Abstract:
BACKGROUND:Sustained low efficiency dialysis (SLED) is increasingly used as a renal replacement modality in critically ill patients with acute kidney injury (AKI) and hemodynamic instability. SLED may reduce the hemodynamic perturbations of intermittent hemodialysis, while obviating the resource demands of CRRT. Although SLED is being increasingly used, few studies have evaluated its impact on clinical outcomes. METHODS:We conducted a cohort study comparing SLED (target 8 h/session, blood flow 200 mL/min, predominantly without anticoagulation) to CRRT in four ICUs at an academic medical centre. The primary outcome was mortality 30 days after RRT initiation, adjusted for demographics, comorbidity, baseline kidney function, and Sequential Organ Failure Assessment score. Secondary outcomes were persistent RRT dependence at 30 days and early clinical deterioration, defined as a rise in SOFA score or death 48 h after starting RRT. RESULTS:We identified 158 patients who initiated treatment with CRRT and 74 with SLED. Mortality at 30 days was 54 % and 61 % among SLED- and CRRT-treated patients, respectively [adjusted odds ratio (OR) 1.07, 95 % CI 0.56-2.03, as compared with CRRT]. Among SLED recipients, the risk of RRT dependence at 30 days (adjusted OR 1.36, 95 % CI 0.51-3.57) and early clinical deterioration (adjusted OR 0.73, 95 % CI 0.40-1.34) were not different as compared to patients who initiated CRRT. CONCLUSIONS:Notwithstanding the limitations of this small non-randomized study, we found similar clinical outcomes for patients treated with SLED and CRRT. While we await the completion of a trial that will definitively assess the non-inferiority of SLED as compared to CRRT, SLED appears to be an acceptable alternative form of renal support in hemodynamically unstable patients with AKI.
journal_name
BMC Nephroljournal_title
BMC nephrologyauthors
Kitchlu A,Adhikari N,Burns KE,Friedrich JO,Garg AX,Klein D,Richardson RM,Wald Rdoi
10.1186/s12882-015-0123-4subject
Has Abstractpub_date
2015-08-04 00:00:00pages
127issn
1471-2369pii
10.1186/s12882-015-0123-4journal_volume
16pub_type
杂志文章相关文献
BMC Nephrology文献大全abstract:BACKGROUND:Data on radial access (RA) as an independent risk factor for acute kidney injury (AKI) in myocardial infarction (MI) patients are conflicting. Our aim was to assess how RA influences the incidence of AKI in MI patients undergoing percutaneous coronary intervention (PCI). METHODS:Data from 3842 MI patients u...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1210-8
更新日期:2019-01-30 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) with edema is a common clinical problem resulting from defects in water and solute excretion. Furosemide is the drug of choice for treatment. In theory, good perfusion and albumin are required for the furosemide to be secreted at the tubular lumen. Thus, in the situation of low g...
journal_title:BMC nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2369-13-92
更新日期:2012-08-29 00:00:00
abstract:BACKGROUND:Canada's pandemic H1N1 influenza A (pH1N1) outbreak led to a high burden of critical illness. Our objective was to describe the incidence of AKI (acute kidney injury) in these patients and risk factors for AKI, renal replacement therapy (RRT), and mortality. METHODS:From a prospective cohort of critically i...
journal_title:BMC nephrology
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2369-14-123
更新日期:2013-06-13 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD) events, and a number of reports have shown a relationship between CKD and CVD in pre-dialysis or maintenance dialysis patients. However, few studies have reported serial observations during dialysis initiation and mai...
journal_title:BMC nephrology
pub_type: 临床试验,杂志文章
doi:10.1186/s12882-017-0495-8
更新日期:2017-02-28 00:00:00
abstract:BACKGROUND:The prevalence of chronic kidney disease (CKD) is increasing worldwide and in Africa. Health related quality of life (QOL) has become an essential outcome measure for patients with CKD and end stage renal disease (ESRD). There is growing interest worldwide in QOL of CKD patients but paucity of data in Ghana....
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1316-z
更新日期:2019-04-08 00:00:00
abstract:BACKGROUND:Self-management education needs have not been assessed in patients with complex co-morbid conditions such as diabetes and chronic kidney disease (CKD). The objectives of this study were to 1) determine the self-management education needs for patients with co-morbid diabetes and CKD and 2) co-develop an educa...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1296-z
更新日期:2019-04-02 00:00:00
abstract:BACKGROUND:During continuous venovenous haemofiltration (CVVH), regional anticoagulation with citrate may be superior to heparin in terms of biocompatibility, since heparin as opposed to citrate may activate complement (reflected by circulating C5a) and induce neutrophil degranulation in the filter and myeloperoxidase ...
journal_title:BMC nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2369-15-19
更新日期:2014-01-17 00:00:00
abstract:BACKGROUND:Studies suggest 24-h blood pressure (BP) variability has prognostic value for cardiovascular disease. Several factors associated with high 24-h BP variability are also common among individuals with chronic kidney disease (CKD). We hypothesized 24-h BP variability would be higher for individuals with versus w...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-015-0085-6
更新日期:2015-06-18 00:00:00
abstract:BACKGROUND:Renal involvement in patients with chronic hepatitis C virus infection has been suggested to be due to a variety of immunological processes. However, the precise mechanism by which the kidneys are damaged in these patients is still unclear. CASE PRESENTATION:A 66 year old man presented with the sudden onset...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/1471-2369-4-7
更新日期:2003-08-29 00:00:00
abstract:BACKGROUND:Evidence suggests that exercise training for hemodialysis patients positively improves morbidity and mortality outcomes, yet exercise programs remain rare and are not systematically incorporated into care. We developed a research-based film, Fit for Dialysis, designed to introduce, motivate, and sustain exer...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-017-0454-4
更新日期:2017-01-26 00:00:00
abstract:BACKGROUND:Peritoneal dialysis (PD) is a home-based therapy performed by patients or their relatives in numerous cases, and the role of patients' educational practices in the risk of peritonitis is not well assessed. Our aim was to evaluate the effect of PD learning methods on the risk of peritonitis. METHODS:This was...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-020-01867-w
更新日期:2020-05-29 00:00:00
abstract:BACKGROUND:There is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an African American cohort. We also examined whether age modifies t...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1432-9
更新日期:2019-07-15 00:00:00
abstract:BACKGROUND:Renal artery stenosis is one of the secondary causes of pediatric hypertension. Cases with critical unilateral renal artery stenosis manifesting with the hyponatremic hypertensive syndrome are rare and a comprehensive description of this disorder in the pediatric population is lacking in the literature. CAS...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1246-9
更新日期:2019-02-21 00:00:00
abstract:BACKGROUND:End-stage kidney disease patients undergoing haemodialysis are prescribed with multiple complex regimens and are predisposed to high risk of medication nonadherence. The aims of this study were to explore factors associated with medication adherence, and, to examine the differential perspectives on medicatio...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-017-0583-9
更新日期:2017-05-22 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) accelerates vascular stiffening related to age. Arterial stiffness may be evaluated measuring the carotid-femoral pulse wave velocity (PWV) or more simply, as recommended by KDOQI, monitoring pulse pressure (PP). Both correlate to survival and incidence of cardiovascular disease....
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-015-0058-9
更新日期:2015-04-23 00:00:00
abstract:BACKGROUND:Estimates of the incidence of glomerulonephritis (GN) and end-stage renal disease (ESRD) in an Iraqi population are compared with the United States (US) and Jordan. METHODS:The study set consist of renal biopsies performed in 2012 and 2013 in the Kurdish provinces of Northern Iraq. The age specific and age ...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-018-1062-7
更新日期:2018-10-11 00:00:00
abstract:BACKGROUND:Patients with advanced chronic kidney disease (CKD) exhibit higher prevalence of coronary artery calcification (CaC) than general population. CaC has been proposed as a risk factor for mortality in end-stage CKD, but most studies in the field are based on short-term follow-up. METHODS:We conducted a cohort,...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1367-1
更新日期:2019-05-28 00:00:00
abstract:BACKGROUND:Pyrrolidine dithiocarbamate (PDTC) reduces renal cyst growth in a rodent model of polycystic kidney disease (PKD) but the mechanism of action is not clear. Here, we investigated the hypothesis that PDTC reduces the proliferation of cystic epithelial cells in vitro in a nuclear factor (NF)-κB-dependent manner...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-015-0193-3
更新日期:2015-12-15 00:00:00
abstract:BACKGROUND:Autosomal dominant polycystic kidney disease (ADPKD) is mainly characterised by the development and enlargement of renal cysts that lead to end-stage renal disease (ESRD) in adult patients. Other clinical manifestations of this pathology include hypertension, haematuria, abdominal pain, cardiovascular system...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1540-6
更新日期:2019-09-13 00:00:00
abstract:BACKGROUND:The current literature recognises that left ventricular hypertrophy makes a key contribution to the high rate of premature cardiovascular mortality in dialysis patients. Determining how we might intervene to ameliorate left ventricular hypertrophy in dialysis populations has become a research priority. Reduc...
journal_title:BMC nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2369-14-149
更新日期:2013-07-15 00:00:00
abstract:BACKGROUND:Primary nephrotic syndrome (PNS) is a common glomerular disease in children. T cell dysfunction plays a crucial role in the pathogenesis of PNS. Moreover, dysbiosis of gut microbiota contributes to immunological disorders. Whether the initial therapy of PNS affects gut microbiota remains an important questio...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1615-4
更新日期:2019-11-26 00:00:00
abstract:BACKGROUND:Adherence to phosphate binder treatment is important to prevent high serum phosphate level in chronic dialysis patients. We therefore wanted to investigate patient knowledge, beliefs about and adherence to phosphate binders among these patients and assess whether one-to-one pharmacist-led education and couns...
journal_title:BMC nephrology
pub_type: 临床试验,杂志文章
doi:10.1186/s12882-019-1334-x
更新日期:2019-05-17 00:00:00
abstract:BACKGROUND:Current guidelines regarding plasma-sampling techniques for glomerular filtration rate (GFR) determination are inconsistent. Single-sample methods are commonly believed not to be precise enough to meet clinical demands. The present study compared the agreement between single- and dual- plasma sampling method...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-018-0965-7
更新日期:2018-07-11 00:00:00
abstract:BACKGROUND:Tissue derived biomarkers may offer utility as indicators of accumulated damage. Reduced thickness of retinal neuronal tissue and the vascular choroid have previously been associated with vascular damage and diabetes. We evaluated associations between retinal thickness, retinal microvascular and choroidal me...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-019-1679-1
更新日期:2020-01-31 00:00:00
abstract:BACKGROUND:To measure health-related and care-related quality of life among informal caregivers of older people with end-stage kidney disease (ESKD), and to determine the association between caregiver quality of life and care recipient's treatment type. METHODS:A prospective cross-sectional study was conducted. Three ...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-020-01830-9
更新日期:2020-05-04 00:00:00
abstract:BACKGROUND:Alport syndrome and ANCA-associated vasculitis are both rare diseases. The co-existence of these two conditions has never been reported. There is no obvious pathogenic link between these two glomerular diseases. The management of this case highlights the importance of a systematic approach when investigating...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-017-0527-4
更新日期:2017-03-29 00:00:00
abstract:BACKGROUND:FGF23 controls serum l,25(OH)2D3 levels and phosphate homeostasis. This study evaluates the effects of ferritin on intact PTH, FGF23, and l,25(OH)2D3 in patients with major thalassemia. It also evaluates FGF23 changes in patients with hypoparathyroidism to clarify the interaction between FGF23 and PTH in the...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-020-02101-3
更新日期:2020-11-16 00:00:00
abstract:BACKGROUND:Use of serum creatinine to estimate GFR may lead to underestimation of the association between self-reported frailty and kidney function. Our objectives were to evaluate the association of measured GFR (mGFR) with self-reported frailty among patients with CKD and to determine whether self-reported frailty wa...
journal_title:BMC nephrology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1186/s12882-015-0202-6
更新日期:2015-12-09 00:00:00
abstract:BACKGROUND:There is conflicting evidence of benefit versus harm for warfarin anticoagulation in hemodialysis patients with atrial fibrillation. This equipoise may be explained by suboptimal Time in Therapeutic Range (TTR), which correlates well with thromboembolic and bleeding complications. This study aimed to compare...
journal_title:BMC nephrology
pub_type: 杂志文章,多中心研究
doi:10.1186/s12882-017-0809-x
更新日期:2018-01-08 00:00:00
abstract:BACKGROUND:Patients with an impaired renal function show a high incidence of bone and mineral disturbances. These 'chronic kidney disease - mineral and bone disorders' (CKD-MBD) range from high turnover osteoporosis to adynamic bone disease. Currently, the histomorphometric analysis of a bone biopsy taken from the ilia...
journal_title:BMC nephrology
pub_type: 杂志文章
doi:10.1186/s12882-017-0550-5
更新日期:2017-04-13 00:00:00