actions of vitamin D are newly discovered therapeutic actions of vitamin D analogs in a number of pathological conditions, including k...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.2009.175
更新日期：2010-07-01 00:00:00
abstract：:Amyloidosis results from protein misfolding, and ongoing amyloid deposition can ultimately lead to organ failure and death. Historically, this is a group of diseases with limited treatment options and frequently poor prognosis. However, there are now 'targeted' therapeutics emerging in the form of stabilizers of the p...
journal_title：Kidney international
pub_type： 杂志文章,评审
doi：10.1038/ki.2014.368
更新日期：2015-03-01 00:00:00
abstract：:Patients with chronic kidney disease have elevated circulating asymmetric dimethylarginine (ADMA). Recent studies have suggested that ADMA impairs endothelial nitric oxide synthase (eNOS) by effects other than competition with the substrate L-arginine. Here, we sought to identify the molecular mechanism by which incre...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.2011.476
更新日期：2012-04-01 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：:The thick ascending limb of Henle's loop ( TAL ) develops a specific and consistent structural lesion during perfusion of the isolated rat kidney that progresses from mitochondrial swelling at 15 min to complete cellular disruption at 90 min. Because it seemed possible that damage localized to this metabolically activ...
journal_title：Kidney international
pub_type： 杂志文章
doi：10.1038/ki.1984.9
更新日期：1984-01-01 00:00:00
