Abstract:
BACKGROUND:Urea kinetic modeling (UKM) and food records are widely used to assess the dialysis adequacy. Clinicians use these methods in individual patients to decide whether the dialysis prescription should be adjusted. We determined the variation in UKM parameters and dietary intake within individual patients in order to determine the required number of UKM measurements, and the number of food recording days to assess dialysis adequacy and dietary intake reliably. METHODS:Session-to-session variation in urea reduction ratio (URR), Kt/V, urea distribution volume (UDVDDQ), and protein catabolic rate (PCR) was determined during three mid-week dialysis sessions in 50 stable hemodialysis patients on three-times per week hemodialysis with a Kt/V of 0.98 +/- 0.13 (mean +/- SD). The dialysis prescription was kept constant. The day-to-day variation in dietary protein intake (DPI) and dietary energy intake (DEI) was determined from seven-day food records. The 90th percentile value of the coefficient of variation (CV) was used to determine the number of measurements. RESULTS:The variation in URR [CV, 2.4% (0.3 to 9.5) median (range)] and in Kt/V [CV, 4.0% (0.6 to 11.6)] was small in the majority of the patients. The variation in UDVDDQ [CV, 4.9% (0.3 to 25.7)] and PCR [CV, 9.3% (0.8 to 28.5)] was considerably larger. The variation in DPI [CV, 17.3% (8.4 to 64.0)] was larger than that in DEI [CV, 12.9% (5.0 to 33.0)]. To assess the URR within +/- 10% of its true value, the average of two measurements was required. Reliable assessment of Kt/V required three measurements. URR and Kt/V could be assessed reliably from a single measurement in 86 and 66% of the patients, but we were not able to distinguish these patients beforehand. Reliable estimation of UDVDDQ required six measurements. The required number of measurements for PCR, DPI, and DEI was determined using a precision of +/- 20%. To assess PCR reliably, three measurements were needed. Estimation of DPI and DEI required seven and five food recording days, respectively. CONCLUSIONS:The session-to-session variation in URR and Kt/V is small in stable hemodialysis patients. Nevertheless, the averaged value of two to three measurements is required to assess the dose of dialysis reliably. Assessment of dietary intake requires at least three PCR measurements or food records for at least one week. Basing clinical decisions on a single dialysis adequacy assessment is an unjustified practice that should be abandoned.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Kloppenburg WD,Stegeman CA,Hooyschuur M,van der Ven J,de Jong PE,Huisman RMdoi
10.1046/j.1523-1755.1999.00412.xsubject
Has Abstractpub_date
1999-05-01 00:00:00pages
1961-9issue
5eissn
0085-2538issn
1523-1755pii
S0085-2538(15)46153-8journal_volume
55pub_type
临床试验,杂志文章,多中心研究abstract:BACKGROUND:High-efficiency hemodialysis may induce a deficiency in hydrosoluble vitamins. Supplementation with B-complex vitamins has been shown to lower serum homocysteine concentrations in several groups, but relatively few studies have concerned hemodialysis patients. Our objectives were to determine the status in B...
journal_title:Kidney international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1523-1755.2000.00234.x
更新日期:2000-08-01 00:00:00
abstract::The role of calcitonin on the calcemic response to parathyroid hormone (PTH) in renal failure has not been evaluated previously. Often animal studies evaluating the calcemic response to PTH in renal failure are performed in thyroparathyroidectomized (TPTX) animals, and thus eliminate any potential physiologic effect o...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1991.203
更新日期:1991-08-01 00:00:00
abstract::Acute phosphate nephropathy (APhN) is a clinical pathological entity characterized by acute and subsequent chronic renal failure following exposure to oral sodium phosphate (OSP) bowel purgatives. Renal biopsy findings include acute and chronic tubular injury with prominent tubular and interstitial calcium phosphate d...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.2009.308
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The substitution of tryptophan for glycine at amino acid 460 (Gly460Trp polymorphism) of the alpha-subunit of the heterodimeric cytoskeleton protein adducin increases renal sodium reabsorption and may be involved in the pathophysiology of essential hypertension. In the present study, we investigated in multi...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00691.x
更新日期:2002-12-01 00:00:00
abstract::Targeted therapies and immune checkpoint inhibitors have advanced the treatment landscape of Renal Cell Carcinoma (RCC) over the last decade. While checkpoint inhibitors have demonstrated survival benefit and are currently approved in the front-line and second-line settings, primary and secondary resistance is common....
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1016/j.kint.2020.08.028
更新日期:2021-01-01 00:00:00
abstract::Renal iron handling was characterized in three experimental models of the nephrotic syndrome: puromycin aminonucleoside, adriamycin and nephrotoxic serum. In adriamycin-induced nephrotic syndrome, which has previously been shown to result from alterations in pore size of the filtration barrier, the transferrin leak wa...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1990.130
更新日期:1990-06-01 00:00:00
abstract::Obesity could affect associations between creatinine generation, estimated body surface area, and excretory burden, with effects on chronic kidney disease assessment. We therefore examined the impact of obesity on the performances of estimated glomerular filtration rate (eGFR), the urine albumin:creatinine ratio (ACR)...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2014.112
更新日期:2014-12-01 00:00:00
abstract::The involvement of cysteinyl leukotrienes (LT) in the etiology of glomerulonephritis (GN) was investigated in a rat model of nephrotoxic serum nephritis in which renal function, morphology, LTC4 synthase activity and urinary cysteinyl LT excretion were monitored over seven days. Significant alterations in renal functi...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1994.401
更新日期:1994-11-01 00:00:00
abstract::As the worldwide prevalence of end-stage renal disease increases it is important to evaluate the rate of living kidney donation in various countries; however there is no comprehensive global assessment of these rates. To measure this, we compiled data from representatives, renal registries, transplant networks, publis...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2009.20
更新日期:2009-05-01 00:00:00
abstract::Pain is a common complaint in patients with autosomal-dominant polycystic kidney disease, and a systematic approach is needed to differentiate the etiology of the pain and define an approach to management. A thorough history is the best clue to the multifactorial causes of the pain, superimposed upon an understanding ...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1046/j.1523-1755.2001.00985.x
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Various gene transfer vectors as well as delivery systems have been developed; however, many problems remain to be solved. We already achieved a technique to introduce genes into glomerular mesangial cells by hemagglutinating virus of Japan (HVJ) liposome-mediated gene transfer via renal artery. The main lim...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2001.0590041390.x
更新日期:2001-04-01 00:00:00
abstract::Previous studies from our laboratory have demonstrated that metabolic clearance rate (MCR) of calcitriol is decreased in experimental renal failure. In this experiment, we examined the effects of calcitriol, 25-hydroxyvitamin D3 (25(OH)D3) and 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) on the MCR of calcitriol in renal ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1989.185
更新日期:1989-08-01 00:00:00
abstract::ESKD patients have a large burden of disease, with high rates of readmission to hospital compared with the general population. A readmission after an acute index hospital discharge is either planned or unplanned. A proportion of unplanned readmissions are potentially avoidable, and could have been prevented with optim...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.2015.307
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Alterations of large artery function and structure are frequently observed in renal allograft recipients. However, endothelial function has not yet been assessed in this population. METHODS:Flow-mediated vasodilation is a useful index of endothelial function. We measured the diameter and distensibility of t...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1999.0550031104.x
更新日期:1999-03-01 00:00:00
abstract::Defects in the primary cilium/basal body complex of renal tubular cells cause polycystic kidney disease (PKD). To uncover pathways associated with disease progression, we determined the kidney transcriptome of 10-day-old severely and mildly affected cpk mice, a model of recessive PKD. In the severe phenotype, the most...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5002627
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:To chart the epidemiology of primary glomerular disease by means of a prospective regional study in the southern part of The Netherlands. METHODS:Experienced renal technicians collected renal biopsies, blood, and 24-hour urine samples at the bed site in each of the participating hospitals. The material was ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2004.00835.x
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Although the existence of multiple isoforms of plasma membrane calcium ATPase (PMCA) is now well documented, their biological functions are not yet known. In this study, we set out to investigate the potential role of PMCA isoforms, previously identified in renal cortical tissue, in tubular reabsorption of c...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1999.00736.x
更新日期:1999-11-01 00:00:00
abstract::Renal ischemia-reperfusion injury is a leading cause of acute kidney injury; the pathogenesis of which remains poorly understood and effective therapies are still lacking. Here we tested whether microRNAs, identified as critical regulators of cell health and disease, are involved in this process. We found that miR-17-...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2016.07.017
更新日期:2017-01-01 00:00:00
abstract::Cytokines and chemokines produced by tubular epithelial and infiltrating cells are critical to inflammation in renal ischemia-reperfusion injury. IL-37, a newly described IL-1 family member, inhibits IL-18-dependent pro-inflammatory cytokine production by its binding to IL-18 receptors and IL-18 binding protein. The p...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2014.295
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Vascular endothelial growth factor (VEGF) and its receptors have been implicated in the pathogenesis of diabetic nephropathy. The objective of this study was to determine whether alterations of the plasma and urinary VEGF and sFLT-1 levels were related to the stages and risk factors of diabetic nephropathy. ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00067.x
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Fractalkine is a newly identified T-cell and monocyte/macrophage (Mphi) chemokine with a transmembrane domain and is a cell-surface protein on activated endothelium. It can mediate adhesion of cells expressing the fractalkine receptor CX3CR1. These unique features make fractalkine well suited for leukocyte r...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1999.00604.x
更新日期:1999-08-01 00:00:00
abstract::Erythropoietin (Epo) is essential for erythropoiesis and is mainly produced by the fetal liver and the adult kidney following hypoxic stimulation. Epo regulation is commonly studied in hepatoma cell lines, but differences in Epo regulation between kidney and liver limit the understanding of Epo dysregulation in polycy...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2018.08.043
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Fistula failure has been classified as early and late. Early failure refers to those cases in which the arteriovenous (AV) fistula never develops to the point that it can be used or fails within the first 3 months of usage. It has been common practice to abandon these early failures; however, aggressive eval...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2003.00210.x
更新日期:2003-10-01 00:00:00
abstract::The remnant kidney (RK) exhibits an enhanced fractional excretion of phosphate (FEPi) even in the absence of parathyroid hormone (PTH). Thus, factors other than PTH contribute to this adaptive phosphaturia. Dopamine (DA) infusion is phosphaturic, whereas stimulation of adrenoreceptors is antiphosphaturic. Therefore, t...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1993.144
更新日期:1993-05-01 00:00:00
abstract::Intravascular hemolysis is relatively rare but can lead to acute kidney injury (AKI), from increased destruction of erythrocytes and release of free hemoglobin. Since hemolysis and hemoglobinuria are known causes of acute kidney injury we sought to define clinicopathologic findings and outcomes of patients with hemoly...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2019.08.026
更新日期:2019-12-01 00:00:00
abstract::The X-linked Hyp and Gy mutations are murine homologues of X-linked hypophosphatemia (XLH), a dominant disorder of phosphate (Pi) homeostasis characterized by growth retardation, rickets, hypophosphatemia and decreased renal tubular maximum for Pi reabsorption relative to glomerular filtration rate (Tmp/GFR). In Hyp a...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1996.149
更新日期:1996-04-01 00:00:00
abstract::In this mini review, we would like to challenge the well-established 'fact' that lead exposure causes chronic renal failure (CRF). Even though only scarce evidence exists of the relationship between lead and renal failure, a World Health Organization Environmental Health Criteria document summarizes that 'Lead has bee...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.2010.394
更新日期:2011-02-01 00:00:00
abstract::Ambient glucose concentrations alter type 1 angiotensin II receptor (AT1R) expression in renal tissues. The direction of change in AT1R density may depend on the specific cell type and the capacity for that cell type to use glucose as an energy substrate. Given the effects of angiotensin II (Ang II) in proximal tubule...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1997.307
更新日期:1997-07-01 00:00:00
abstract::The present study examined the effect of sodium transport inhibition by amiloride, ouabain, and luminal sodium removal on potassium secretion in isolated cortical collecting tubules from adrenalectomized and DOCA-stimulated rabbits. Collecting tubules from adrenalectomized rabbits had a mean potassium secretion of 3.6...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1985.96
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one) is a potent scavenger of free radicals and has the antioxidant ability to inhibit lipid peroxidation. Its protective effect on brain ischemia has been shown. This study aimed to elucidate its possible therapeutic effects on renal oxidative stress in a rat ische...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2004.00567.x
更新日期:2004-05-01 00:00:00