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BACKGROUND AND OBJECTIVES Prognostic information is rarely conveyed by nephrologists because of clinical uncertainty about accuracy. The objective of this study was to develop an integrated prognostic model of 6-mo survival for patients who receive hemodialysis (HD). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A short-term prognostic model was developed(More)
Patients with advanced chronic kidney disease (CKD) have a high burden of physical and psychosocial symptoms, poor outcomes, and high costs of care. Current paradigms of care for this highly vulnerable population are variable, prognostic and assessment tools are limited, and quality of care, particularly regarding conservative and palliative care, is(More)
BACKGROUND The current study was designed to examine the effect of 12 weeks of resistance training on strength and functional ability in 10 medically stable hemodialysis patients (age, 42.8 +/- 4.4 years). METHODS Subjects were tested on four separate occasions, each separated by 6 weeks. The first (T1) and second tests (T2) were controls with no exercise(More)
Renal failure is a common medical condition, and many patients have comorbid psychiatric disorders. In this review, which is intended as a resource for consultation psychiatrists, the authors discuss pharmacokinetic considerations and provide information about the use of individual psychotropic medications in patients with renal disease. Most psychotropic(More)
BACKGROUND Calcitriol lowers parathyroid hormone (PTH) levels in patients with chronic kidney disease (CKD) stages 3 and 4, but its use is limited by a low therapeutic index and concerns regarding hypercalcemia and acceleration of kidney disease. We evaluated doxercalciferol (1alpha-hydroxyvitamin D2) as an alternative therapy in a randomized,(More)
BACKGROUND AND OBJECTIVES Although uremic pruritus (UP) is a highly prevalent complication of chronic kidney disease, it remains poorly characterized. There have been no longitudinal studies of natural history, and no health-related quality of life (HR-QOL) instruments have been developed for UP. The objectives of this study were to describe the natural(More)
OBJECTIVE To examine the hypothesis that 12 weeks of resistance training would alter circulating concentrations of IGF-I system components in end-stage renal disease (ESRD) patients. DESIGN Ten ESRD patients underwent 12 weeks of resistance training after a 6 week control period and had morning fasted blood drawn on four occasions (weeks - 6, 0, 6, 12).(More)
PURPOSE The current pilot and feasibility study was designed to examine the effect of 48 wk of moderate-intensity exercise training and dietary modification on kidney function and vascular parameters in chronic kidney disease (CKD) patients. METHODS Twenty-one stage 2-4 CKD patients (age, 18-70 yr) were randomly assigned to either the training group (TG,(More)
BACKGROUND AND OBJECTIVES More than 90,000 patients with ESRD die annually in the United States, yet advance care planning (ACP) is underutilized. Understanding patients' and families' diverse needs can strengthen systematic efforts to improve ACP. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In-depth interviews were conducted with a purposive sample of(More)
Studies performed at large metropolitan medical centers have reported an increasing incidence of idiopathic focal segmental glomerulosclerosis (FSGS) in adults. To determine whether a similar trend occurs in small urban and rural communities and to determine the role of race in these observations, we reviewed the patient records of all adults who underwent(More)