Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Feb 2009
Comparative StudyHigh-volume haemofiltration with a new haemofiltration membrane having enhanced adsorption properties in septic pigs.
High-volume haemofiltration (HVHF) has been suggested as an adjuvant treatment of septic shock due to its capacities to remove from blood both pro- and anti-inflammatory mediators involved in the sepsis syndrome. Adsorption properties of some haemofiltration membranes are also interesting with this indication because inflammatory mediators are caught in the membrane itself. The aim of this study was to determine the haemodynamic and immunological effects of a new haemofiltration membrane, which has enhanced adsorption properties due to a special surface treatment, allowing the adsorption of endotoxins. ⋯ The use of a membrane with enhanced adsorption properties during a 6-h HVHF session in septic pigs improves haemodynamics compared to a standard haemofiltration membrane. These results are probably due to an efficient endotoxins and cytokines adsorption. A human study using this membrane is now necessary to confirm these results.
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Nephrol. Dial. Transplant. · Jan 2009
Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life.
To date, the pathophysiology underlying symptoms in renal patients is still unclear. Symptom management research suggests that identification of related clusters of symptoms could provide insight into underlying determinants associated with multiple symptom experience. Theoretically, symptoms within a cluster could have a synergistic relationship. We aimed to identify symptom clusters in incident dialysis patients, and investigated associations between symptom clusters, clinical variables, functional status as measured by the Karnofsky Index and quality of life. ⋯ Symptom clustering does not explain the lack of meaningful associations between symptoms and clinical variables. Strong associations of symptom clusters with quality of life dimensions suggest that psychological factors could better explain symptom burden. Patients' perceptions of symptoms should be routinely assessed as part of clinical care to improve self-management strategies.
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Nephrol. Dial. Transplant. · Jan 2009
Renal dysfunction in acute stroke: an independent predictor of long-term all combined vascular events and overall mortality.
Acute stroke is the third leading cause of death in western societies after ischemic heart disease and cancer. Although it is an emergency disease sharing the same atherosclerotic risk factors with ischemic heart disease, the association of renal function and stroke is poorly investigated. The present study aims at assessing renal function status in patients with acute stroke and investigate any prognostic significance on the outcome. ⋯ Renal function on admission appears to be a significant independent prognostic factor for long term mortality and new cardiovascular morbidity over a 10-year period.