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Clinical Quality of the Patient at Onset of Dialysis Treatment

  • T. Alpikizler
  • Raymond M. Hakim
Part of the Developments in Nephrology book series (DINE, volume 39)

Abstract

The mortality rate of treated ESRD patients remains high in United States (24% per year) [1]. The life-expectancy of treated ESRD patients is 20–25 years less than the normal age-sex-race matched U.S. population over the age of 45. Despite recent advances in our understanding of the uremic state and improvements in the science and technology of renal replacement therapy, the prognosis of this patient population remains poor. Moreover, the health care cost of treating the U.S. ESRD program exceed $8 billion annually.

Keywords

Metabolic Acidosis ESRD Patient Clinical Quality Residual Renal Function Chronic Renal Failure Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    United States Renal Data System. The USRDS 1996 annual data report. 1997; S1–S152.Google Scholar
  2. 2.
    Hakim RM and Lazarus JM. Initiation of dialysis. J Am Soc Nephrol 1995; 6:1319–28.PubMedGoogle Scholar
  3. 3.
    Iseki K, Uehara H, Nishime K, Tokuyama K, Yoshihara K, Kinjo K et al. Impact of the initial levels of laboratory variables on survival in chronic dialysis patients. Am J Kidney Dis 1996; 28:541–8.PubMedGoogle Scholar
  4. 4.
    Avram MM, Mittman N, Bonomini L, Chattopadhyay J, and Fein P. Markers for survival in dialysis: a seven-year prospective study. Am J Kidney Dis 1995; 26:209–19.PubMedGoogle Scholar
  5. 5.
    Churchill DN. Adequacy of peritoneal dialysis: how much dialysis do we need? Kidney Int 1997; 48:S2–S6.Google Scholar
  6. 6.
    Khan IH, Catto GR, Edward N and Macleod AM. Chronic renal failure: factors influencing nephrology referral. Quart J Med 1994; 87:559–64.Google Scholar
  7. 7.
    Campbell JD, Ewigman B, Hosokawa M and Van Stone JC. The timing of referral of patients with end stage renal disease. Dialysis Transplant 1989; 18:66–86.Google Scholar
  8. 8.
    Jungers P, Zingraff J, Albouze G, Chauveau P, Page B, Hannedouche T and Man NK. Late referral to maintenance dialysis: detrimental consequences. Nephrol Dial Transplant 1993; 8:1089–93.PubMedGoogle Scholar
  9. 9.
    May RC, Kelly RA and Mitch WE. Mechanisms for defects in muscle protein metabolism in rats with chronic uremia: the influence of metabolic acidosis. J Clin Invest 1987; 79:1099–103.PubMedGoogle Scholar
  10. 10.
    Mitch WE and Walser M. Nutritional therapy of the uremic patient. In Brenner BM and Rector FC, editors. The Kidney. Philadelphia, Saunders, 1991; 2186.Google Scholar
  11. 11.
    Mitch WE, Medina R, Greiber S, May RC, England BK, Russ PS et al. Metabolic acidosis stimulates muscle protein degradation by activating the adenosine triphosphate-dependent pathway involving ubiquitin and proteasomes. J Clin Invest 1994; 93:2127–33.PubMedGoogle Scholar
  12. 12.
    Ballmer PE, McNurlan MA, Hulter HN, Anderson SE, Garlick PJ and Krapf R. Chronic metabolic acidosis decreases albumin synthesis and induces negative nitrogen balance in humans. J Clin Invest 1995; 95:39–45.PubMedCrossRefGoogle Scholar
  13. 13.
    Graham KA, Reaich D, Channon SM, Downie S, Gilmour E, Passlick-Deetjen J et al. Correction of acidosis in CAPD decreases whole body protein degradation. Kidney Int 1996; 49:1396–400.PubMedCrossRefGoogle Scholar
  14. 14.
    Foley RN and Parfrey PS. Cardiac disease in chronic uremia: clinical outcome and risk factors. Adv Renal Repl Ther 1997; 4:234–48.Google Scholar
  15. 15.
    Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC and Barre PE. Impact of hypertension on cardiomyopathy, morbidity and mortality in end-stage renal disease. Kidney Int 1996; 49:1379–85.PubMedCrossRefGoogle Scholar
  16. 16.
    Klahr S, Levey AS, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW et al. for Modification of diet in renal disease study group. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. N Engl J Med 1994; 330:877–84PubMedCrossRefGoogle Scholar
  17. 17.
    Knochel JP. Biochemical alterations in advanced uremic failure. In Jacobson HR, Striker GE and Klahr S, editors. The principles and practice of nephrology. Philadelphia, BC Decker, 1991; 682.Google Scholar
  18. 18.
    Collins A, Xia H and Ma J. Pre-ESRD vascular access insertion is associated with improved elderly patient survival. J Am Soc Nephrol 1997; 8:230.Google Scholar
  19. 19.
    Sands J and Miranda CL. Increasing numbers of AV fistulas for hemodialysis access. Clin Nephrol 1997; 48:114–17.PubMedGoogle Scholar
  20. 20.
    Levy AS. Measurement of renal function in chronic renal disease. Kidney Int 1990; 38:167–84.CrossRefGoogle Scholar
  21. 21.
    Shemesh O, Golbetz H, Kriss JP and Myers BD. Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 1985; 28:830–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Hakim RM and Lazarus JM. Progression of chronic renal failure. Am J Kidney Dis 1989; 14:396–401.PubMedGoogle Scholar
  23. 23.
    Jungers P, Chauveau P, Ployard F, Lebkiri B, Ciancioni C and Man NK. Comparison of ketoacids and low protein diet on advanced chronic renal failure progression. Kidney Int 1987; 32:67–71.Google Scholar
  24. 24.
    Nissenson AR. Epoetin and cognitive function. Am J Kidney Dis 1992; 20:S21–S24.Google Scholar
  25. 25.
    Ikizler TA, Evanson JA, Greene JH and Hakim RM. Impact of nutritional status and residual renal function at initiation of hemodialysis on subsequent morbidity in chronic hemodialysis patients. J Am Soc Nephrol 1996; 7:1319.Google Scholar
  26. 26.
    Tattersall J, Greenwood R and Farrington K. Urea kinetics and when to commence dialysis. Am J Nephrol 1995; 15:283–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Modification of diet in renal disease study group. Nutritional status of patients with different levels of chronic renal failure. Kidney Int 1989; 36:S184–S194.Google Scholar
  28. 28.
    Modification of diet in renal disease study group. Relationship between GFR and nutritional status-results from the MDRD study. J Am Soc Nephrol 1994; 5:335.Google Scholar
  29. 29.
    Ikizler TA, Greene J, Wingard RL, Parker RA and Hakim RM. Spontaneous dietary protein intake during progression of chronic renal failure. J Am Soc Nephrol 1995; 6:1386–91.PubMedGoogle Scholar
  30. 30.
    Canada-USA (CANUSA) Peritoneal Dialysis Study Group. Adequacy of dialysis and nutrition in continuous peritoneal dialysis: association with clinical outcomes. J Am Soc Nephrol 1996; 7:198–207.Google Scholar
  31. 31.
    McCusker FX, Tcehan BP, Thorpe KE, Keshaviah PR and Churchill DN. How much peritoneal dialysis is required for the maintenance of a good nutritional state? Kidney Int Suppl 1996; 56-50:S56–S61.Google Scholar
  32. 32.
    Pollock CA, Ibels LS, Zhu FY, Warnant M, Caterson RJ, Waugh DA et al. Protein intake in renal disease. J Am Soc Nephrol 1997; 8:777–83.PubMedGoogle Scholar
  33. 33.
    Kaysen GA, Stevenson FT and Depner TA. Determinants of albumin concentration in hemodialysis patients. Am J Kidney Dis 1997; 29:658–68.PubMedGoogle Scholar
  34. 34.
    Maroni B, Steinman TI and Mitch NE. A method for estimating nitrogen intake of patients with chronic renal failure. Kidney Int 1985; 27:58–61.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • T. Alpikizler
  • Raymond M. Hakim

There are no affiliations available

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