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2. Bioprocess intensification using flow reactors: stereoselective oxidation of achiral 1,3-diols with immobilized Acetobacter Aceti

Author

De Vitis, V., Dall'Oglio, F., Tentori, F., Contente, M. L., Romano, D., Brenna, E., Tamborini, L., Molinari, F., and Francesco

Subjects
biocatalysis, oxidation, lcsh:Chemical technology, 010402 general chemistry, 01 natural sciences, Catalysis, lcsh:Chemistry, polycyclic compounds, lcsh:TP1-1185, heterocyclic compounds, Physical and Theoretical Chemistry, Bioprocess, Acetobacter aceti, biology, 010405 organic chemistry, Chemistry, Continuous flow, Continuous reactor, organic chemicals, whole cells, biology.organism_classification, 0104 chemical sciences, flow reactor, lcsh:QD1-999, Chemical engineering, Biocatalysis, immobilization, reactor design, Stereoselectivity
Abstract

Enantiomerically enriched 2-hydroxymethylalkanoic acids were prepared by oxidative desymmetrisation of achiral 1,3-diols using immobilized cells of Acetobacter aceti in water at 28 &deg, C. The biotransformations were first performed in batch mode with cells immobilized in dry alginate, furnishing the desired products with high molar conversion and reaction times ranging from 2 to 6 h. The biocatalytic process was intensified using a multiphasic flow reactor, where a segmented gas&ndash, liquid flow regime was applied for achieving an efficient O2-liquid transfer, the continuous flow systems allowed for high yields and high biocatalyst productivity.

Published
2019

4. US Renal Data System 2016 Annual Data Report: Epidemiology of Kidney Disease in the United States (vol 69, pg s7, 2017)

Author

Saran, R, Robinson, B, Abbott, KC, Agodoa, LYC, Albertus, P, Ayanian, J, Balkrishnan, R, Bragg-Gresham, J, Cao, J, Chen, JLT, Cope, E, Dharmarajan, S, Dietrich, X, Eckard, A, Eggers, PW, Gaber, C, Gillen, D, Gipson, D, Gu, H, Hailpern, SM, Hall, YN, Han, Y, He, K, Hebert, P, Helmuth, M, Herman, W, Heung, M, Hutton, D, Jacobsen, SJ, Ji, N, Jin, Y, Kalantar-Zadeh, K, Kapke, A, Katz, R, Kovesdy, CP, Kurtz, V, Lavallee, D, Li, Y, Lu, Y, McCullough, K, Molnar, MZ, Montez-Rath, M, Morgenstern, H, Mu, Q, Mukhopadhyay, P, Nallamothu, B, Nguyen, DV, Norris, KC, O'Hare, AM, Obi, Y, Pearson, J, Pisoni, R, Plattner, B, Port, FK, Potukuchi, P, Rao, P, Ratkowiak, K, Ravel, V, Ray, D, Rhee, CM, Schaubel, DE, Selewski, DT, Shaw, S, Shi, J, Shieu, M, Sim, JJ, Song, P, Soohoo, M, Steffick, D, Streja, E, Tamura, MK, Tentori, F, Tilea, A, Tong, L, Turf, M, Wang, D, Wang, M, Woodside, K, Wyncott, A, Xin, X, Zeng, W, Zepel, L, Zhang, S, Zho, H, Hirth, RA, and Shahinian, V

Published
2017

7. Associations of coping strategies with quality of life, depression and mortality among hemodialysis patients in the dialysis outcomes and practice patterns study (DOPPS).

Author

Hal M., Robinson B., Rayner H., Lopes A., Pisoni R., Speyer E., Kerr P., Tentori F., Hal M., Robinson B., Rayner H., Lopes A., Pisoni R., Speyer E., Kerr P., and Tentori F.

Abstract

INTRODUCTION AND AIMS: Little is known about how different strategies used by hemodialysis (HD) patients to cope with their disease might affect their health status. Our objective was to estimate the effects of 4 coping strategies on quality of life (QoL) and mortality. We hypothesized that active engagement coping would lead to better patient outcomes than would avoidance or disengagement. METHOD(S): Coping strategies were reported by 2,339 HD patients from the US, UK, Australia/New Zealand, Canada, Germany and Sweden in DOPPS 4 (2009-11), using the Coping Strategies Inventory-Short Form (CSI-SF) previously validated for HD patients in these countries. The CSI-SF contains 4 subscales: problem-focused engagement & disengagement (PFE & PFD); and emotion-focused engagement & disengagement (EFE & EFD). Cox or linear regression were used to estimate the associations of each coping strategy (by quartile) with all-cause mortality during follow-up and 6 cross-sectional patient-reported outcomes (3 KDQoL kidney-disease measures with higher scores reflecting less impact on patients' lives (Effects, Burdens, Symptoms); 2 SF-12 scores (MCS, PCS) reflecting better functional status; and a CES-D score reflecting more depression symptoms), adjusting for age, sex, vintage, BMI, catheter use, 13 comorbidities, and country. RESULT(S): PFE was positively associated with less kidney-disease burden and effect scores and better mental and physical function scores, and it was inversely associated with depression symptoms. EFE was not associated with any QoL outcomes (Figure 1). In contrast, disengagement strategies (PFD & EFD) were inversely associated with the kidney-disease and functional-status scores, and they were positively associated with depression symptoms. Compared to patients in the lowest PFE quartile (Q1), the hazard ratio for mortality (95% CI) was 0.73 (0.55, 0.98) for patients in Q2, 0.67 (0.49,0.93) for patients in Q3, and 0.74 (0.53, 1.03) for patients in Q4. Little ass

Published
2017

8. Developing a Set of Core Outcomes for Trials in Hemodialysis: An International Delphi Survey

Author

Evangelidis, N, Tong, A, Manns, B, Hemmelgarn, B, Wheeler, DC, Tugwell, P, Crowe, S, Harris, T, Van Biesen, W, Winkelmayer, WC, Sautenet, B, O'Donoghue, D, Tam-Tham, H, Youssouf, S, Mandayam, S, Ju, A, Hawley, C, Pollock, C, Harris, DC, Johnson, DW, Rifkin, DE, Tentori, F, Agar, J, Polkinghorne, KR, Gallagher, M, Kerr, PG, McDonald, SP, Howard, K, Howell, M, Craig, JC, Evangelidis, N, Tong, A, Manns, B, Hemmelgarn, B, Wheeler, DC, Tugwell, P, Crowe, S, Harris, T, Van Biesen, W, Winkelmayer, WC, Sautenet, B, O'Donoghue, D, Tam-Tham, H, Youssouf, S, Mandayam, S, Ju, A, Hawley, C, Pollock, C, Harris, DC, Johnson, DW, Rifkin, DE, Tentori, F, Agar, J, Polkinghorne, KR, Gallagher, M, Kerr, PG, McDonald, SP, Howard, K, Howell, M, and Craig, JC

Abstract

Background Survival and quality of life for patients on hemodialysis therapy remain poor despite substantial research efforts. Existing trials often report surrogate outcomes that may not be relevant to patients and clinicians. The aim of this project was to generate a consensus-based prioritized list of core outcomes for trials in hemodialysis. Study Design In a Delphi survey, participants rated the importance of outcomes using a 9-point Likert scale in round 1 and then re-rated outcomes in rounds 2 and 3 after reviewing other respondents’ scores. For each outcome, the median, mean, and proportion rating as 7 to 9 (critically important) were calculated. Setting & Participants 1,181 participants (202 [17%] patients/caregivers, 979 health professionals) from 73 countries completed round 1, with 838 (71%) completing round 3. Outcomes & Measurements Outcomes included in the potential core outcome set met the following criteria for both patients/caregivers and health professionals: median score ≥ 8, mean score ≥ 7.5, proportion rating the outcome as critically important ≥ 75%, and median score in the forced ranking question < 10. Results Patients/caregivers rated 4 outcomes higher than health professionals: ability to travel, dialysis-free time, dialysis adequacy, and washed out after dialysis (mean differences of 0.9, 0.5, 0.3, and 0.2, respectively). Health professionals gave a higher rating for mortality, hospitalization, decrease in blood pressure, vascular access complications, depression, cardiovascular disease, target weight, infection, and potassium (mean differences of 1.0, 1.0, 1.0, 0.9, 0.9, 0.8, 0.7, 0.4, and 0.4, respectively). Limitations The Delphi survey was conducted online in English and excludes participants without access to a computer and internet connection. Conclusions Patients/caregivers gave higher priority to lifestyle-related outcomes than health professionals. The prioritized outcomes for both groups were vascular access problems, dialysis ad

Published
2017

9. Developing a Set of Core Outcomes for Trials in Hemodialysis: An International Delphi Survey.

Author

Howell M., McDonald S.P., Howard K., Craig J.C., Polkinghorne K.R., Evangelidis N., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Crowe S., Harris T., Van Biesen W., Winkelmayer W.C., Sautenet B., O'Donoghue D., Tam-Tham H., Youssouf S., Mandayam S., Ju A., Kerr P.G., Hawley C., Pollock C., Harris D.C., Johnson D.W., Rifkin D.E., Tentori F., Agar J., Gallagher M., Howell M., McDonald S.P., Howard K., Craig J.C., Polkinghorne K.R., Evangelidis N., Tong A., Manns B., Hemmelgarn B., Wheeler D.C., Tugwell P., Crowe S., Harris T., Van Biesen W., Winkelmayer W.C., Sautenet B., O'Donoghue D., Tam-Tham H., Youssouf S., Mandayam S., Ju A., Kerr P.G., Hawley C., Pollock C., Harris D.C., Johnson D.W., Rifkin D.E., Tentori F., Agar J., and Gallagher M.

Abstract

Background Survival and quality of life for patients on hemodialysis therapy remain poor despite substantial research efforts. Existing trials often report surrogate outcomes that may not be relevant to patients and clinicians. The aim of this project was to generate a consensus-based prioritized list of core outcomes for trials in hemodialysis. Study Design In a Delphi survey, participants rated the importance of outcomes using a 9-point Likert scale in round 1 and then re-rated outcomes in rounds 2 and 3 after reviewing other respondents' scores. For each outcome, the median, mean, and proportion rating as 7 to 9 (critically important) were calculated. Setting & Participants 1,181 participants (202 [17%] patients/caregivers, 979 health professionals) from 73 countries completed round 1, with 838 (71%) completing round 3. Outcomes & Measurements Outcomes included in the potential core outcome set met the following criteria for both patients/caregivers and health professionals: median score >= 8, mean score >= 7.5, proportion rating the outcome as critically important >= 75%, and median score in the forced ranking question < 10. Results Patients/caregivers rated 4 outcomes higher than health professionals: ability to travel, dialysis-free time, dialysis adequacy, and washed out after dialysis (mean differences of 0.9, 0.5, 0.3, and 0.2, respectively). Health professionals gave a higher rating for mortality, hospitalization, decrease in blood pressure, vascular access complications, depression, cardiovascular disease, target weight, infection, and potassium (mean differences of 1.0, 1.0, 1.0, 0.9, 0.9, 0.8, 0.7, 0.4, and 0.4, respectively). Limitations The Delphi survey was conducted online in English and excludes participants without access to a computer and internet connection. Conclusions Patients/caregivers gave higher priority to lifestyle-related outcomes than health professionals. The prioritized outcomes for both groups were vascular access problems, dialysis

Published
2017

11. Developing a set of core outcomes for trials in haemodialysis: An international DELPHI survey.

Author

Youssouf S., Wheeler D., Tugwell P., Crowe S., Harris T., Van Biesen W., Winkelmayer W., Sautenet B., O'Donaghue D., Tam-Tham H., Hemmelgarn B., Mandayam S., Ju A., Hawley C., Mcdonald S., Kerr P., Gallagher M., Polkinghorne K., Agar J., Tentori F., Rifkin D., Johnson D., Harris D., Pollock C., Evangelidis N., Tong A., Manns B., Craig J., Howell M., Youssouf S., Wheeler D., Tugwell P., Crowe S., Harris T., Van Biesen W., Winkelmayer W., Sautenet B., O'Donaghue D., Tam-Tham H., Hemmelgarn B., Mandayam S., Ju A., Hawley C., Mcdonald S., Kerr P., Gallagher M., Polkinghorne K., Agar J., Tentori F., Rifkin D., Johnson D., Harris D., Pollock C., Evangelidis N., Tong A., Manns B., Craig J., and Howell M.

Abstract

Aim: To generate a consensus-based, prioritized list of core outcomes for trials in haemodialysis. Background(s): Survival and quality of life for patients on haemodialysis remain poor despite substantial research efforts. Existing trials often report surrogate outcomes that may not be relevant to patients and clinicians. A core outcome set that reflects stakeholder priorities would improve the relevance, efficiency, and comparability of haemodialysis trials. Method(s): In an online Delphi survey, participants rated the importance of outcomes using a 9-point Likert scale. In Round 2 and 3, participants reviewed the scores and comments of other respondents and re-rated the outcomes. For each outcome, we calculated the median, mean, and proportion rating 7-9 ("critically important"). Result(s): 1,181 participants (202 [17%] patients/caregivers, 979 health professionals) from 73 countries completed Round 1 and 838 (150 [18%] patients/caregivers) completed Round 3 (71% response rate). Outcomes achieving consensus as high priorities across both groups were: vascular access complications, cardiovascular disease, mortality, dialysis adequacy and fatigue. Patients/caregivers rated four outcomes higher than health professionals: ability to travel (mean difference 0.9), dialysis- free time (0.5), dialysis adequacy (0.3), and washed out after dialysis (0.2). Health professionals rated 11 outcomes higher: mortality (1.0), hospitalization (1.0), drop in blood pressure (1.0), vascular access complications (0.9), depression (0.9), cardiovascular disease (0.8), target weight (0.7), infection (0.4), potassium (0.4), ability to work (0.3), and pain (0.3). Conclusion(s): The top stakeholder prioritized outcomes were vascular access problems, cardiovascular disease, mortality, dialysis adequacy and fatigue. Patients/caregivers gave higher priority to lifestyle-related outcomes than health professionals. This prioritized set of outcomes can inform the establishment of a core outcome set

Published
2016

15. High rates of death and hospitalization follow bone fracture among hemodialysis patients.

Author

Robinson B.M., Pisoni R.L., Kerr P.G., Tentori F., McCullough K., Kilpatrick R.D., Bradbury B.D., Robinson B.M., Pisoni R.L., Kerr P.G., Tentori F., McCullough K., Kilpatrick R.D., and Bradbury B.D.

Abstract

Altered bone structure and function contribute to the high rates of fractures in dialysis patients compared to the general population. Fracture events may increase the risk of subsequent adverse clinical outcomes. Here we assessed the incidence of post-fracture morbidity and mortality in an international cohort of 34,579 in-center hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). We estimated country-specific rates of fractures requiring a hospital admission and associated length of stay in the hospital. Incidence rates of death and of a composite event of death/rehospitalization were estimated for 1 year after fracture. Overall, 3% of participants experienced a fracture. Fracture incidence varied across countries, from 12 events/1000 patient-years (PY) in JPN to 45/1000 PY in BEL. In all countries, fracture rates were higher in the hemodialysis group compared to those reported for the general population. Median length of stay ranged from 7 to 37 days in the United States and JPN, respectively. In most countries, postfracture mortality rates exceeded 500/1000 PY and death/rehospitalization rates exceeded 1500/1000 PY. Fracture patients had higher unadjusted rates of death (3.7-fold) and death/rehospitalization (4.0-fold) compared to the overall DOPPS population. Mortality and hospitalization rates were highest in the first month after the fracture and declined thereafter. Thus, the high frequency of fractures and increased adverse outcomes following a fracture pose a significant health burden for dialysis patients. Fracture prevention strategies should be identified and applied broadly in nephrology practices © 2013 International Society of Nephrology.

Published
2014

16. The authors reply.

Author

Pisoni R.L., McCullough K., Kilpatrick R.D., Bradbury B.D., Robinson B.M., Kerr P.G., Tentori F., Pisoni R.L., McCullough K., Kilpatrick R.D., Bradbury B.D., Robinson B.M., Kerr P.G., and Tentori F.

Published
2014

17. Associations between psychiatric and neurological disorders and vascular access infections among patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Author

UCL - SSS/IREC/NEFR-Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Bornstein, J., McCullough, K., Combe, C., Bieber, B., Jadoul, Michel, Pisoni, R., Mariani, L., Robinson, B., Saito, A., Sen, A., Tentori, F., 51st ERA-EDTA CONGRESS, UCL - SSS/IREC/NEFR-Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Bornstein, J., McCullough, K., Combe, C., Bieber, B., Jadoul, Michel, Pisoni, R., Mariani, L., Robinson, B., Saito, A., Sen, A., Tentori, F., and 51st ERA-EDTA CONGRESS

Published
2014

18. The Dialysis Outcomes and Practice Patterns Study (DOPPS): results of the Italian cohort

Author

Pontoriero, G, Santoro, Domenico, Messina, A, Vitiello, P, Tasco, A, Milei, M, Capiferri, R, Bellazzi, R, Flammini, A, Baroni, A, Morra, M, Cappelli, G, Mucaria, S, Boggi, R, Amico, Me, Volzone, A, D'Andrea, T, Paglionico, C, Antonucci, F, Ivaldi, R, Tentori, F, BRAGG GRESHAM, J, Pisoni, R, Andreucci, Ve, and Locatelli, F.

Subjects
Male, Middle Aged, outcomes, Cohort Studies, Treatment Outcome, Italy, Renal Dialysis, quality, Dialysis, Humans, Kidney Failure, Chronic, Female, Aged
Abstract

The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international prospective, longitudinal, observational study examining the relationship between dialysis unit practices and outcomes for hemodialysis (HD) patients in seven developed countries France, Germany, Italy, Spain, United Kingdom, Japan and the United States. Results of the DOPPS in Italy are the subject of this report.A national representative sample of 20 dialysis units (21 in Germany) was randomly selected in each of the European DOPPS countries (Euro-DOPPS). In these units, the HD in-center patients were included on a facility census, and their survival rates continuously monitored. A representative sample of incident (269 in Italy, 1553 in the Euro-DOPPS) and prevalent (600 in Italy, 3038 in the Euro-DOPPS) patients was randomly selected from the census for more detailed longitudinal investigation with regard to medical history, laboratory values and hospital admission.Comparing the Italian and Euro-DOPPS cohorts we found comparable mean age for prevalent patients (61.4 vs. 59.5 yrs), but incident patients were older in Italy. Italian prevalent patients had less cardiovascular disease, more satisfactory nutritional status and more frequent use of native vascular access. These data were associated with a comparable mortality (15.7 vs. 16.3 deaths/100 patient yrs), but morbidity was lower in Italy. Kt/V levels were comparable in the two cohorts (1.32 vs. 1.37), but 35% of Italian patients showed a Kt/V below the recommended target. Moreover, hemoglobin levels were below 11 g/dL in 60% of Italian patients.The DOPPS results bring to light several positive aspects and the opportunity for further possible improvements for Italian patients, but at the same time highlight some critical points that could represent a risk for dialysis quality.

Published
2005

19. PRIMARY AND SECONDARY GLOMERULONEPHRITIDES 2

Author

Monova, D., primary, Monov, S., additional, Todorov, T., additional, Soderberg, D., additional, Kurz, T., additional, Weiner, M., additional, Eriksson, P., additional, Segelmark, M., additional, Jakuszko, K., additional, Sebastian, A., additional, Bednarz, Z., additional, Krajewska, M., additional, Wiland, P., additional, Madziarska, K., additional, Weyde, W., additional, Klinger, M., additional, Naidoo, J., additional, Wearne, N., additional, Jones, E., additional, Swanepoel, C., additional, Rayner, B., additional, Okpechi, I., additional, Endo, N., additional, Tsuboi, N., additional, Furuhashi, K., additional, Matsuo, S., additional, Maruyama, S., additional, Clerte, M., additional, Levi, C., additional, Touzot, M., additional, Fakhouri, F., additional, Monge, C., additional, Lebas, C., additional, Abboud, I., additional, Huart, A., additional, Durieux, P., additional, Charlin, E., additional, Thervet, E., additional, Karras, A., additional, Smykal-Jankowiak, K., additional, Niemir, Z. I., additional, Polcyn-Adamczak, M., additional, Whatmough, S., additional, Sweeney, N., additional, Fernandez, S., additional, Hussain, M., additional, Dhaygude, A., additional, Gniewek, K., additional, Manenti, L., additional, Urban, M. L., additional, Vaglio, A., additional, Gintoli, E., additional, Galletti, M., additional, Buzio, C., additional, Monova, D., additional, Argirova, T., additional, Wong, I., additional, Ibrahim, F. H., additional, Goh, B. L., additional, Lim, T. S., additional, Chan, M. W., additional, Hiramtasu, R., additional, Ubara, Y., additional, Hoshino, J., additional, Takaichi, K., additional, Ghafoor, V., additional, Sahay, M., additional, Soma, J., additional, Nakaya, I., additional, Sasaki, N., additional, Yoshikawa, K., additional, Sato, H., additional, Kaminskyy, V., additional, ZAbi Ska, M., additional, Ko Cielska-Kasprzak, K., additional, Niemir, Z., additional, Wozniczka, K., additional, Swierzko, A., additional, Cedzynski, M., additional, Sokolowska, A., additional, Szala, A., additional, Arjunan, A., additional, Mikhail, A., additional, Shrivastava, R., additional, Parker, C., additional, Aithal, S., additional, Gursu, M., additional, Ozari, M., additional, Yucetas, E., additional, Sumnu, A., additional, Doner, B., additional, Cebeci, E., additional, Ozkan, O., additional, Aktuglu, M. B., additional, Karaali, Z., additional, Koldas, M., additional, Ozturk, S., additional, Marco, H., additional, Picazo, M., additional, Da Silva, I., additional, Gonzalez, A., additional, Arce, Y., additional, Gracia, S., additional, Corica, M., additional, Llobet, J., additional, Diaz, M., additional, Ballarin, J., additional, Schonermarck, U., additional, Hagele, H., additional, Baumgartner, A., additional, Fischereder, M., additional, Muller, S., additional, Oliveira, C. B. L., additional, Oliveira, A. S. A., additional, Carvalho, C. J. B., additional, Pessoa, C. T. B. C., additional, Sette, L. H. B. C., additional, Fernandes, G. V., additional, Cavalcante, M. A. G. M., additional, Valente, L. M., additional, Wan, Q., additional, Hu, H., additional, He, Y., additional, Li, T., additional, Aazair, N., additional, Houmaid, Z., additional, Rhair, A., additional, Bennani, N., additional, Demin, A., additional, Petrova, O., additional, Kotova, O., additional, Demina, L., additional, Roccatello, D., additional, Sciascia, S., additional, Rossi, D., additional, Naretto, C., additional, Baldovino, S., additional, Alpa, M., additional, Salussola, I., additional, Modena, V., additional, Zakharova, E. V., additional, Vinogradova, O. V., additional, Stolyarevich, E. S., additional, Yap, D. Y. H., additional, Chan, T. M., additional, Thanaraj, V., additional, Ponnusamy, A., additional, Pillai, S., additional, Argentiero, L., additional, Schena, A., additional, Rossini, M., additional, Manno, C., additional, Castellano, G., additional, Martino, M., additional, Mitrotti, A., additional, Giliberti, M., additional, Digiorgio, C., additional, Di Palma, A. M., additional, Battaglia, M., additional, Ditonno, P., additional, Grandaliano, G., additional, Gesualdo, L., additional, Neprintseva, N., additional, Tchebotareva, N., additional, Bobkova, I., additional, Kozlovskaya, L., additional, Rabrenovi , V., additional, Kova Evi , Z., additional, Jovanovi , D., additional, Rabrenovi , M., additional, Anti , S., additional, Ignjatovi , L., additional, Petrovi , M., additional, Longhi, S., additional, Del Vecchio, L., additional, Vigano, S., additional, Casartelli, D., additional, Bigi, M. C., additional, Corti, M., additional, Limardo, M., additional, Tentori, F., additional, Pontoriero, G., additional, Zeraati, A. A., additional, Shariati Sarabi, Z., additional, Davoudabadi Farahani, A., additional, Mirfeizi, Z., additional, and Bae, E., additional

Published
2014
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20. Patient involvement with the tasks of in-center hemodialysis and health-related quality of life in the DOPPS.

Author

Karaboyas A., Morgenstern H., Li Y., Mendelssohn D., Wikstrom B., Tentori F., Pisoni R., Robinson B., Kerr P., Fluck R., Wilkie M., Rayner H., Karaboyas A., Morgenstern H., Li Y., Mendelssohn D., Wikstrom B., Tentori F., Pisoni R., Robinson B., Kerr P., Fluck R., Wilkie M., and Rayner H.

Abstract

Introduction and Aims:We measured the involvement of in-center patients in their dialysis treatment and assessed cross-sectional associations with measures of health-related quality of life in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Method(s): Data on self-care activities (listed in Table 1) were available in DOPPS phase 4 (2009-11). Descriptive analyses included 5657 patients in 8 countries with >2% of patients reporting >=1 activity. 3242 of these patients reported the physical (PCS) and mental (MCS) component summary of the KDQoL-36TM. Linear mixed models adjusted for many potential confounders, including country, estimated the effects of self-care activities on PCS and MCS. Result(s): The % of patients who performed >=1 self-care activity was 9% overall and highest in Australia/New Zealand and Sweden (16% each, Table 1). The activity most commonly performed was setting up the machine/dialyzer (7%). Facility % of patients who performed >=1 self-care activity was 0% in 39% of facilities, with median 4% (IQR: 0%, 12%) and 95th percentile 36%. Patients performing >=1 self-care activity were younger (51 vs 66 yrs), had longer vintage (6.2 vs 3.6 yrs), lower catheter use (23% vs 36%), higher albumin (3.9 vs 3.6 g/dL), higher creatinine (9.3 vs 7.5 mg/dL), longer session length, (256 vs 238 min), and fewer comorbidities than patients performing none of the 4 activities. For patients performing >=1 self-care activity: crude mean PCS (39.2 vs 34.9) and MCS (47.9 vs 45.3) were higher, and after covariate adjustment, mean PCS was 1.6 points higher (95% CI: 0.3, 2.8) and mean MCS was 2.2 points higher (95% CI: 0.7, 3.7). Conclusion(s): Greater patient involvement in the routine tasks of hemodialysis is associated with better physical and mental quality of life; however, methodological limitations limit causal inference. Marked variation in up-take of self-care is likely to represent facility preferences for empowering patients. The impact and safety of th

Published
2013

21. Phosphate binder use and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS): Evaluation of possible confounding by nutritional status.

Author

Gillespie B.W., Akiba T., Robinson B.M., Pisoni R.L., Port F.K., Lopes A.A., Tong L., Thumma J., Li Y., Fuller D.S., Morgenstern H., Bommer J., Kerr P.G., Tentori F., Gillespie B.W., Akiba T., Robinson B.M., Pisoni R.L., Port F.K., Lopes A.A., Tong L., Thumma J., Li Y., Fuller D.S., Morgenstern H., Bommer J., Kerr P.G., and Tentori F.

Abstract

Background: Poor nutritional status and both hyper- and hypophosphatemia are associated with increased mortality in maintenance hemodialysis (HD) patients. We assessed associations of phosphate binder prescription with survival and indicators of nutritional status in maintenance HD patients. Study Design: Prospective cohort study (DOPPS [Dialysis Outcomes and Practice Patterns Study]), 1996-2008. Setting & Participants: 23,898 maintenance HD patients at 923 facilities in 12 countries. Predictors: Patient-level phosphate binder prescription and case-mix-adjusted facility percentage of phosphate binder prescription using an instrumental-variable analysis. Outcome(s): All-cause mortality. Result(s): Overall, 88% of patients were prescribed phosphate binders. Distributions of age, comorbid conditions, and other characteristics showed small differences between facilities with higher and lower percentages of phosphate binder prescription. Patient-level phosphate binder prescription was associated strongly at baseline with indicators of better nutrition, ie, higher values for serum creatinine, albumin, normalized protein catabolic rate, and body mass index and absence of cachectic appearance. Overall, patients prescribed phosphate binders had 25% lower mortality (HR, 0.75; 95% CI, 0.68-0.83) when adjusted for serum phosphorus level and other covariates; further adjustment for nutritional indicators attenuated this association (HR, 0.88; 95% CI, 0.80-0.97). However, this inverse association was observed for only patients with serum phosphorus levels <3.5 mg/dL. In the instrumental-variable analysis, case-mix-adjusted facility percentage of phosphate binder prescription (range, 23%-100%) was associated positively with better nutritional status and inversely with mortality (HR for 10% more phosphate binders, 0.93; 95% CI, 0.89-0.96). Further adjustment for nutritional indicators reduced this association to an HR of 0.95 (95% CI, 0.92-0.99). Limitation(s): Results were based o

Published
2012

22. Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS).

Author

Port F.K., Bommer J., Young E.W., Akizawa T., Akiba T., Pisoni R.L., Robinson B.M., Tentori F., Blayney M.J., Albert J.M., Gillespie B.W., Kerr P.G., Port F.K., Bommer J., Young E.W., Akizawa T., Akiba T., Pisoni R.L., Robinson B.M., Tentori F., Blayney M.J., Albert J.M., Gillespie B.W., and Kerr P.G.

Abstract

Background: Abnormalities in serum calcium, phosphorus, and parathyroid hormone (PTH) concentrations are common in patients with chronic kidney disease and have been associated with increased morbidity and mortality. No clinical trials have been conducted to clearly identify categories of calcium, phosphorus, and PTH levels associated with the lowest mortality risk. Current clinical practice guidelines are based largely on expert opinions, and clinically relevant differences exist among guidelines across countries. We sought to describe international trends in calcium, phosphorus, and PTH levels during 10 years and identify mortality risk categories in the Dialysis Outcomes and Practice Patterns Study (DOPPS), an international study of hemodialysis practices and associated outcomes. Study Design: Prospective cohort study. Participant(s): 25,588 patients with end-stage renal disease on hemodialysis therapy for longer than 180 days at 925 facilities in DOPPS I (1996-2001), DOPPS II (2002-2004), or DOPPS III (2005-2007). Predictors: Serum calcium, albumin-corrected calcium (CaAlb), phosphorus, and PTH levels. Outcome(s): Adjusted hazard ratios for all-cause and cardiovascular mortality calculated using Cox models. Result(s): Distributions of mineral metabolism markers differed across DOPPS countries and phases, with lower calcium and phosphorus levels observed in the most recent phase of DOPPS. Survival models identified categories with the lowest mortality risk for calcium (8.6 to 10.0 mg/dL), CaAlb (7.6 to 9.5 mg/dL), phosphorus (3.6 to 5.0 mg/dL), and PTH (101 to 300 pg/mL). The greatest risk of mortality was found for calcium or CaAlb levels greater than 10.0 mg/dL, phosphorus levels greater than 7.0 mg/dL, and PTH levels greater than 600 pg/mL and in patients with combinations of high-risk categories of calcium, phosphorus, and PTH. Limitation(s): Because of the observational nature of DOPPS, this study can only indicate an association between mineral metabolism c

Published
2012

23. Blood pressure levels and mortality risk among hemodialysis patients in the dialysis outcomes and practice patterns study.

Author

Fukuhara S., Pisoni R.L., Saran R., Tentori F., Akizawa T., Port F.K., Robinson B.M., Tong L., Zhang J., Wolfe R.A., Goodkin D.A., Greenwood R.N., Kerr P.G., Morgenstern H., Li Y., Fukuhara S., Pisoni R.L., Saran R., Tentori F., Akizawa T., Port F.K., Robinson B.M., Tong L., Zhang J., Wolfe R.A., Goodkin D.A., Greenwood R.N., Kerr P.G., Morgenstern H., and Li Y.

Abstract

KDOQI practice guidelines recommend predialysis blood pressure <140/90 mm Hg; however, most prior studies had found elevated mortality with low, not high, systolic blood pressure. This is possibly due to unmeasured confounders affecting systolic blood pressure and mortality. To lessen this bias, we analyzed 24,525 patients by Cox regression models adjusted for patient and facility characteristics. Compared with predialysis systolic blood pressure of 130-159 mm Hg, mortality was 13% higher in facilities with 20% more patients at systolic blood pressure of 110-129 mm Hg and 16% higher in facilities with 20% more patients at systolic blood pressure of >=160 mm Hg. For patient-level systolic blood pressure, mortality was elevated at low (>130 mm Hg), not high (>=180 mm Hg), systolic blood pressure. For predialysis diastolic blood pressure, mortality was lowest at 60-99 mm Hg, a wide range implying less chance to improve outcomes. Higher mortality at systolic blood pressure of <130 mm Hg is consistent with prior studies and may be due to excessive blood pressure lowering during dialysis. The lowest risk facility systolic blood pressure of 130-159 mm Hg indicates this range may be optimal, but may have been influenced by unmeasured facility practices. While additional study is needed, our findings contrast with KDOQI blood pressure targets, and provide guidance on optimal blood pressure range in the absence of definitive clinical trial data. © 2012 International Society of Nephrology.

Published
2012

24. Longer dialysis session length is associated with better intermediate outcomes and survival among patients on in-center three times per week hemodialysis: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Author

Pisoni R., Saran R., Bommer J., Port F., Akiba T., Robinson B., Tentori F., Zhang J., Li Y., Karaboyas A., Kerr P., Pisoni R., Saran R., Bommer J., Port F., Akiba T., Robinson B., Tentori F., Zhang J., Li Y., Karaboyas A., and Kerr P.

Abstract

BackgroundLonger dialysis session length (treatment time, TT) has been associated with better survival among hemodialysis (HD) patients. The impact of TT on clinical markers that may contribute to this survival advantage is not well known.MethodsUsing data from the international Dialysis Outcomes and Practice Patterns Study, we assessed the association of TT with clinical outcomes using both standard regression analyses and instrumental variable approaches. The study included 37 414 patients on in-center HD three times per week with prescribed TT from 120 to 420 min.ResultsFacility mean TT ranged from 214 min in the USA to 256 min in Australia-New Zealand. Accounting for country effects, mortality risk was lower for patients with longer TT {hazard ratio for every 30 min: all-cause mortality: 0.94 [95 confidence interval (CI): 0.92-0.97], cardiovascular mortality: 0.95 (95 CI: 0.91-0.98) and sudden death: 0.93 (95 CI: 0.88-0.98)}. Patients with longer TT had lower pre- and post-dialysis systolic blood pressure, greater intradialytic weight loss, higher hemoglobin (for the same erythropoietin dose), serum albumin and potassium and lower serum phosphorus and white blood cell counts. Similar associations were found using the instrumental variable approach, although the positive associations of TT with weight loss and potassium were lost.ConclusionsFavorable levels of a variety of clinical markers may contribute to the better survival of patients receiving longer TT. These findings support longer TT prescription in the setting of in-center, three times per week HD. © The Author 2012. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Published
2012

26. CKD-MBD II

Author

Fujii, T., primary, Suzuki, S., additional, Shinozaki, M., additional, Tanaka, H., additional, Bell, S., additional, Cooper, S., additional, Lomonte, C., additional, Libutti, P., additional, Chimienti, D., additional, Casucci, F., additional, Bruno, A., additional, Antonelli, M., additional, Lisi, P., additional, Cocola, L., additional, Basile, C., additional, Negri, A., additional, Del Valle, E., additional, Zanchetta, M., additional, Zanchetta, J., additional, Di Vico, M. C., additional, Ferraresi, M., additional, Pia, A., additional, Aroasio, E., additional, Gonella, S., additional, Mongilardi, E., additional, Clari, R., additional, Moro, I., additional, Piccoli, G. B., additional, Gonzalez-Parra, E., additional, Rodriguez-Osorio, L., additional, Ortiz-Arduan, A., additional, de la Piedra, C., additional, Egido, J., additional, Perez Gomez, M. V., additional, Tabikh, A. A., additional, Afsar, B., additional, Kirkpantur, A., additional, Imanishi, Y., additional, Yamagata, M., additional, Nagata, Y., additional, Ohara, M., additional, Michigami, T., additional, Yukimura, T., additional, Inaba, M., additional, Bieber, B., additional, Robinson, B., additional, Mariani, L., additional, Jacobson, S., additional, Frimat, L., additional, Bommer, J., additional, Pisoni, R., additional, Tentori, F., additional, Ciceri, P., additional, Elli, F., additional, Brancaccio, D., additional, Cozzolino, M., additional, Adamczak, M., additional, Wiecek, A., additional, Kuczera, P., additional, Sezer, S., additional, Bal, Z., additional, Tutal, E., additional, Kal, O., additional, Yavuz, D., additional, Y ld r m, I., additional, Sayin, B., additional, Ozelsancak, R., additional, Ozkurt, S., additional, Turk, S., additional, Ozdemir, N., additional, Lehmann, R., additional, Roesel, M., additional, Fritz, P., additional, Braun, N., additional, Ulmer, C., additional, Steurer, W., additional, Dagmar, B., additional, Ott, G., additional, Dippon, J., additional, Alscher, D., additional, Kimmel, M., additional, Latus, J., additional, Turkvatan, A., additional, Balci, M., additional, Mandiroglu, S., additional, Seloglu, B., additional, Alkis, M., additional, Serin, M., additional, Calik, Y., additional, Erkula, S., additional, Gorboz, H., additional, Mandiroglu, F., additional, Lindley, E., additional, Cruz Casal, M., additional, Rogers, S., additional, Pancirova, J., additional, Kernc, J., additional, Copley, J. B., additional, Fouque, D., additional, Kiss, I., additional, Kiss, Z., additional, Szabo, A., additional, Szegedi, J., additional, Balla, J., additional, Ladanyi, E., additional, Csiky, B., additional, orkossy, O., additional, Torok, M., additional, Turi, S., additional, Ambrus, C., additional, Deak, G., additional, Tisler, A., additional, Kulcsar, I., additional, K d r, V., additional, Altuntas, A., additional, Akp nar, A., additional, Orhan, H., additional, Sezer, M., additional, Filiopoulos, V., additional, Manolios, N., additional, Arvanitis, D., additional, Pani, I., additional, Panagiotopoulos, K., additional, Vlassopoulos, D., additional, Rodriguez-Ortiz, M. E., additional, Canalejo, A., additional, Herencia, C., additional, Martinez-Moreno, J. M., additional, Peralta-Ramirez, A., additional, Perez-Martinez, P., additional, Navarro-Gonzalez, J. F., additional, Rodriguez, M., additional, Peter, M., additional, Gundlach, K., additional, Steppan, S., additional, Passlick-Deetjen, J., additional, Munoz-Castaneda, J. R., additional, Almaden, Y., additional, Rodriguez-Ortiz, M., additional, Martinez-Moreno, J., additional, Lopez, I., additional, Aguilera-Tejero, E., additional, Hanafusa, N., additional, Masakane, I., additional, Ito, S., additional, Nakai, S., additional, Maeda, K., additional, Suzuki, H., additional, Tsunoda, M., additional, Ikee, R., additional, Sasaki, N., additional, Sato, M., additional, Hashimoto, N., additional, Wang, M.-H., additional, Hung, K.-Y., additional, Chiang, C.-K., additional, Huang, J.-W., additional, Lu, K.-C., additional, Lang, C.-L., additional, Okano, K., additional, Yamashita, T., additional, Tsuruta, Y., additional, Hibi, A., additional, Miwa, N., additional, Kimata, N., additional, Tsuchiya, K., additional, Nitta, K., additional, Akiba, T., additional, Harb, L., additional, Komaba, H., additional, Kakuta, T., additional, Suga, T., additional, Fukagawa, M., additional, Kikuchi, H., additional, Shimada, H., additional, Karasawa, R., additional, Suzuki, M., additional, Zhelyazkova-Savova, M., additional, Gerova, D., additional, Paskalev, D., additional, Ikonomov, V., additional, Zortcheva, R., additional, Galunska, B., additional, Jean, G., additional, Deleaval, P., additional, Hurot, J.-M., additional, Lorriaux, C., additional, Mayor, B., additional, Chazot, C., additional, Vannucchi, H., additional, Vannucchi, M. T., additional, Martins, J. C., additional, Merino, J. L., additional, Teruel, J. L., additional, Fernandez-Lucas, M., additional, Villafruela, J. J., additional, Bueno, B., additional, Gomis, A., additional, Paraiso, V., additional, Quereda, C., additional, Ibrahim, F. H., additional, Fadhlina, N. Z., additional, Ng, E. K., additional, Thong, K. M., additional, Goh, B. L., additional, Sulaiman, D. M., additional, Fatimah, D. A. N., additional, Evi, D. O., additional, Siti, S. R., additional, Wilson, R. J., additional, Keith, M., additional, Gros, B., additional, Galan, A., additional, Herrero, J. A., additional, Oyaguez, I., additional, Casado, M. A., additional, Lucisano, S., additional, Coppolino, G., additional, Villari, A., additional, Cernaro, V., additional, Lupica, R., additional, Trimboli, D., additional, Aloisi, C., additional, and Buemi, M., additional

Published
2013
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27. Nutrition / inflammation

Author

Wong, M. M. Y., primary, Thijssen, S., additional, Usvyat, L. A., additional, Kotanko, P., additional, Maddux, F. W., additional, Speer, T., additional, Rohrer, L., additional, Blyzszuk, P., additional, Krankel, N., additional, Zewinger, S., additional, Martin, T., additional, von Eckardstein, A., additional, Luscher, T., additional, Landmesser, U., additional, Fliser, D., additional, Prats, M., additional, Font, R., additional, Garcia, C., additional, Cabre, C., additional, Jariod, M., additional, Martinez Vea, A., additional, Costa, E., additional, Ribeiro, S., additional, do Sameiro-Faria, M., additional, Rocha-Pereira, P., additional, Kohlova, M., additional, Fernandes, J., additional, Reis, F., additional, Miranda, V., additional, Quintanilha, A., additional, Bronze-da-Rocha, E., additional, Belo, L., additional, Santos-Silva, A., additional, Nascimento, H., additional, Schepers, E., additional, Glorieux, G., additional, Van den Abeele, T., additional, Neirynck, N., additional, Vanholder, R., additional, Boelaert, J., additional, Liabeuf, S., additional, Massy, Z., additional, Kaynar, K., additional, Kural, B. V., additional, Ulusoy, S., additional, Cansiz, M., additional, Akcan, B., additional, Misir, N., additional, Yaman, S., additional, Kaya, N., additional, Dimas, G. G., additional, Iliadis, F. S., additional, Tegos, T. J., additional, Spiroglou, S. G., additional, Pitsalidis, C. G., additional, Karamouzis, I. M., additional, Didaggelos, T. P., additional, Adamidou, A. P., additional, Savopoulos, C. G., additional, Karamouzis, M. I., additional, Orologas, A. G., additional, Hatzitolios, A. I., additional, Grekas, D. M., additional, Flisinski, M., additional, Brymora, A., additional, Stefanska, A., additional, Strozecki, P., additional, Manitius, J., additional, Khalfina, T. N., additional, Maksudova, A. N., additional, Valeeva, I. K., additional, Bantis, C., additional, Kouri, N.-M., additional, Bamichas, G., additional, Stangou, M., additional, Tsantekidou, E., additional, Natse, T., additional, Fazio, M. R., additional, Basile, G., additional, Lucisano, S., additional, Montalto, G., additional, Valeria, C., additional, Donato, V., additional, Lupica, R., additional, Trimboli, D., additional, Aloisi, C., additional, Buemi, M., additional, Henze, A., additional, Raila, J., additional, Scholze, A., additional, Schweigert, F., additional, Tepel, M., additional, Nakamichi, R., additional, Prates, E., additional, Redublo Quinto, B. M., additional, Zanella, M. T., additional, Batista, M. C., additional, Masajtis-Zagajewska, A., additional, Kurnatowska, I., additional, Wajdlich, M., additional, Nowicki, M., additional, Mennini, F., additional, Russo, S., additional, Marcellusi, A., additional, Quintaliani, G., additional, Andrulli, S., additional, Chiavenna, C., additional, Bigi, M. C., additional, Tentori, F., additional, Crepaldi, M., additional, Corti, M. M., additional, Dell'Oro, C., additional, Bacchini, G., additional, Limardo, M., additional, Pontoriero, G., additional, Williams, C., additional, Abbas, S. R., additional, Zhu, F., additional, Flores-Gama, C., additional, Moskowitz, J., additional, Cartagena, C., additional, Carter, M., additional, Levin, N., additional, de Oliveira, R. B., additional, Okazaki, H., additional, Lenglet, A., additional, Desjardins, L., additional, Lemke, H.-D., additional, Valholder, R., additional, Choukroun, G., additional, and Massy, Z. A., additional

Published
2013
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28. Proteinuria and blood pressure as causal components of progression to end-stage renal failure

Author

Locatelli, F., Marcelli, D., Comelli, M., Alberti, D., Graziani, G., Buccianti, G., Redaelli, B., Giangrande, A., Marai, P., Tentori, F., Ponti, R., Ambroso, G., Aroldi, A., Ponticelli, C., Gentile, M. G., Manna, M. G., D'Amico, G., Cresseri, D., Lorenz, M., Vigano, M. R., Bonoldi, G., Castighoni, A., Donati, D., Gastaldi, L., Como, G., Silenzio, R., Brancaccio, D., Gotti, E., Mecca, G., Dozio, B., Cairo, G., Conte, F., Meroni, M., Sessa, A., Picardi, L., Villa, G., Salvadeo, A., Cosci, P., Surian, M., Depetri, C., Mileti, M., Bracchi, O., Giraldi, B., Grassi, C., Reina, E., Malcangi, U., Ramello, A., Baruffaldi, M., Baroni, C., Guida, G. E., Verzetti, G., Costantino, A., Vallino, F., Bassi, S., Poiatti, P., Castellani, A., Gaiani, G., Lusvarghi, E., Francucci, B. M., and Battiros, G.

Subjects
Proteinuria, Multicentre, End-stage renal failure, Blood pressure, Hypertension, Prognostic factors, Prospective randomized trial
Published
1996

30. Bone and mineral diseases - 2

Author

Block, G., primary, Bell*, G., additional, Pickthorn, K., additional, Huang, S., additional, Martin, K., additional, Tentori, F., additional, Bieber, B., additional, Morgenstern, H., additional, Jacobson, S., additional, Andreucci, V., additional, Fukagawa, M., additional, Mendelssohn, D., additional, Pisoni, R., additional, Robinson, B., additional, De Schutter, T., additional, Neven, E., additional, Behets, G., additional, Peter, M., additional, Steppan, S., additional, Passlick-Deetjen, J., additional, D'haese, P., additional, Senatore, F., additional, Manning, A., additional, Nakajima, S., additional, Ushirogawa, Y., additional, Tsuda, K., additional, Egawa, H., additional, Lucisano, G., additional, Seiler, S., additional, Ege, P., additional, Romero de Vorsmann, F., additional, Klingele, M., additional, Lerner-Graber, A.-K., additional, Fliser, D., additional, Heine, G. H., additional, Molony, D., additional, Bellasi, A., additional, Bellizzi, V., additional, Russo, D., additional, and DI Iorio, B., additional

Published
2012
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31. Mineral and bone disease - CKD 5D

Author

Hecking, M., primary, Kainz, A., additional, Bielesz, B., additional, Plischke, M., additional, Beilhack, G., additional, Hoerl, W. H., additional, Sunder-Plassmann, G., additional, Bieglmayer, C., additional, Benchetrit, S., additional, Green, J., additional, Bernheim, J., additional, Golan, E., additional, Oyake, N., additional, Suzuki, K., additional, Itoh, S., additional, Tanabe, K., additional, Fujimori, A., additional, Okada, S., additional, Yamamoto, K., additional, Sakai, M., additional, Kamiura, N., additional, Solenne, P., additional, Guebre-Egziabher, F., additional, Bacchetta, J., additional, Drai, J., additional, Richard, M., additional, Chapurlat, R., additional, Fouque, D., additional, Nowak, Z., additional, Grzegorz, K., additional, Maria, K., additional, Zofia, W., additional, Zamboch, K., additional, Zahalkova, J., additional, Kosatikova, Z., additional, Skypalova, P., additional, Skarda, J., additional, Cunha, J., additional, Boim, M., additional, Ferreira, V., additional, Naves, M., additional, Kikuchi, H., additional, Shimada, H., additional, Takimoto, Y., additional, Karasawa, R., additional, Shimotori, M., additional, Ikarashi, K., additional, Saito, N., additional, Miyazaki, S., additional, Sakai, S., additional, Suzuki, M., additional, Ogata, H., additional, Takeshima, A., additional, Yamamoto, M., additional, Asakura, K., additional, Kato, T., additional, Shishido, K., additional, Koiwa, F., additional, Mizobuchi, M., additional, Kinugasa, E., additional, Akizawa, T., additional, Londrino, F., additional, Corbani, V., additional, Ardini, M., additional, Falqui, V., additional, Zattera, T., additional, Rombola', G., additional, Takeshige, Y., additional, Matsuzaka, K., additional, Ciceri, P., additional, Volpi, E., additional, Brenna, I., additional, Elli, F., additional, Borghi, E., additional, Brancaccio, D., additional, Cozzolino, M., additional, Farrand, K., additional, Copley, J. B., additional, Heise, J., additional, Fridman, M., additional, Keith, M., additional, Silverberg, A., additional, Wilson, R., additional, Poole, L., additional, Jean, G., additional, Bresson, E., additional, Chazot, C., additional, Maduell, F., additional, Arias, M., additional, Sentis, A., additional, Rodriguez, N., additional, Jimenez, S., additional, Alemany, B., additional, Perez, N., additional, Vera, M., additional, Fontsere, N., additional, Carrera, M., additional, Cases, A., additional, Sonikian, M., additional, Miha, T., additional, Skarakis, I., additional, Karatzas, I., additional, Karaitianou, A., additional, Tomanoski, V., additional, Petkovic, D., additional, Curic, I., additional, Hrvacevic, R., additional, Kaperonis, N., additional, Kourvelou, C., additional, Sgantzos, A., additional, Nastou, D., additional, Ntatsis, G., additional, Ziakka, S., additional, Karakasis, F., additional, Nikolopoulos, V., additional, Zoubaniotou, D., additional, Koutsovasili, A., additional, Zagorianakos, A., additional, Kolovos, V., additional, Papagalanis, N., additional, Forni, V., additional, Pruijm, M., additional, Tousset, E., additional, Zweiacker, C., additional, Menetrey, I., additional, Berwert, L., additional, Bullani, R., additional, Cherpillod, A., additional, Gabutti, L., additional, Gauthier, T., additional, Halabi, G., additional, Mathieu, C., additional, Meier, P., additional, Phan, O., additional, Pianca, S., additional, Schoenholzer, C., additional, Teta, D., additional, Von Albertini, B., additional, Vrijens, B., additional, Burnier, M., additional, Kurita, N., additional, Fukagawa, M., additional, Onishi, Y., additional, Yamaguchi, T., additional, Hasegawa, T., additional, Fukuma, S., additional, Kurokawa, K., additional, Fukuhara, S., additional, Urena, P., additional, Bridges, I., additional, Christiano, C., additional, Cournoyer, S., additional, Cooper, K., additional, Farouk, M., additional, Kopyt, N., additional, Rodriguez, M., additional, Zehnder, D., additional, Covic, A., additional, Tominaga, Y., additional, Hiramitsu, T., additional, Yamamoto, T., additional, Nanmoku, K., additional, Matsuda, Y., additional, Tsuzuki, T., additional, Lang, C.-L., additional, Lu, K.-C., additional, Wang, M.-H., additional, Liu, S.-Y., additional, Huang, J.-W., additional, Chiang, C.-K., additional, Hung, K.-Y., additional, Bantis, C., additional, Kouri, N.-M., additional, Tsandekidou, E., additional, Frangidis, S., additional, Tsiandoulas, A., additional, Liakou, E., additional, Bamichas, G., additional, Stangou, M., additional, Papagianni, A., additional, Efstratiadis, G., additional, Natse, T., additional, Memmos, D., additional, Messa, P., additional, Cannella, G., additional, Mazzaferro, S., additional, Yu, X., additional, Bieber, B., additional, Guidinger, M., additional, Yang, X., additional, Tentori, F., additional, Pisoni, R., additional, Qian, J., additional, Chen, N., additional, Yan, Y., additional, Wang, M., additional, Zuo, L., additional, Wang, H., additional, Albert, J., additional, Ramirez, S., additional, Caccetta, F., additional, Caroppo, M., additional, Musio, F., additional, Mudoni, A., additional, Accogli, A., additional, Zacheo, M. D., additional, Nuzzo, V., additional, Selim, G., additional, Stojceva-Taneva, O., additional, Tozija, L., additional, Gelev, S., additional, Pusevski, V., additional, Dzekova-Vidimliski, P., additional, Rambabova-Busletic, I., additional, Sikole, A., additional, Esposito, P., additional, Coppo, R., additional, Malberti, F., additional, Dal Canton, A., additional, Moriwaki, K., additional, Komaba, H., additional, Kakuta, T., additional, Cernaro, V., additional, Lupica, R., additional, Donato, V., additional, Lacquaniti, A., additional, Fazio, M. R., additional, Lucisano, S., additional, Buemi, M., additional, Okuno, S., additional, Ishimura, E., additional, Tsuboniwa, N., additional, Norimine, K., additional, Yamakawa, K., additional, Yamakawa, T., additional, Shoji, S., additional, Mori, K., additional, Nishizawa, Y., additional, Inaba, M., additional, Dahaba, M., additional, Seck, S., additional, Cisse, M., additional, Jotoku, Y., additional, Sato, Y., additional, Dimkovic, N., additional, Asicioglu, E., additional, Kahveci, A., additional, Arikan, H., additional, Koc, M., additional, Tuglular, S., additional, Ozener, C., additional, Kido, R., additional, Yamaguch, T., additional, Krasniak, A., additional, Drozdz, M., additional, Chmiel, G., additional, Podolec, P., additional, Pasowicz, M., additional, Kowalczyk-Michalek, M., additional, Sulowicz, W., additional, Perez-Suarez, G., additional, Baamonde, E., additional, Bosch, E., additional, Ramirez, J. I., additional, El Hayek, B., additional, Lago, M. D. M., additional, Garcia, C., additional, Checa, M. D., additional, Hiramatsu, R., additional, Ubara, Y., additional, Salas, K., additional, Vicent, E. S., additional, Gonzalez Oliva, J. C., additional, Fulquet, M., additional, Duarte, V., additional, Pou, M., additional, Saurina, A., additional, Macias, J., additional, Ramirez de Arellano, M., additional, Matias, P., additional, Jorge, C., additional, Mendes, M., additional, Amaral, T., additional, Ferreira, C., additional, Aires, I., additional, Gil, C., additional, Ferreira, A., additional, Arcal, C., additional, Campistol, J. M., additional, Seferi, S., additional, Rroji, M., additional, Likaj, E., additional, Petrela, E., additional, Barbullushi, M., additional, Zeneli, N., additional, Mumajesi, S., additional, Thereska, N., additional, Vulpio, C., additional, Bossola, M., additional, Stigliano, E., additional, Fadda, G., additional, Gueiros, A. P. S., additional, Borba Junior, J. O., additional, Lordsllen, A. B. d. M. D. S., additional, Gueiros, J. E. d. B., additional, Itami, N., additional, Tuneyama, K., additional, Uemura, S., additional, Hamada, H., additional, Takada, J., additional, Takahashi, K., additional, Adamidis, K., additional, Apostolou, T., additional, Pleros, C., additional, Oikonomaki, T., additional, Kyratzi, E., additional, Exarchos, D., additional, Metaxatos, G., additional, Dracopoulos, S., additional, Nikolopoulou, N., additional, Delanaye, P., additional, Dubois, B., additional, Krzesinski, J.-M., additional, Cavalier, E., additional, De la Fuente, V., additional, Gil, M. T., additional, Gutierrez, P., additional, Delgado, P., additional, Ribero, J., additional, Arenas, L., additional, Sezer, S., additional, Tutal, E., additional, Bal, Z., additional, Erkmen Uyar, M., additional, Ozdemir Acar, F. N., additional, Azevedo de Oliveira, R., additional, Carvalho Barreto, F., additional, Dos Reis, L., additional, Cunha Ferreira, J., additional, Maria Leme Britto, Z., additional, Maria Moyses, R., additional, Jorgetti, V., additional, Ozelsancak, R., additional, Gurlek Demirci, B., additional, Torun, D., additional, Veljancic, L., additional, Radojevic, M., additional, Paunic, Z., additional, Vavic, N., additional, Obrencevic, K., additional, Kovacevic, Z., additional, and Pejovic, J., additional

Published
2012
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32. Longer dialysis session length is associated with better intermediate outcomes and survival among patients on in-center three times per week hemodialysis: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Author

Tentori, F., primary, Zhang, J., additional, Li, Y., additional, Karaboyas, A., additional, Kerr, P., additional, Saran, R., additional, Bommer, J., additional, Port, F., additional, Akiba, T., additional, Pisoni, R., additional, and Robinson, B., additional

Published
2012
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34. Physical exercise among participants in the Dialysis Outcomes and Practice Patterns Study (DOPPS): correlates and associated outcomes

Author

Tentori, F., primary, Elder, S. J., additional, Thumma, J., additional, Pisoni, R. L., additional, Bommer, J., additional, Fissell, R. B., additional, Fukuhara, S., additional, Jadoul, M., additional, Keen, M. L., additional, Saran, R., additional, Ramirez, S. P. B., additional, and Robinson, B. M., additional

Published
2010
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35. [Diet therapy in preventing the progression of chronic renal insufficiency]

Author

Locatelli F, Tentori F, Daniele Marcelli, Mc, Bigi, and Marai P

Subjects
Humans, Kidney Failure, Chronic, Dietary Proteins, Prospective Studies, Randomized Controlled Trials as Topic
Abstract

The effect of a low protein diet (LPD) on the progression of chronic renal insufficiency (CRI) was investigated by reviewing the published studies. Only the trials of Rosman, Ihle and Locatelli fulfilled the main methodological criteria of being randomized, prospective and controlled. They involved 811 patients (671 evaluated: 338 on an LPD, 333 as controls) and had a mean follow-up of 29 months (range 18-48) for an estimated total of about 17,335 patient-months. The only trial whose results showed that LPD had a positive effect on the progression of chronic renal failure (CRF) was Ihle's study with the lowest weight (6.7%) and which involved the most severe CRF; effects limited to the patients with more advanced CRF were found in Roman's study, with an intermediate weight (41.8%); and little effect, if any, in Locatelli's trial accounting for 51.5% of patient-months, with less severe CRI. In conclusion, analysis of published randomized, prospective and controlled trials offers little or no evidence for the hypothesis that an LPD has a greater clinically significant effect on early CRI progression than a controlled protein diet, although a very low protein diet seems to postpone the need for dialysis.

Published
1993

36. The survival advantage for haemodialysis patients taking vitamin D is questioned: findings from the Dialysis Outcomes and Practice Patterns Study

Author

Tentori, F., primary, Albert, J. M., additional, Young, E. W., additional, Blayney, M. J., additional, Robinson, B. M., additional, Pisoni, R. L., additional, Akiba, T., additional, Greenwood, R. N., additional, Kimata, N., additional, Levin, N. W., additional, Piera, L. M., additional, Saran, R., additional, Wolfe, R. A., additional, and Port, F. K., additional

Published
2008
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43. Prevention of Chronic Renal Failure Progression

Author

Locatelli, F., Tentori, F., Marcelli, D., Bigi, M.C., Marai, P., Locatelli, F., Tentori, F., Marcelli, D., Bigi, M.C., and Marai, P.

Abstract

No abstract, non disponibile

Published
1993

46. Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Author

Tentori F, Blayney MJ, Albert JM, Gillespie BW, Kerr PG, Bommer J, Young EW, Akizawa T, Akiba T, Pisoni RL, Robinson BM, and Port FK

Abstract

BACKGROUND: Abnormalities in serum calcium, phosphorus, and parathyroid hormone (PTH) concentrations are common in patients with chronic kidney disease and have been associated with increased morbidity and mortality. No clinical trials have been conducted to clearly identify categories of calcium, phosphorus, and PTH levels associated with the lowest mortality risk. Current clinical practice guidelines are based largely on expert opinions, and clinically relevant differences exist among guidelines across countries. We sought to describe international trends in calcium, phosphorus, and PTH levels during 10 years and identify mortality risk categories in the Dialysis Outcomes and Practice Patterns Study (DOPPS), an international study of hemodialysis practices and associated outcomes. STUDY DESIGN: Prospective cohort study. PARTICIPANTS: 25,588 patients with end-stage renal disease on hemodialysis therapy for longer than 180 days at 925 facilities in DOPPS I (1996-2001), DOPPS II (2002-2004), or DOPPS III (2005-2007). PREDICTORS: Serum calcium, albumin-corrected calcium (Ca(Alb)), phosphorus, and PTH levels. OUTCOMES: Adjusted hazard ratios for all-cause and cardiovascular mortality calculated using Cox models. RESULTS: Distributions of mineral metabolism markers differed across DOPPS countries and phases, with lower calcium and phosphorus levels observed in the most recent phase of DOPPS. Survival models identified categories with the lowest mortality risk for calcium (8.6 to 10.0 mg/dL), Ca(Alb) (7.6 to 9.5 mg/dL), phosphorus (3.6 to 5.0 mg/dL), and PTH (101 to 300 pg/mL). The greatest risk of mortality was found for calcium or Ca(Alb) levels greater than 10.0 mg/dL, phosphorus levels greater than 7.0 mg/dL, and PTH levels greater than 600 pg/mL and in patients with combinations of high-risk categories of calcium, phosphorus, and PTH. LIMITATIONS: Because of the observational nature of DOPPS, this study can only indicate an association between mineral metabolism categories and mortality. CONCLUSIONS: Our results provide important information about mineral metabolism trends in hemodialysis patients in 12 countries during a decade. The risk categories identified in the DOPPS cohort may be relevant to efforts at international harmonization of existing clinical guidelines for mineral metabolism. [ABSTRACT FROM AUTHOR]

Published
2008
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48. Impact of the Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines for Bone Metabolism and Disease in a large dialysis network.

Author

Wald R, Tentori F, Tighiouart H, Zager PG, and Miskulin DC

Abstract

BACKGROUND: The impact of the Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease has not been assessed. METHODS: We compared albumin-adjusted serum calcium, phosphate, calcium x phosphate (Ca x P) product, and parathyroid hormone (PTH) values among active hemodialysis patients who received care at Dialysis Clinic Inc facilities during 8-month periods before (n = 9,516) and after (n = 9,543) the October 2003 release of the KDOQI guidelines. We examined the impact of missed sessions, abbreviated sessions, and patient-dietitian ratio on achievement of consistent control (defined as >or= 75% values within guideline targets) for each parameter. We also evaluated whether achievement of consistent control of a given parameter precluded control of another. RESULTS: There was a modest decrease in mean per-patient concentration for all mineral metabolic indicators after release of the guidelines. Similarly, the proportion of values within the recommended ranges for serum calcium, phosphate, and Ca x P product increased, but remained unchanged for PTH. The likelihood of achieving consistent control for each indicator increased when other parameters were concomitantly in range. Missed dialysis sessions were associated with a lower likelihood of achieving consistent control of calcium, phosphate, and Ca x P product levels, whereas abbreviated sessions were associated inversely with consistent achievement of phosphate and Ca x P product target levels. Variations in patient-dietitian ratio had no discernible association with mineral metabolic control. CONCLUSION: The KDOQI Clinical Practice Guidelines for Bone Metabolism and Disease had a small, but noticeable, effect in the year after their release. Additional studies should evaluate whether achievement of the prescribed target levels confers an advantage with respect to relevant clinical outcomes. Copyright © 2007 by the National Kidney Foundation, Inc. [ABSTRACT FROM AUTHOR]

Published
2007
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50. Sodium removal during pre-dilution haemofiltration

Author

Filippo, S. Di, Manzoni, C., Andrulli, S., Tentori, F., and Locatelli, F.

Abstract

Background. Cardiovascular instability still affects a large percentage of uraemic patients undergoing extracorporeal substitutive treatments. Post-dilution haemofiltration has been reported to be a method for improving cardiovascular stability; however, the limited removal of small molecular weight solutes together with the need for high blood flow from the fistula greatly restrict the use of this treatment. To increase the solute clearances and to partially resolve the necessity for high blood flow, the replacement solution, in a quantity about double that used in post-dilution mode, can be administered in pre-dilution mode. A high vascular stability has also been observed for pre-dilution haemofiltration. Since the lower morbidity may be due to less sodium removal when compared with haemodialysis, it would be important to characterize the sodium transport in this kind of treatment.
Methods. Nine patients underwent nine pre-dilution haemofiltration treatments (one for each patient) with on-line prepared substitution fluid.
Results. As mean values, total (NaFpw) and ionized (NaEpw) plasma water sodium concentrations increased from 149.4 ± 2.8 mEq/l to 151.1 ± 2.4 mEq/l, and from 143.1 ± 2.8 to 144.5 ± 1.2 mEq/l, respectively, during the treatment, suggesting a hypotonic concentration of net ultrafiltrate. Plotting the difference between final and initial ionized plasma water concentrations (fNaEpw - iNaEpw) against the difference between initial plasma water values and ionized sodium concentration in the reinfusate (iNaEpw - NaER), a significant negative correlation was found, with the regression line that intercepts the abscissa at the (iNaEpw - NaER) value of 8.8 mEq/l; this means that to avoid changes in NaEpw in our patients, the NaER should be lower than the iNaEpw by this amount. This is quite different from the theoretical value of ∼4 mEq/l necessary to avoid changes in NaEpw during haemodialysis. The ratio between the total sodium concentration in the ultrafiltrate (NaFuf) and NaFpw (α) at the post-reinfusion site was 0.96 and decreased to 0.94 when NaFpw values at the pre-reinfusion site were considered. This last value is quite close to the theoretical α value of post-dilution haemofiltration.
Conclusion. As for post-dilution haemofiltration, less sodium removal, compared with haemodialysis, can partly explain the improved cardiovascular stability during pre-dilution haemofiltration.

Published
2003

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