By C. Ronco, N.W. Levin
Reprint of: Blood Purification 2001, Vol. 19, No. 2 during this well timed booklet, a number of themes regarding ESRD are mentioned, together with vascular illness and atherosclerosis in uremia, results of hemodialysis sufferers in several international locations, malnutrition in addition to oxidative pressure and protracted irritation as probability components for heart problems. in addition, the potential of utilizing peritoneal dialysis as a primary therapy modality for ESRD is debated, including the advantages that may be completed with day-by-day dialysis. extra themes comprise the main complicated innovations for electrolyte tracking and profiling in hemodialysis in addition to the therapy of acute renal failure, describing the recent acute dialysis caliber initiative. one other vital a part of this e-book is an issue on no matter if hemoglobin degrees in pre-ESRD and hemodialysis sufferers may be normalized or now not, by way of a dialogue of the capability long term advantages of a brand new know-how coupling hemoperfusion with hemodialysis, using a brand new sorbent machine. A definition of the genuine application of those applied sciences in day-by-day medical perform and whether or not they are economically cheaper with current repayment rules rounds off the shows. Being the second one quantity during this sequence (see additionally the volumes for the years 2000, 2002 and 2003), this publication is meant to function a syllabus for meetings in addition to an academic device for fellows and citizens. whilst, it offers a so much beneficial replace on fresh perform and know-how for all physicians taken with the sphere of hemodialysis.
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Additional info for Advances in End-Stage Renal Diseases 2001: International Conference on Dialysis Iii, Miami Beach, Fla., January 2001
26 Rostand SG, Kirk KA, Rutsky EA: Dialysisassociated ischemic heart disease: Insights from coronary angiography. Kidney Int 1984; 25:653–659. 27 Saragoca MA, Canziani ME, Cassiolato JL, Gil MA, Andrude JL, Draibe SA, Martinez EE: Left ventricular hypertrophy as a risk factor for arrhythmias in hemodialysis patients. J Cardiovasc Pharmacol 1991;17(suppl 2):S136– S138. 28 Mall G, Huther W, Schneider J, Lundin P, Ritz E: Diffuse intermyocardial fibrosis in uremic patients. Nephrol Dial Transplant 1990;5:39– 44.
The first component is whether sufficient data exists to support the role of any type of dialysis therapy earlier in the course of chronic renal failure; the second component is whether peritoneal dialysis or hemodialysis is the best therapy to employ when one initiates therapy. ABC © 2001 S. com/journals/bpu Early Initiation Multiple lines of evidence support the role of early referral to a nephrologist for management once chronic renal insufficiency has been identified [4–6]. Survival and hospitalizations, once dialysis has been initiated, appear to be lower in the group of patients who are referred early (table 1).
This must be the strongest piece of evidence yet for not introducing a global normalization of hemoglobin policy across all dialysis units. The Scandinavian [10, 11] and Canadian  Multicentre Studies also Blood Purif 2001;19:157–167 161 Fig. 2. Relative mortality risk in relation to hematocrit in a US observational study conducted in 1992 and 1993 in 75,283 hemodialysis patients. p values are calculated versus a hematocrit of 30–33%. Data from Ma et al. . Fig. 3. Relationship between hemoglobin and Sickness Impact Profile score as a measure of quality-of-life in 1,013 dialysis patients.