Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis

Eknoyan, Garabed; Beck, Gerald J.; Cheung, Alfred K.; Daugirdas, John T.; Greene, Tom; Kusek, John W.; Allon, Michael; Bailey, James L.; Delmez, James A.; Depner, Thomas A.; Dwyer, Johanna T.; Levey, Andrew S.; Levin, Nathan W.; Milford, Edgar L.; Ornt, Daniel B.; Rocco, Michael V.; Schulman, Gerald; Schwab, Steve J.; Teehan, Brendan P.; Toto, Robert D.

doi:10.1056/nejmoa021583

Cited by 1,684 publications

(1,426 citation statements)

References 31 publications

Supporting

Mentioning

1,331

Contrasting

Unclassified

Order By: Relevance

“…A secondary analysis suggested a benefit of high-flux membranes in those who were on hemodialysis for Ͼ3.7 years. 6 Higher dose was shown to be associated with a trend toward reduction in relative risk of mortality for women but not men; this was found to be nonsignificant after applying the Bonferroni correction for multiple comparisons. 7 Although the HEMO study is a significant landmark in the history of dialysis therapy, several limitations need to be considered while interpreting its results.…”

Section: An Overview Of the Hemo Studymentioning

confidence: 94%

Dose of dialysis: Key lessons from major observational studies and clinical trials

Saran

Canaud

Depner

et al. 2004

American Journal of Kidney Diseases

Self Cite

View full text Add to dashboard Cite

Section: An Overview Of the Hemo Studymentioning

confidence: 94%

Dose of dialysis: Key lessons from major observational studies and clinical trials

Saran

Canaud

Depner

et al. 2004

American Journal of Kidney Diseases

Self Cite

View full text Add to dashboard Cite

“…either for a urea reduction ratio (URR) > 65% or an equilibrated Kt/V urea >1.2, delivered thrice weekly [19,20]. The Hemodialysis (HEMO) Study trial in adults showed no difference in survival between patients with a mean eKt/V of 1.16 and those achieving a Kt/V of 1.53 [30]. These findings are similar to those in a recent study of 613 adolescents on HD, in which hospitalization risk was increased with a single pool Kt/V <1.2 compared to 1.2-1.4 but a spKt/V of >1.4 did not improve outcome [31].…”

Section: Haemodialysismentioning

confidence: 99%

Long-term outcome of chronic dialysis in children

et al. 2005

View full text Add to dashboard Cite

As the prevalence of children on renal replacement therapy (RRT) increases world wide and such therapy comprises at least 2% of any national dialysis or transplant programme, it is essential that paediatric nephrologists are able to advise families on the possible outcome for their child on dialysis. Most children start dialysis with the expectation that successful renal transplantation is an achievable goal and will provide the best survival and quality of life.

show abstract

“…In adults, the result of the National Cooperative Dialysis Study showed a survival benefit with increased dialysis prescription [1]. Disappointingly, no survival benefits with further increase in small solutes clearances once a certain threshold level was reached, which were demonstrated in two major adult trials: the Effects of Increased Peritoneal Clearances on Mortality Rates in Peritoneal Dialysis: ADEMEX, a Prospective, Randomized, Controlled Trial (ADEMEX) and the Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis (HEMO) studies [2,3]. However, residual renal clearance as the major predictor of survival in dialysis patients (both hemodialysis and peritoneal dialysis) was demonstrated in carefully conducted re-analyses of both studies [4,5].…”

Section: Introductionmentioning

confidence: 99%

Residual renal function assessment with cystatin C

2010

View full text Add to dashboard Cite

Su Jin Kim and coworkers from Korea published an important study on the relationship of residual renal function (RRF) and cystatin in pediatric peritoneal dialysis (PD) patients in this issue of Pediatric Nephrology, both in anuric patients and patients with RRF. Based on a lack of correlation between cystatin C and standard small solutebased dialysis adequacy parameters such as Kt/V urea but a significant correlation with RRF, the authors concluded that cystatin C may be a good tool to monitor RRF. The editorial reviews the available literature in adults, the different handing between urea and cystatin C, and the determinants of cystatin C clearance in dialysis patients. In adults, cystatin C levels are determined predominantly by RRF, but not exclusively. In anephric hemodialysis and PD patients, there is a correlation with standard weekly Kt/V urea . Cystatin C levels will also depend on ultrafiltration. Despite these factors that affect cystatin C levels beyond RRF, cystatin C is a useful parameter for monitoring PD patients that may be more closely related to long-term outcomes than small solute adequacy parameters.

show abstract

Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis

Abstract: Patients undergoing hemodialysis thrice weekly appear to have no major benefit from a higher dialysis dose than that recommended by current U.S. guidelines or from the use of a high-flux membrane.

Cited by 1,684 publications

References 31 publications

Dose of dialysis: Key lessons from major observational studies and clinical trials

Dose of dialysis: Key lessons from major observational studies and clinical trials

Long-term outcome of chronic dialysis in children

Residual renal function assessment with cystatin C

Contact Info

Product

Resources

About