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Hidden risks associated with conventional short intermittent hemodialysis:A call for action to mitigate cardiovascular risk and morbidity 被引量:2
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作者 Bernard Canaud Jeroen P Kooman +6 位作者 Nicholas M Selby Maarten Taal Andreas Maierhofer Pascal Kopperschmidt susan francis Allan Collins Peter Kotanko 《World Journal of Nephrology》 2022年第2期39-57,共19页
The development of maintenance hemodialysis(HD)for end stage kidney disease patients is a success story that continues to save many lives.Nevertheless,intermittent renal replacement therapy is also a source of recurre... The development of maintenance hemodialysis(HD)for end stage kidney disease patients is a success story that continues to save many lives.Nevertheless,intermittent renal replacement therapy is also a source of recurrent stress for patients.Conventional thrice weekly short HD is an imperfect treatment that only partially corrects uremic abnormalities,increases cardiovascular risk,and exacerbates disease burden.Altering cycles of fluid loading associated with cardiac stretching(interdialytic phase)and then fluid unloading(intradialytic phase)likely contribute to cardiac and vascular damage.This unphysiologic treatment profile combined with cyclic disturbances including osmotic and electrolytic shifts may contribute to morbidity in dialysis patients and augment the health burdenof treatment. As such, HD patients are exposed to multiple stressors including cardiocirculatory,inflammatory, biologic, hypoxemic, and nutritional. This cascade of events can be termed thedialysis stress storm and sickness syndrome. Mitigating cardiovascular risk and morbidityassociated with conventional intermittent HD appears to be a priority for improving patientexperience and reducing disease burden. In this in-depth review, we summarize the hidden effectsof intermittent HD therapy, and call for action to improve delivered HD and develop treatmentschedules that are better tolerated and associated with fewer adverse effects. 展开更多
关键词 End stage kidney disease Cardiovascular mortality Dialytic morbidity Circulatory stress Biologic storm Dialysis sickness Personalized medicine
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航海“浪花”一朵朵
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作者 susan francis 《游艇业》 2009年第1期122-127,共6页
驾驶着用两年半时间等来的Nordhavn55游艇,我们战胜了邪恶的飓风,穿过了弥漫的大雾。经过了“致命航线”。这次历时5个半月的航行使我这个“乘客”变成了“船员”,也使家人和朋友之间学会了相互信任和依靠。
关键词 浪花 航海 游艇 驾驶 航线 船员 航行
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