Advances in CKD 2008 (RRI Conference, Cancun, Mexico, January, 2008).


Vanholder: : Uremic toxins: do we know enough to explain uremia? Kotanko: How do various aspects of body composition seriously affect dialysis outcomes (more...)

key Try Dr. Daugirdas' QUIZ: Solute Molecular Weight, Diffusion, Ultrafiltration, and Flux. This is the second in the Basic Dialysis Quiz Series. In fact, the first quiz should be considered a pre-requisite. What is the effect of solute molecular weight on diffusive transport? On transport by ultrafiltration? What is a high efficiency vs. a high-flux dialyzer? What are the relative transport rates for urea and beta-2-microglobulin with these dialyzers?
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key Try Dr. Daugirdas' QUIZ: Basics of Dialyzer Function: Extraction ratio and clearance. What is the dialyzer extraction ratio (ER)? How is the ER used to derive dialyzer clearance? How do blood and dialysate flow affect the extraction ratio and clearance? What is the dialyzer mass transfer area coefficient (K0A)? How does use of twin dialyzers in series or parallel improve extraction ratio and clearance? When does the dialyzer size matter?.?
Note: Feedback sections of this quiz will work ONLY with internet explorer and not with Firefox.

Updated: January 04, 2018 (Jan04)
Jan04 J-curve in BP studies is an artifact - similar to dose targeting bias in HEMO.
Dec14 Even more news on the new HDCN Facebook page!
Dec01 ISHD Home Dialysis Toolkit: Prescriptions for Home HD (Module 9)
Aug30 High blood flow rate and high negative venous pressure lead to microbubbles
Dec14 Tall people have lower amounts of coronary artery plaque.
Feb16 JASN: Full text of RCT comparing hemodiafiltration to hemodialysis.
Feb16 Randomized trial shows that switching from HD to online-HDF lowers mortality by 30%.
Nov01 DOPPS practice monitor updated in October 2012
Nov01 Sodium-modified hemodiafiltration use results in lower intradialytic hypotension
Oct09 Kidney disease alters gut bacteria composition.
Oct05 Incenter short daily hemodialysis associated with INCREASED mortality.
Sep27 University of Pennsylvania and LDOs to launch hemodialysis TIME trial as part of NIH HCS Research Collaboratory
Aug16 Adjusting and setting the dialysate total base concentration differs by dialysis machine.
Aug16 DOPPS Practice Monitor website
May01 Randomized trial of hemodiafiltration vs. low-flux dialysis shows no overall benefit.
Industry Advances Emphasis
Dialyzers and Dialysis Adequacy (Curtis) NANT 2009
Timing of Dialysis: Is it K, T, or V? (F. Clark) ASN Renal Week 2008
Hemodialysis Is the Best Therapy (Kjellstrand) ADC 2008
In-Center HD (Friedman) ADC 2008
Why the Stress on Biocompatibility? Inflammation in Dialysis and Its Consequences (Pecoits-Filho) ADC 2008
Peritoneal Dialysis Is the Best Therapy (Mujais) ADC 2008
Debate Part I CKD Stage V in the aged population (>70 yrs): dialysis or (low protein) diet? (Misra) RRI 2008
Uremic toxins: do we know enough to explain uremia? (C. Vanholder) RRI 2008
How do various aspects of body composition seriously affect dialysis outcomes (Kotanko) RRI 2008
Debate Part II CKD Stage V in the aged population (>70 yrs): dialysis or (low protein) diet? (Brunori) RRI 2008
What a nephrologist should understand about a dialysis machine (A. Ward) RRI 2008
Understanding the Federal ESRD survey process: current issues & future directions (Kari) RRI 2008
Understanding the finances of a dialysis facility and its medical director (B. DeOreo) RRI 2008
How dialysis membranes can affect outcome - new developments (Ofsthun) RRI 2008
How water quality & dialysate composition affect dialysis practice (A. Hoenich) RRI 2008
Debate Part II CKD Stage V in the aged population (>70 yrs): dialysis or (low protein) diet? (Brunori) RRI 2008
Kt/V is a Measure of Adequate But Not Optimal Dialysis (S. Kenley) ADC 2007
What is the Difference Between Adequate and Optimal Dialysis? (M. Kjellstrand) ADC 2007
Debate: The New K/DOQI Guidelines Provide Safe and Adequate Standards (M. Bargman) RRI 2007
Debate: The Treatment Time and Ultrafiltration Rate Are More Important in Dialysis Prescription than Small Molecule Clearance (J. Twardowski) RRI 2007
Does size matter ? How new studies on body composition can improve understanding of outcomes in dialysis patients (Kotanko) RRI 2007
Difficulties in Providing Adequate Dialysis (Diaz-Buxo) RRI 2007
A Kinetic Model of Calcium Mass Balance During Dialysis Therapy (Gotch) RRI 2007
Debate: The Treatment Time and Ultrafiltration Debate (Gotch) RRI 2007
Debate: The 2006 K/DOQI Guidelines for Peritoneal Dialysis Adequacy Are Not Adequate (Winchester) RRI 2007
Debate: Hemodialysis Adequacy: Observational Research Results are Often Misleading! (T. Daugirdas) RRI 2007
Debate: Observational Research Generates Many New Insights into Dialysis (K. Port) RRI 2007
Emerging Dialysis Techniques (Derrick Latos, MD; Robert S. Lockridge, Jr., MD) ADC 2006 (audiofiles)
What Do We Know About Uremic Toxins? (William R. Clark, MD; Bernard J. Canaud, MD; Thomas A. Depner, MD; Muriel P.C. Grooteman, MD, PhD) ADC 2006 (audio only)
Solute Kinetics 101, or Understanding Kinetic Modeling for the Non-Mathematician (Ting) ADC 2006 - (audio only)
Hemodiafiltration (HDF) A Critical Evaluation of its Value (Ronco) RRI 2006 - Part 2 (handout only)
New Important Technologies. Oral Sorbents in Uremia: Early Results (Schulman) RRI 2006 - Part 3 (handout only)
The Significance of Residual Renal Function Is it the Pee or the Bean? (Burkart) RRI 2006 - Part 3 (handout only)
Dialysis Kinetic Q and A (Gotch) RRI 2006 - Part 1 (handout only)
Uric Acid as a Uremic Toxin (Ikizler, Nakagawa) RRI 2006 - Part 2 (handout only)
Sodium as a Uremic Toxin (Ritz) RRI 2006 - Part 2 (handout only)
Preservation of residual renal function in hemodialysis patients (Lameire) ASN Renal Week 2005
Assessment of Dialysis Adequacy Using Urea Kinetics (Depner) ASN Renal Week 2005 (audio only)
Determinants of Diffusive and Convective Solute Transport (Clark) ASN Renal Week 2005 (audio only)
Renal Replacement Therapy in ARF -- Timing and Dose of Therapy (Palevsky) ASN Renal Week 2005 (audio only)
Clinical Trials in Dialysis: An Appraisal of Results and Ongoing Trials (Cheung) ASN Renal Week 2005 (audio only)
The Uremic Syndrome (Vanholder) ASN Renal Week 2005 (audio only)
Hemodiafiltration (HDF): Theory, Quantification, Clinical Management (Canaud, Clark, Kjellstrand, Traeger, Akiba) ADC 2005 (audio only)
Dialysis Adequacy vs. Mortality: Implications of Dose Targeting Biases (Daugirdas) RRI 2005 (audio only)
DEBATE: Are practice patterns the prime factors responsible for mortality differences between Europe, Japan and USA? (Kuhlmann vs. Young) RRI 2005 (audio only)
Dialysis Dose: Measurement, prescription and delivery - case discussions (Paganini) ASN Renal Week
How should ADEMEX affect PD practice in the United States? (Teitelbaum) NKF 2002 Spring Meeting
Peritoneal dialysis adequacy: what is the role of ADEMEX? (Mujais) NKF 2002 Spring Meeting
Kt/V, body mass determinants, and survival (Daugirdas) ASN/ISN 2001 Meeting
Physician extenders in the dialysis unit (Bolton) RPA 2001 Annual Meeting

Citrate- vs. acetate-based dialysate in bicarbonate haemodialysis: consequences on haemodynamics, coagulation, acid-base status, and electrolytes (Gabutti et al) BMC Nephrol (March 2009)
Primary care-based disease management of chronic kidney disease (CKD), based on estimated glomerular filtration rate (eGFR) reporting, improves patient outcomes Nephrol Dial Transplant (Feb 2008)
The impact of population-based identification of chronic kidney disease using estimated glomerular filtration rate (eGFR) reporting Nephrol Dial Transplant (Feb 2008)
Recent advances in the prevention and management of intradialytic hypotension J Am Soc Nephrol (Jan 2008)
Dry Weight: Sine qua non of adequate dialysis (Wystrychowski et al) Adv Chronic Kidney Dis (Jul 2007)
Impact of glucose levels on advanced glycation end products in hemodialysis (Godfrey) Hemodial Int (Jul 2007)
Major Difficulties the US Nephrologist Faces in Providing Adequate Dialysis (Diaz-Buxo and Crawford-Bonadio) Blood Purification 01-07
International differences in dialysis mortality reflect background general population atherosclerotic cardiovascular mortality. (Yoshino et al.) JASN 12-06
Should dialysis patients ever receive warfarin and for what reasons? (Bennett) CJASN 11-06
2006 Adequacy Update
Topic Pages
Physiology of HD
Modeling, Adequacy
Dialysis Outcomes
Tools, Calculators
Standard Kt/V
Body Surface area and BSA
What is the Kt/V, PCRn, and V?
Dialysis session length, first session
Dialysis session length, V known
Dialyzer K0A
Dialyzer Table (KEY)
Batch calculator (KEY)
Dialyzer Table by Co. (KEY)
Dialysis Facility COMPARE
U Mich Kidney Epid Center
European Uremic Toxin Workgroup (EUTox)
NIH Patient Info on Dose

Dr. John Daugirdas, M.D.
Clinical Professor of Medicine, University of Illinois at Chicago, IL.