Separating the Effects of Hemodialysis Dose and Nutrition: In Search of the Optimal Dialysis Dose

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73859/1/j.1525-139X.1999.90218.x.pd

How Will the Results of the HEMO Study Impact Dialysis Practice?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71984/1/j.1525-139X.2003.03003_3.x.pd

Anatomy of an Encounter

The project Anatomy of an Encounter was driven by the idea that we should not take for granted that we already know what ‘encounters’ are. What does ‘meeting’ another person — with a different cultural or disciplinary background — mean? How much of an encounter is in all actuality a ‘finding one another’? How much of ‘being in touch’ is depending on the work of the imagination — fed by assumptions, existing cultural frames, stereotypes, fantasies about the other?Encounters are at the heart of every ethnographic project: anthropologists no longer claim to be speaking about the other (define the other in his/her otherness; know the other). They study what occurs between themselves and others when they meet. Encounters are also at the heart of the ENCOUNTERS project, where artistically inclined ethnographers and ethnographically inclined artists meet each other. The project Anatomy of an Encounter was driven by the idea that we should not take for granted that we already know what ‘encounters’ are. What does ‘meeting’ another person — with a different cultural or disciplinary background — mean? How much of an encounter is in all actuality a ‘finding one another’? How much of ‘being in touch’ is depending on the work of the imagination — fed by assumptions, existing cultural frames, stereotypes, fantasies about the other

Prevention of dialysis disequilibrium syndrome by use of high sodium concentration in the dialysate

Prevention of dialysis disequilibrium syndrome by use of high sodium concentration in the dialysate. Nine patients, including four undergoing their first hemodialysis, were observed clinically and by hourly electroencephalographic recordings before, during, and three hours after highly efficient hemodialyses during which plasma osmolality was maintained by use of a dialysate with increased concentrations of sodium and chloride. As a control group, 8 patients (five undergoing their first hemodialysis) were similarly studied but with a dialysate of standard composition (Na=133 mEq/liter). The EEG showed definitely increased abnormality in 10 of 13 control dialyses and in 2 of 9 dialyses in the experimental group (P < 0.01). Symptoms suggestive of the dialysis disequilibrium syndrome appeared in nine of the control dialyses but in none of the experimental group (P < 0.001). No ill effects from increased dialysate sodium concentration could be demonstrated during or after a single hemodialysis.Prévention du syndrome de déséquilibre de la dialyse au moyen d'une concentration de sodium élevée dans le dialysat. Neuf malades, dont quatre subissaient leur première hémodialyse, ont été observés cliniquement et au moyen d'enregistrements électro-encéphalographiques horaires pendant et trois heures après des hémodialyses très efficaces où l'osmolalité plasmatique était maintenue constante grace à un dialysat dont les concentrations de sodium et de chlore étaient augmentées. Un groupe contrôle de 8 malades, dont cinq subissaient leur première hémodialyse, a été étudié de la même façon alors que le dialysat avait une composition standard (Na = 133 mEq/1). L'électroencéphalogramme a montré une augmentation patente des anomalies chez 10 des 13 contrôles et chez deux des neuf sujets du groupe expérimental (P < 0.01). Des symptomes suggérant un syndrome de déséquilibre au cours de la dialyse sont apparus chez neuf sujets du groupe contrôle mais seulement chez un sujet du groupe expérimental (P < 0.001). Aucun effet nuisible du à l'augmentation de la concentration du sodium n'a pu être mis en évidence pendant ou après une unique hémodialyse

A Sequential Stratification Method for Estimating the Effect of a Time-Dependent Experimental Treatment in Observational Studies

Survival analysis is often used to compare experimental and conventional treatments. In observational studies, the therapy may change during follow-up and such crossovers can be summarized by time-dependent covariates. Given the ever-increasing donor organ shortage, higher-risk kidneys from expanded criterion donors (ECD) are being transplanted. Transplant candidates can choose whether to accept an ECD organ (experimental therapy), or to remain on dialysis and wait for a possible non-ECD transplant later (conventional therapy). A three-group time-dependent analysis of such data involves estimating parameters corresponding to two time-dependent indicator covariates representing ECD transplant and non-ECD transplant, each compared to remaining on dialysis on the waitlist. However, the ECD hazard ratio estimated by this time-dependent analysis fails to account for the fact that patients who forego an ECD transplant are not destined to remain on dialysis forever, but could subsequently receive a non-ECD transplant. We propose a novel method of estimating the survival benefit of ECD transplantation relative to conventional therapy (waitlist with possible subsequent non-ECD transplant). Compared to the time-dependent analysis, the proposed method more accurately characterizes the data structure and yields a more direct estimate of the relative outcome with an ECD transplant.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66010/1/j.1541-0420.2006.00527.x.pd

The Risk of Cancer for Patients on Dialysis: A Review

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72354/1/j.1525-139X.1991.tb00104.x.pd

Interleukin-1: The Pros and Cons of Its Clinical Relevance

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75148/1/j.1525-1594.1988.tb02759.x.pd