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  • 1
    Electronic Resource
    Electronic Resource
    KARYOMEGALIC NEPHROPATHY A RARE CAUSE OF RENAL FAILURE - HLA AND PLOIDY ANALYSIS (2000)
    Melbourne, Australia : Blackwell Science Pty
    Nephrology 5 (2000), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1440-1797.2000.005003a109.x
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  • 2
    Electronic Resource
    Electronic Resource
    Cardiovascular risk in dialysis patients: A comparison of risk factors and cardioprotective therapy between 1996 and 2001 (2003)
    Melbourne, Australia : Blackwell Science Pty
    Nephrology 8 (2003), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SUMMARY:  Cardiovascular disease (CVD) is the major cause of mortality in dialysis patients. Aspirin, beta-blockers, statins, and angiotensin-converting enzyme (ACE) inhibitors reduce CVD mortality in the general population, as may angiotensin II receptor antagonists. The prevalence of cardiovascular risk factors and usage rates of cardioprotective agents in end-stage renal failure are unknown. A retrospective, cross-sectional study of dialysis patients was performed to compare: (i) prevalence of cardiovascular risk factors (age, hypertension, hyperlipidaemia, diabetes mellitus, and smoking); (ii) use of cardioprotective agents; and (iii) prevalence of cardiovascular disease between the time-points: 1996 (n = 262) versus 2001 (n = 369). We found an increase in the risk factors of age (53.6 ± 14.9 years in 1996 vs 58.4 ± 14.3 in 2001; P 〈 0.001) and hyperlipidaemia (45 vs 51.8%; P 〈 0.001) between the two time-points, with a reduction in the prevalence of smoking (14.5 vs 8.1%; P = 0.016). There was no difference in the prevalence of cardiovascular disease (37.4 vs 40.7%; P = 0.44). Cardioprotective agents were underutilized, with improvement in prescribing practice between 1996 and in 2001, especially in the usage of statins (21.4 vs 38.7% in 2001; P = 0.019). In conclusion, CVD is the primary cause of mortality in our dialysis patients. Although traditional cardiovascular risk factors affect the majority of the dialysis population, underutilization of cardioprotective agents is common. Proof of efficacy of these agents in this population of enormous risk is urgently required.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1440-1797.2003.00157.x
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  • 3
    Electronic Resource
    Electronic Resource
    Historical controlled trial of OKT3 versus basiliximab induction therapy in simultaneous pancreas–renal transplantation (2003)
    Melbourne, Australia : Blackwell Science Pty
    Nephrology 8 (2003), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SUMMARY:  Simultaneous pancreas–kidney (SPK) transplant recipients are at high immunological risk of rejection. Antibody induction is beneficial but lymphocyte-depleting therapy is associated with a high incidence of side-effects. We performed a historical controlled trial to compare OKT3 versus anti-CD25 antibody (basiliximab) induction therapy with regard to patient, kidney and pancreas survival, as well as to examine for any differences in acute rejection, graft function, and infective complications. Twenty-eight consecutive SPK transplants were performed at the Monash Medical Centre between December 1997 and November 2001. Anti CD3 monoclonal antibody (OKT3) was used prior to March 2000 (n = 12) and basiliximab was used after (n = 16), both in combination with cyclosporin, mycophenolate, and prednisolone. A retrospective comparison of outcomes was performed. At 6 months, patient (100 vs 100%), kidney (91.7 vs 91.7%) and pancreas (75 vs 83.3%) survival were similar in the OKT3 and basiliximab groups, respectively. A minority of subjects in each group remained free from rejection (42% basiliximab vs 25% on OKT3, P = NS). Renal function was superior in the basiliximab group (mean calculated creatinine clearance 79.4 ± 11.9 vs 54.5 ± 15.9 mL/min for  basiliximab vs OKT3, P 〈 0.001). The incidence of major opportunistic infection was lower in basiliximab-treated patients (9 vs 50% in the OKT3 group, P = 0.033). Basiliximab was associated with similar 6-month patient, kidney and pancreas survival, superior renal function and less opportunistic infection as compared with OKT3 induction therapy in SPK transplants. Basiliximab is at least as effective and is safer than OKT3 for induction therapy in SPK transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1440-1797.2003.00158.x
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  • 4
    Electronic Resource
    Electronic Resource
    High-flux dialysers (2002)
    Oxford, UK : Blackwell Publishing Ltd
    Nephrology 7 (2002), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: SUMMARY: This brief review attempts to define high-flux dialysis and differentiate it from low-flux and high-efficiency dialysis. High-flux dialysis membranes offer improved clearance of larger-molecular-weight solutes, particularly β-2 microglobulin. Patients exhibit improved cardiovascular stability and long-term use of these membranes may delay the onset of dialysis-related amyloidosis. Although high-flux membranes have improved biocompatibility compared with most low-flux membranes, this has not been demonstrated to provide morbidity or mortality benefits. Backfiltration of solutes and toxins from the dialysate to the blood is a potential but probably overstated complication of high-flux dialysis. Most high-flux membranes are actually efficient barriers to the passage of endotoxins. Cost is the major barrier to more widespread use of high-flux dialysis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1440-1797.2002.00079.x
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  • 5
    Electronic Resource
    Electronic Resource
    Dose of haemodialysis (2005)
    Melbourne, Australia : Blackwell Science Pty
    Nephrology 10 (2005), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1797.2005.00464_1.x
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  • 6
    Electronic Resource
    Electronic Resource
    Phosphate removal in haemodialysis: Effect of two different dialysis membranes (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Nephrology 2 (1996), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary: Phosphate removal with two different dialysis membranes (a standard cellulose acetate membrane and a high performance cellulose diacetate membrane) were studied in ten haemodialysis patients. All patients were dialysed sequentially with two membranes (surface area was 1.5 m2) against bicarbonate buffered dialysis for 4 hours three times a week. With the diacetate membrane, the instantaneous clearances of urea and phosphate after 1 hour of haemodialysis were significantly higher than with the cellulose membrane. Also, the weekly total amount of urea and phosphate removal were significantly increased with the diacetate membrane (a 15% increase in urea and a 16% increase of phosphate). Although there was a significant increase in urea reduction ratio and significantly lower post dialytic plasma urea concentration with the diacetate membrane, these for phosphate did not reach statistical significance. These data suggest that the use of the diacetate membrane potentially offer clinical benefit. However, whether 16% of phosphate removal could improve clinical control of serum phosphate levels will need further investigation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1797.1996.tb00121.x
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  • 7
    Electronic Resource
    Electronic Resource
    Recent trends in haemodialysis: Australia 1994 (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Nephrology 1 (1995), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary: Haemodialysis in Australia is mostly practiced without many of the innovations seen in the USA and Europe. Home haemodialysis is common, high-flux dialysis is uncommon and 4 h dialysis is the norm.This review examines the practice of haemodialysis in Australia, reflected in an annual mortality for dialysis patients of 11%. Issues of dialysis adequacy and biocompatibility are only just beginning to influence dialysis techniques in Australia and to this end the author's personal recommendations are put forward as suggestions regarding a sensible approach to Kt/v, biocompatibility, water quality and dialyser reuse.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1797.1995.tb00002.x
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  • 8
    Electronic Resource
    Electronic Resource
    Carotid Artery Intima–Medial Thickness Is Increased In Chronic Renal Failure (2000)
    Melbourne, Australia : Blackwell Science Pty
    Clinical and experimental pharmacology and physiology 27 (2000), S. 0 
    Details
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. Chronic renal failure (CRF) is associated with rapidly progressive atherosclerotic vascular disease. In the present study, carotid arterial intima–medial thickness (IMT) was assessed in a large cohort of patients with CRF and matched controls and related to risk factors.2. A total of 159 subjects with CRF (serum creatinine ≥ 0.40 mmol/L) aged 〉 50 years (mean (±SD) 63.8±7.7 years) and 159 healthy controls matched for age, sex and smoking status were studied.3. The IMT was determined using B-mode ultrasound measurements of the far wall of both common carotid arteries and presented as the mean IMT. Fasting plasma homocysteine (tHcy) was measured in the CRF group.4. Intima–medial thickness was significantly greater in CRF patients than controls (0.89±0.17 vs 0.73±0.13 mm, respectively) after matching for age, sex and smoking status. Heart rate and pulse pressure were also significantly increased. The tHcy was increased two-fold in the CRF group (27.7±11.3 μmol/L; normal 〈 13.0 μmol/L) and did not correlate with carotid IMT.5. Compared with controls after adjusting for traditional risk factors, patients with CRF exhibit significantly increased IMT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1440-1681.2000.03301.x
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  • 9
    Electronic Resource
    Electronic Resource
    Determinants of native arteriovenous fistula blood flow (2004)
    Melbourne, Australia : Blackwell Science Pty
    Nephrology 9 (2004), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Determinants of native arteriovenous fistula (AVF) placement have been well studied. Little is known on whether these factors impact on subsequent blood flow (Qa) in the mature AVF.Methods:  Arteriovenous fistula Qa and cardiac index (CI) were determined by ultrasound dilution. Multiple linear regression was used to assess independent predictors of AVF Qa.Results:  Of the 148 patients available for the analysis, 68% were male, with 61% using a radiocephalic AVF. Aetiology of renal disease was: 38% glomerulonephritis (GN), 22% diabetes mellitus (DM), 9% hypertension/ischaemic (HTN) and 31% other. Thirty per cent had coronary artery disease (CAD), 10% cerebrovascular disease and 11% peripheral vascular disease (PVD). Median (iqr) Qa was 1185 mL/min (790–1650) and CI was 3.15 L/min per 1.73 m2 (2.60–3.93). On univariable analysis, log CI (0.98, P 〈 0.001), age (−0.1 per 10 years, P = 0.002), access position (upper vs lower 0.26, P = 0.003, PVD (−0.35, P = 0.015), CAD (−0.25, P = 0.008), and primary renal disease (DM vs GN, −0.35, P = 0.003, HTN vs GN, −0.34, P = 0.04) were associated with Qa. On multivariable analysis, CI (0.84, P 〈 0.001), access position (upper vs lower, 0.17, P = 0.018) and primary renal disease (DM vs GN, −0.26, P = 0.005, and HTN vs GN, −0.26, P = 0.038) remained significant predictors of AVF Qa.Conclusion:  Once established, CI, AVF position and primary renal disease (hypertension/ischaemic and diabetes) are the major determinants of AVF Qa while female gender, CAD, PVD and body mass index were not significant determinants of Qa in this cohort.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1797.2004.00257.x
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  • 10
    Electronic Resource
    Electronic Resource
    Introduction (2002)
    Oxford, UK : Blackwell Science Pty
    Nephrology 7 (2002), S. 0 
    Details
    ISSN: 1440-1797
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1440-1797.7.s2.3.x
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