Solute Clearances and Fluid Removal in the Frequent Hemodialysis Network Trials

Greene, Tom; Daugirdas, John T.; Depner, Thomas A.; Gotch, Frank A.; Kuhlman, Martin

doi:10.1053/j.ajkd.2008.12.039

Cited by 40 publications

(28 citation statements)

References 20 publications

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“…In addition, we recorded the use of cardiovascularrelated medications including beta blockers, calcium channel blockers, aspirin, and lipid-lowering medications. All patients received conventional hemodialysis of three sessions per week with a minimum eKt/V of 1.1 per session and a minimum treatment time of Ͼ2.5 hours per session (5). All patients provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

Determinants of Cardiac Autonomic Dysfunction in ESRD

Chan¹,

Levin²,

Chertow³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: Cardiovascular events are common in patients with ESRD. Whether sympathetic overactivity or vagal withdrawal contribute to cardiovascular events is unclear. We determined the general prevalence and clinical correlates of heart rate variability in patients on hemodialysis.Design Conclusions: Holter findings in patients on hemodialysis are characterized by sympathetic overactivity and vagal withdrawal and are associated with higher LVM and impaired physical performance. Understanding the spectrum of autonomic heart rate modulation and its determinants could help to guide preventive and therapeutic strategies.

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Section: Methodsmentioning

confidence: 99%

Determinants of Cardiac Autonomic Dysfunction in ESRD

Chan¹,

Levin²,

Chertow³

et al. 2010

Clinical Journal of the American Society of Nephrology

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“…We characterized the weekly clearance of urea using standard Kt/V (stdKt/V urea ), calculated as the average stdKt/V urea from two baseline kinetic modeling sessions, as described previously (18). We selected four nutritional markers: (1) normalized protein catabolic rate (enPCR); (2) body mass index (BMI); (3) body composition as estimated by bioelectrical impedence analysis (BIA), herein reflected by the phase angle; and (4) serum albumin concentration.…”

Section: Explanatory Variables and Covariatesmentioning

confidence: 99%

Prevalence and Correlates of Cognitive Impairment in Hemodialysis Patients

Tamura

Larive²,

Unruh³

et al. 2010

Clinical Journal of the American Society of Nephrology

179

151

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Background and objectives: Cognitive impairment is common among persons with ESRD, but the underlying mechanisms are unknown. This study evaluated the prevalence of cognitive impairment and association with modifiable ESRD-and dialysis-associated factors in a large group of hemodialysis patients.Design, setting, participants, & measurements: Cross-sectional analyses were conducted on baseline data collected from 383 subjects participating in the Frequent Hemodialysis Network trials. Global cognitive impairment was defined as a score <80 on the Modified Mini-Mental State Exam, and impaired executive function was defined as a score >300 seconds on the Trailmaking B test. Five main categories of explanatory variables were examined: urea clearance, nutritional markers, hemodynamic measures, anemia, and central nervous system (CNS)-active medications.Results: Subjects had a mean age of 51.6 ؎ 13.3 years and a median ESRD vintage of 2.6 years. Sixty-one subjects (16%) had global cognitive impairment, and 110 subjects (29%) had impaired executive function. In addition to several nonmodifiable factors, the use of H1-receptor antagonists and opioids were associated with impaired executive function. No strong association was found between several other potentially modifiable factors associated with ESRD and dialysis therapy, such as urea clearance, proxies of dietary protein intake and other nutritional markers, hemodynamic measures, and anemia with global cognition and executive function after adjustment for case-mix factors.Conclusions: Cognitive impairment, especially impaired executive function, is common among hemodialysis patients, but with the exception of CNS-active medications, is not strongly associated with several ESRD-and dialysis-associated factors.

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“…Compared with in-center HD, these treatments deliver greater small solute, phosphorus, and b 2 -microglobulin clearances and better volume control, potentially resulting in regression of left ventricular hypertrophy, improved nutrition, and enhanced quality of life (32)(33)(34)(35)(36)(37). In addition, considerable evidence suggests that more frequent treatments are best delivered at home (25,(38)(39)(40)(41)(42)(43)(44).…”

Section: Benefits Of Home Hd Potential For Greater Dialysis Deliverymentioning

confidence: 99%

How to Overcome Barriers and Establish a Successful Home HD Program

Young

Chan

Blagg

et al. 2012

Clinical Journal of the American Society of Nephrology

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Summary Home hemodialysis (HD) is an underused dialysis modality in the United States, even though it provides an efficient and probably cost-effective way to provide more frequent or longer dialysis. With the advent of newer home HD systems that are easier for patients to learn, use, and maintain, patient and provider interest in home HD is increasing. Although barriers for providers are similar to those for peritoneal dialysis, home HD requires more extensive patient training, nursing education, and infrastructure support in order to maintain a successful program. In addition, because many physicians and patients do not have experience with home HD, reluctance to start home HD programs is widespread. This in-depth review describes barriers to home HD, focusing on patients, individual physicians and practices, and dialysis facilities, and offers suggestions for how to overcome these barriers and establish a successful home HD program.

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Solute Clearances and Fluid Removal in the Frequent Hemodialysis Network Trials

Cited by 40 publications

References 20 publications

Determinants of Cardiac Autonomic Dysfunction in ESRD

Determinants of Cardiac Autonomic Dysfunction in ESRD

Prevalence and Correlates of Cognitive Impairment in Hemodialysis Patients

How to Overcome Barriers and Establish a Successful Home HD Program

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