FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 347:2010-2019 December 19, 2002 Number 25 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Himmelfarb, J. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The effects of the dose of dialysis and the level of flux of the dialyzer membrane on mortality and morbidity among patients undergoing maintenance hemodialysis are uncertain.

Methods We undertook a randomized clinical trial in 1846 patients undergoing thrice-weekly dialysis, using a two-by-two factorial design to assign patients randomly to a standard or high dose of dialysis and to a low-flux or high-flux dialyzer.

Results In the standard-dose group, the mean (±SD) urea-reduction ratio was 66.3±2.5 percent, the single-pool Kt/V was 1.32±0.09, and the equilibrated Kt/V was 1.16±0.08; in the high-dose group, the values were 75.2±2.5 percent, 1.71±0.11, and 1.53±0.09, respectively. Flux, estimated on the basis of beta₂-microglobulin clearance, was 3±7 ml per minute in the low-flux group and 34±11 ml per minute in the high-flux group. The primary outcome, death from any cause, was not significantly influenced by the dose or flux assignment: the relative risk of death in the high-dose group as compared with the standard-dose group was 0.96 (95 percent confidence interval, 0.84 to 1.10; P=0.53), and the relative risk of death in the high-flux group as compared with the low-flux group was 0.92 (95 percent confidence interval, 0.81 to 1.05; P=0.23). The main secondary outcomes (first hospitalization for cardiac causes or death from any cause, first hospitalization for infection or death from any cause, first 15 percent decrease in the serum albumin level or death from any cause, and all hospitalizations not related to vascular access) also did not differ significantly between either the dose groups or the flux groups. Possible benefits of the dose or flux interventions were suggested in two of seven prespecified subgroups of patients.

Conclusions Patients undergoing hemodialysis thrice weekly appear to have no major benefit from a higher dialysis dose than that recommended by current U.S. guidelines or from the use of a high-flux membrane.

Source Information

From the Baylor College of Medicine, Houston (G.E.); the Cleveland Clinic Foundation, Cleveland (G.J.B., T.G.); the University of Utah and the Veterans Affairs Salt Lake City Health Care System, Salt Lake City (A.K.C.); the University of Illinois and the Veterans Affairs Chicago Health Care System, Chicago (J.T. Daugirdas); the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md. (J.W.K.); the University of Alabama at Birmingham, Birmingham (M.A.); Emory University Hospital, Atlanta (J.B.); Washington University, St. Louis (J.A.D.); the University of California at Davis, Sacramento (T.A.D.); New England Medical Center, Boston (J.T. Dwyer, A.S.L.); Beth Israel Medical Center, New York (N.W.L.); Brigham and Women's Hospital, Boston (E.M.); the University of Rochester, Rochester, N.Y. (D.B.O.); Wake Forest University, Winston-Salem, N.C. (M.V.R.); Vanderbilt University, Nashville (G.S.); Duke University, Durham, N.C. (S.J.S.); Lankenau Hospital and Medical Research Center, Wynnewood, Pa. (B.P.T.); and the University of Texas Southwestern Medical Center, Dallas (R.T.).

Address reprint requests to Dr. Beck at the HEMO Study Data Coordinating Center, Dept. of Biostatistics and Epidemiology, Wb4, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, or at beckg{at}ccf.org.

Full Text of this Article

Related Letters:

Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis
Scribner B. H., Blagg C. R., Friedman E. A., Hoenich N. A., Locatelli F., Greene T., Cheung A. K., Eknoyan G., the Hemodialysis (HEMO) Study Group , Himmelfarb J.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:1491-1494, Apr 10, 2003. Correspondence

This article has been cited by other articles:

• Okuno, S., Ishimura, E., Kohno, K., Fujino-Katoh, Y., Maeno, Y., Yamakawa, T., Inaba, M., Nishizawa, Y. (2008). Serum {beta}2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients. Nephrol Dial Transplant 0: gfn521v1-gfn521 [Abstract] [Full Text]  
• Ledebo, I., Ronco, C. (2008). The best dialysis therapy? Results from an international survey among nephrology professionals. NDT Plus 0: sfn148v2-sfn148 [Abstract] [Full Text]  
• Dalrymple, L. S., Go, A. S. (2008). Epidemiology of Acute Infections among Patients with Chronic Kidney Disease. CJASN 3: 1487-1493 [Abstract] [Full Text]  
• Lee, C. P., Zenios, S. A., Chertow, G. M. (2008). Cost-Effectiveness of Frequent In-Center Hemodialysis. J. Am. Soc. Nephrol. 19: 1792-1797 [Abstract] [Full Text]  
• Rao, M., Li, L., Tighiouart, H., Jaber, B. L., Pereira, B. J. G., Balakrishnan, V. S., the HEMO Study Group, (2008). Plasma adiponectin levels and clinical outcomes among haemodialysis patients. Nephrol Dial Transplant 23: 2619-2628 [Abstract] [Full Text]  
• Wolf, M. (2008). Active Vitamin D and Survival. J. Am. Soc. Nephrol. 19: 1442-1443 [Full Text]  
• Saudan, P., Kossovsky, M., Halabi, G., Martin, P. Y., Perneger, T. V., for the Western Switzerland Dialysis Study Group, (2008). Quality of care and survival of haemodialysed patients in western Switzerland. Nephrol Dial Transplant 23: 1975-1981 [Abstract] [Full Text]  
• Mehta, R. L., Bouchard, J. (2008). Dialysis Dosage in Acute Kidney Injury: Still a Conundrum?. J. Am. Soc. Nephrol. 19: 1046-1048 [Full Text]  
• Tonelli, M. (2008). Randomized Trials in Hemodialysis Patients: Time to Step Up to the Plate. JAMA 299: 2205-2207 [Full Text]  
• Ouseph, R., Hutchison, C. A., Ward, R. A. (2008). Differences in solute removal by two high-flux membranes of nominally similar synthetic polymers. Nephrol Dial Transplant 23: 1704-1712 [Abstract] [Full Text]  
• Ravani, P., Parfrey, P., Gadag, V., Malberti, F., Barrett, B. (2008). Clinical research of kidney diseases V: extended analytic models. Nephrol Dial Transplant 23: 1484-1492 [Full Text]  
• Vanholder, R., Baurmeister, U., Brunet, P., Cohen, G., Glorieux, G., Jankowski, J., for the European Uremic Toxin Work Group, (2008). A Bench to Bedside View of Uremic Toxins. J. Am. Soc. Nephrol. 19: 863-870 [Abstract] [Full Text]  
• Stenvinkel, P., Carrero, J. J., Axelsson, J., Lindholm, B., Heimburger, O., Massy, Z. (2008). Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient: How Do New Pieces Fit into the Uremic Puzzle?. CJASN 3: 505-521 [Abstract] [Full Text]  
• van der Weerd, N. C., Penne, E. L., van den Dorpel, M. A., Grooteman, M. P.C., Nube, M. J., Bots, M. L., ter Wee, P. M., Blankestijn, P. J. (2008). Haemodiafiltration: promise for the future?. Nephrol Dial Transplant 23: 438-443 [Full Text]  
• Vanholder, R., Laecke, S. V., Verbeke, F., Glorieux, G., Biesen, W. V. (2008). Uraemic toxins and cardiovascular disease: in vitro research versus clinical outcome studies. NDT Plus 1: 2-10 [Full Text]  
• Garg, A. X., Greene, T., Levin, N. W. (2008). A well-conducted randomized trial that establishes no benefit of therapy is an important medical advance. Nephrol Dial Transplant 23: 52-55 [Full Text]  
• Covic, A., Gusbeth-Tatomir, P., Goldsmith, D. (2008). Negative outcome studies in end-stage renal disease: how dark are the storm clouds?. Nephrol Dial Transplant 23: 56-61 [Full Text]  
• Cheung, A. K., Greene, T., Leypoldt, J. K., Yan, G., Allon, M., Delmez, J., Levey, A. S., Levin, N. W., Rocco, M. V., Schulman, G., Eknoyan, G., for HEMO Study Group, (2008). Association between Serum 2-Microglobulin Level and Infectious Mortality in Hemodialysis Patients. CJASN 3: 69-77 [Abstract] [Full Text]  
• Tonelli, M. (2007). Vitamin D in Patients with Chronic Kidney Disease: Nothing New under the Sun. ANN INTERN MED 147: 880-881 [Full Text]  
• Kessler, M., Zannad, F., Lehert, P., Grunfeld, J. P., Thuilliez, C., Leizorovicz, A., Lechat, P., for the FOSIDIAL Investigators, (2007). Predictors of cardiovascular events in patients with end-stage renal disease: an analysis from the Fosinopril in Dialysis study. Nephrol Dial Transplant 22: 3573-3579 [Abstract] [Full Text]  
• Wingard, R. L., Pupim, L. B., Krishnan, M., Shintani, A., Ikizler, T. A., Hakim, R. M. (2007). Early Intervention Improves Mortality and Hospitalization Rates in Incident Hemodialysis Patients: RightStart Program. CJASN 2: 1170-1175 [Abstract] [Full Text]  
• Macdougall, I. C., Eckardt, K.-U., Locatelli, F. (2007). Latest US KDOQI Anaemia Guidelines update what are the implications for Europe?. Nephrol Dial Transplant 22: 2738-2742 [Full Text]  
• Ravani, P., Parfrey, P. S., Dicks, E., Barrett, B. J. (2007). Clinical research of kidney diseases II: problems of study design. Nephrol Dial Transplant 22: 2785-2794 [Full Text]  
• Foley, R. N., Collins, A. J. (2007). End-Stage Renal Disease in the United States: An Update from the United States Renal Data System. J. Am. Soc. Nephrol. 18: 2644-2648 [Abstract] [Full Text]  
• Meyer, T. W., Hostetter, T. H. (2007). Uremia. NEJM 357: 1316-1325 [Full Text]  
• Culleton, B. F., Walsh, M., Klarenbach, S. W., Mortis, G., Scott-Douglas, N., Quinn, R. R., Tonelli, M., Donnelly, S., Friedrich, M. G., Kumar, A., Mahallati, H., Hemmelgarn, B. R., Manns, B. J. (2007). Effect of Frequent Nocturnal Hemodialysis vs Conventional Hemodialysis on Left Ventricular Mass and Quality of Life: A Randomized Controlled Trial. JAMA 298: 1291-1299 [Abstract] [Full Text]  
• Kliger, A. S. (2007). Frequent Nocturnal Hemodialysis A Step Forward?. JAMA 298: 1331-1333 [Full Text]  
• Lok, C. E., Allon, M., Donnelly, S., Dorval, M., Hemmelgarn, B., Moist, L., Oliver, M. J., Tonelli, M., Stanley, K. (2007). Design of the fish oil inhibition of stenosis in hemodialysis grafts (FISH) study. Clin Trials 4: 357-367 [Abstract]  
• Tentori, F., Hunt, W. C., Rohrscheib, M., Zhu, M., Stidley, C. A., Servilla, K., Miskulin, D., Meyer, K. B., Bedrick, E. J., Johnson, H. K., Zager, P. G. (2007). Which Targets in Clinical Practice Guidelines Are Associated with Improved Survival in a Large Dialysis Organization?. J. Am. Soc. Nephrol. 18: 2377-2384 [Abstract] [Full Text]  
• Santoro, A., Ferramosca, E., Mancini, E., Monari, C., Varasani, M., Sereni, L., Wratten, M. (2007). Reverse mid-dilution: new way to remove small and middle molecules as well as phosphate with high intrafilter convective clearance. Nephrol Dial Transplant 22: 2000-2005 [Abstract] [Full Text]  
• Ajiro, J., Alchi, B., Narita, I., Omori, K., Kondo, D., Sakatsume, M., Kazama, J. J., Akazawa, K., Gejyo, F. (2007). Mortality Predictors after 10 Years of Dialysis: A Prospective Study of Japanese Hemodialysis Patients. CJASN 2: 653-660 [Abstract] [Full Text]  
• Himmelfarb, J. (2007). Chronic Kidney Disease and the Public Health: Gaps in Evidence From Interventional Trials. JAMA 297: 2630-2633 [Full Text]  
• Himmelfarb, J., Henrich, W., DuBose, T. (2007). Anemia of Kidney Disease and Clinical Practice Guidelines: Quo Vadis?. CJASN 2: 213-214 [Full Text]  
• Kliger, A. S., for the Frequent Hemodialysis Network Study Group, (2007). High-Frequency Hemodialysis: Rationale for Randomized Clinical Trials. CJASN 2: 390-392 [Full Text]  
• Depner, T., Himmelfarb, J. (2007). Uremic Retention Solutes: The Free and the Bound. J. Am. Soc. Nephrol. 18: 675-676 [Full Text]  
• Singh, A. K., Szczech, L., Tang, K. L., Barnhart, H., Sapp, S., Wolfson, M., Reddan, D., the CHOIR Investigators, (2006). Correction of Anemia with Epoetin Alfa in Chronic Kidney Disease. NEJM 355: 2085-2098 [Abstract] [Full Text]  
• Tonelli, M. (2006). Do statins protect the kidney as well as the heart?. Nephrol Dial Transplant 21: 3005-3006 [Full Text]  
• Appel, L. J. (2006). A Primer on the Design, Conduct, and Interpretation of Clinical Trials. CJASN 1: 1360-1367 [Abstract] [Full Text]  
• Thadhani, R., Tonelli, M. (2006). Cohort Studies: Marching Forward. CJASN 1: 1117-1123 [Full Text]  
• Hsu, C.-y., Feldman, H. I. (2006). Clinical Research Methods in CJASN. CJASN 1: 1115-1116 [Full Text]  
• Martins Castro, M. C., Luders, C., Elias, R. M., Abensur, H., Romao Junior, J. E. (2006). High-efficiency short daily haemodialysis--morbidity and mortality rate in a long-term study. Nephrol Dial Transplant 21: 2232-2238 [Abstract] [Full Text]  
• Monk, R. D., Bennett, D. A. (2006). Reno-cerebrovascular disease? The incognito kidney in cognition and stroke.. Neurology 67: 196-198 [Full Text]  
• Murray, A. M., Tupper, D. E., Knopman, D. S., Gilbertson, D. T., Pederson, S. L., Li, S., Smith, G. E., Hochhalter, A. K., Collins, A. J., Kane, R. L. (2006). Cognitive impairment in hemodialysis patients is common.. Neurology 67: 216-223 [Abstract] [Full Text]  
• Himmelfarb, J. (2006). Dialysis at a Crossroads: Reverse Engineering Renal Replacement Therapy. CJASN 1: 896-902 [Full Text]  
• Ricci, Z., Bellomo, R., Ronco, C. (2006). Dose of Dialysis in Acute Renal Failure. CJASN 1: 380-388 [Full Text]  
• Johansen, K. L, Kutner, N. G, Young, B., Chertow, G. M (2006). Association of body size with health status in patients beginning dialysis. Am. J. Clin. Nutr. 83: 543-549 [Abstract] [Full Text]  
• Port, F. K., Pisoni, R. L., Bommer, J., Locatelli, F., Jadoul, M., Eknoyan, G., Kurokawa, K., Canaud, B. J., Finley, M. P., Young, E. W. (2006). Improving Outcomes for Dialysis Patients in the International Dialysis Outcomes and Practice Patterns Study. CJASN 1: 246-255 [Abstract] [Full Text]  
• Jindal, K., Chan, C. T., Deziel, C., Hirsch, D., Soroka, S. D., Tonelli, M., Culleton, B. F. (2006). CHAPTER 1: Hemodialysis Adequacy in Adults. J. Am. Soc. Nephrol. 17: S4-S7 [Full Text]  
• Cheung, A. K., Rocco, M. V., Yan, G., Leypoldt, J. K., Levin, N. W., Greene, T., Agodoa, L., Bailey, J., Beck, G. J., Clark, W., Levey, A. S., Ornt, D. B., Schulman, G., Schwab, S., Teehan, B., Eknoyan, G., for HEMO Study Group, (2006). Serum beta-2 Microglobulin Levels Predict Mortality in Dialysis Patients: Results of the HEMO Study. J. Am. Soc. Nephrol. 17: 546-555 [Abstract] [Full Text]  
• Burrowes, J. D., Larive, B., Chertow, G. M., Cockram, D. B., Dwyer, J. T., Greene, T., Kusek, J. W., Leung, J., Rocco, M. V., for the HEMO Study Group, (2005). Self-reported appetite, hospitalization and death in haemodialysis patients: findings from the Hemodialysis (HEMO) Study. Nephrol Dial Transplant 20: 2765-2774 [Abstract] [Full Text]  
• Dixon, B. S, Beck, G. J, Dember, L. M, Depner, T. A, Gassman, J. J, Greene, T., Himmelfar, J., Hunsicker, L. G, Kaufman, J. S, Lawson, J. H, Meyers, C. M, Middleton, J. P, Radeva, M., Schwab, S. J, Whiting, J. F, Feldman, H. I (2005). Design of the Dialysis Access Consortium (DAC) Aggrenox prevention of access stenosis trial. Clin Trials 2: 400-412 [Abstract]  
• Heaf, J. G., Sarac, S., Afzal, S. (2005). A high peritoneal large pore fluid flux causes hypoalbuminaemia and is a risk factor for death in peritoneal dialysis patients. Nephrol Dial Transplant 20: 2194-2201 [Abstract] [Full Text]  
• Chan, C. T., Li, S. H., Verma, S. (2005). Nocturnal hemodialysis is associated with restoration of impaired endothelial progenitor cell biology in end-stage renal disease. Am. J. Physiol. Renal Physiol. 289: F679-F684 [Abstract] [Full Text]  
• Kalantar-Zadeh, K., Kilpatrick, R. D., Kuwae, N., McAllister, C. J., Alcorn, H. Jr, Kopple, J. D., Greenland, S. (2005). Revisiting mortality predictability of serum albumin in the dialysis population: time dependency, longitudinal changes and population-attributable fraction. Nephrol Dial Transplant 20: 1880-1888 [Abstract] [Full Text]  
• Ayus, J. C., Mizani, M. R., Achinger, S. G., Thadhani, R., Go, A. S., Lee, S. (2005). Effects of Short Daily versus Conventional Hemodialysis on Left Ventricular Hypertrophy and Inflammatory Markers: A Prospective, Controlled Study. J. Am. Soc. Nephrol. 16: 2778-2788 [Abstract] [Full Text]  
• Ward, R. A. (2005). Protein-Leaking Membranes for Hemodialysis: A New Class of Membranes in Search of an Application?. J. Am. Soc. Nephrol. 16: 2421-2430 [Abstract] [Full Text]  
• Andreoli, S. P., Brewer, E. D., Watkins, S., Fivush, B., Powe, N., Shevchek, J., Foreman, J. (2005). American Society of Pediatric Nephrology Position Paper on Linking Reimbursement to Quality of Care. J. Am. Soc. Nephrol. 16: 2263-2269 [Full Text]  
• Winchester, J. F. (2005). Novel Changes in {beta}2-Microglobulin in Dialysis Patients. Clin. Chem. 51: 1089-1090 [Full Text]  
• Allon, M., Radeva, M., Bailey, J., Beddhu, S., Butterly, D., Coyne, D. W., Depner, T. A., Gassman, J. J., Kaufman, A. M., Kaysen, G. A., Lewis, J. A., Schwab, S. J., for the HEMO Study Group, (2005). The spectrum of infection-related morbidity in hospitalized haemodialysis patients. Nephrol Dial Transplant 20: 1180-1186 [Abstract] [Full Text]  
• Himmelfarb, J., Chertow, G. M. (2005). Medicare ESRD Prospective Payment System: Weighing the Evidence. J. Am. Soc. Nephrol. 16: 1164-1165 [Full Text]  
• Wali, R. K., Wang, G. S., Gottlieb, S. S., Bellumkonda, L., Hansalia, R., Ramos, E., Drachenberg, C., Papadimitriou, J., Brisco, M. A., Blahut, S., Fink, J. C., Fisher, M. L., Bartlett, S. T., Weir, M. R. (2005). Effect of kidney transplantation on left ventricular systolic dysfunction and congestive heart failure in patients with end-stage renal disease. J Am Coll Cardiol 45: 1051-1060 [Abstract] [Full Text]  
• Bargman, J. M., Golper, T. A. (2005). The importance of residual renal function for patients on dialysis. Nephrol Dial Transplant 20: 671-673 [Full Text]  
• Kalantar-Zadeh, K., Abbott, K. C, Salahudeen, A. K, Kilpatrick, R. D, Horwich, T. B (2005). Survival advantages of obesity in dialysis patients. Am. J. Clin. Nutr. 81: 543-554 [Abstract] [Full Text]  
• Rocco, M. V., Cheung, A. K., Greene, T., Eknoyan, G., for the Hemodialysis Study Group, (2005). The HEMO Study: applicability and generalizability. Nephrol Dial Transplant 20: 278-284 [Full Text]  
• Locatelli, F., Buoncristiani, U., Canaud, B., Kohler, H., Petitclerc, T., Zucchelli, P. (2005). Dialysis dose and frequency. Nephrol Dial Transplant 20: 285-296 [Abstract] [Full Text]  
• Weissinger, E. M., Kaiser, T., Meert, N., De Smet, R., Walden, M., Mischak, H., Vanholder, R. C., for the European Uremic Toxin Work Group, (2004). Proteomics: a novel tool to unravel the patho-physiology of uraemia. Nephrol Dial Transplant 19: 3068-3077 [Abstract] [Full Text]  
• Grooteman, M. P. C., Nube, M. J. (2004). Impact of the type of dialyser on the clinical outcome in chronic haemodialysis patients: does it really matter?. Nephrol Dial Transplant 19: 2965-2970 [Full Text]  
• Himmelfarb, J., Pereira, B. J.G., Wesson, D. E., Smedberg, P. C., Henrich, W. L. (2004). Payment for Quality in End-Stage Renal Disease. J. Am. Soc. Nephrol. 15: 3263-3269 [Full Text]  
• Lowrie, E. G., Li, Z., Ofsthun, N., Lazarus, J. M. (2004). Reprocessing dialysers for multiple uses: recent analysis of death risks for patients. Nephrol Dial Transplant 19: 2823-2830 [Abstract] [Full Text]  
• Koch, M., Trapp, R., Kulas, W., Grabensee, B. (2004). Critical limb ischaemia as a main cause of death in patients with end-stage renal disease: a single-centre study. Nephrol Dial Transplant 19: 2547-2552 [Abstract] [Full Text]  
• Block, G. A., Klassen, P. S., Lazarus, J. M., Ofsthun, N., Lowrie, E. G., Chertow, G. M. (2004). Mineral Metabolism, Mortality, and Morbidity in Maintenance Hemodialysis. J. Am. Soc. Nephrol. 15: 2208-2218 [Abstract] [Full Text]  
• Meyer, T. W., Leeper, E. C., Bartlett, D. W., Depner, T. A., Lit, Y. Z., Robertson, C. R., Hostetter, T. H. (2004). Increasing Dialysate Flow and Dialyzer Mass Transfer Area Coefficient to Increase the Clearance of Protein-bound Solutes. J. Am. Soc. Nephrol. 15: 1927-1935 [Abstract] [Full Text]  
• Choi, J.-H., Kim, K. L., Huh, W., Kim, B., Byun, J., Suh, W., Sung, J., Jeon, E.-S., Oh, H.-Y., Kim, D.-K. (2004). Decreased Number and Impaired Angiogenic Function of Endothelial Progenitor Cells in Patients With Chronic Renal Failure. Arterioscler. Thromb. Vasc. Bio. 24: 1246-1252 [Abstract] [Full Text]  
• Collins, A. J., Liu, J., Ebben, J. P. (2004). Dialyser reuse-associated mortality and hospitalization risk in incident Medicare haemodialysis patients, 1998-1999. Nephrol Dial Transplant 19: 1245-1251 [Abstract] [Full Text]  
• Termorshuizen, F., Dekker, F. W., van Manen, J. G., Korevaar, J. C., Boeschoten, E. W., Krediet, R. T. (2004). Relative Contribution of Residual Renal Function and Different Measures of Adequacy to Survival in Hemodialysis Patients: An analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. J. Am. Soc. Nephrol. 15: 1061-1070 [Abstract] [Full Text]  
• Chertow, G. M. (2004). A 43-Year-Old Woman With Chronic Renal Insufficiency. JAMA 291: 1252-1259 [Full Text]  
• Boure, T., Vanholder, R. (2004). Which dialyser membrane to choose?. Nephrol Dial Transplant 19: 293-296 [Full Text]  
• Kalantar-Zadeh, K., Block, G., Humphreys, M. H., McAllister, C. J., Kopple, J. D. (2004). A Low, Rather than a High, Total Plasma Homocysteine Is an Indicator of Poor Outcome in Hemodialysis Patients. J. Am. Soc. Nephrol. 15: 442-453 [Abstract] [Full Text]  
• Andreucci, V. E., Kerr, D. N. S., Kopple, J. D. (2004). Rights of chronic renal failure patients undergoing chronic dialysis therapy. Nephrol Dial Transplant 19: 30-38 [Abstract] [Full Text]  
• Hecking, E., Bragg-Gresham, J. L., Rayner, H. C., Pisoni, R. L., Andreucci, V. E., Combe, C., Greenwood, R., McCullough, K., Feldman, H. I., Young, E. W., Held, P. J., Port, F. K. (2004). Haemodialysis prescription, adherence and nutritional indicators in five European countries: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 19: 100-107 [Abstract] [Full Text]  
• Daugirdas, J. T., Greene, T., Depner, T. A., Leypoldt, J., Gotch, F., Schulman, G., Star, R. (2004). Factors that Affect Postdialysis Rebound in Serum Urea Concentration, Including the Rate of Dialysis: Results from the HEMO Study. J. Am. Soc. Nephrol. 15: 194-203 [Abstract] [Full Text]  
• Tisler, A., Akocsi, K., Borbas, B., Fazakas, L., Ferenczi, S., Gorogh, S., Kulcsar, I., Nagy, L., Samik, J., Szegedi, J., Toth, E., Wagner, G., Kiss, I. (2003). The effect of frequent or occasional dialysis-associated hypotension on survival of patients on maintenance haemodialysis. Nephrol Dial Transplant 18: 2601-2605 [Abstract] [Full Text]  
• Cheung, A. K., Levin, N. W., Greene, T., Agodoa, L., Bailey, J., Beck, G., Clark, W., Levey, A. S., Leypoldt, J. K., Ornt, D. B., Rocco, M. V., Schulman, G., Schwab, S., Teehan, B., Eknoyan, G. (2003). Effects of High-Flux Hemodialysis on Clinical Outcomes: Results of the HEMO Study. J. Am. Soc. Nephrol. 14: 3251-3263 [Abstract] [Full Text]  
• Miller, C. D., Robbin, M. L., Barker, J., Allon, M. (2003). Comparison of Arteriovenous Grafts in the Thigh and Upper Extremities in Hemodialysis Patients. J. Am. Soc. Nephrol. 14: 2942-2947 [Abstract] [Full Text]  
• Chan, C. T., Harvey, P. J., Picton, P., Pierratos, A., Miller, J. A., Floras, J. S. (2003). Short-Term Blood Pressure, Noradrenergic, and Vascular Effects of Nocturnal Home Hemodialysis. Hypertension 42: 925-931 [Abstract] [Full Text]  
• Salahudeen, A. K., Dykes, P., May, W. (2003). Risk factors for higher mortality at the highest levels of spKt/V in haemodialysis patients. Nephrol Dial Transplant 18: 1339-1344 [Abstract] [Full Text]  
• Allon, M., Depner, T. A., Radeva, M., Bailey, J., Beddhu, S., Butterly, D., Coyne, D. W., Gassman, J. J., Kaufman, A. M., Kaysen, G. A., Lewis, J. A., Schwab, S. J. (2003). Impact of Dialysis Dose and Membrane on Infection-Related Hospitalization and Death: Results of the HEMO Study. J. Am. Soc. Nephrol. 14: 1863-1870 [Abstract] [Full Text]  
• Locatelli, F. (2003). Dose of dialysis, convection and haemodialysis patients outcome--what the HEMO study doesn't tell us: the European viewpoint. Nephrol Dial Transplant 18: 1061-1065 [Full Text]  
• Scribner, B. H., Blagg, C. R., Friedman, E. A., Hoenich, N. A., Locatelli, F., Greene, T., Cheung, A. K., Eknoyan, G., the Hemodialysis (HEMO) Study Group, , Himmelfarb, J. (2003). Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis. NEJM 348: 1491-1494 [Full Text]