Dissociation between progression of coronary artery calcification and endothelial function in hemodialysis patients: a prospective pilot study.

Unlabelled: Chronic kidney disease profoundly disturbs calcium-phosphate metabolism and predisposes to premature atherosclerosis. Both coronary artery calcification (CAC) and endothelial dysfunction are common in hemodialysis (HD) patients. We hypothesized that a calcium-free phosphate binder would improve endothelial function and delay progression of vascular calcification in HD patients.

On-line near-infrared spectrometer to monitor urea removal in real time during hemodialysis.

The ex vivo removal of urea during hemodialysis treatments is monitored in real time with a noninvasive near-infrared spectrometer. The spectrometer uses a temperature-controlled acousto optical tunable filter (AOFT) in conjunction with a thermoelectrically cooled extended wavelength InGaAs detector to provide spectra with a 20 cm(-1) resolution over the combination region (4000-5000 cm(-1)) of the near-infrared spectrum. Spectra are signal averaged over 15 seconds to provide root mean square noise levels of 24 micro-absorbance units for 100% lines generated over the 4600-4500 cm(-1) spectral range.

Physician access and early nephrology care in elderly patients with end-stage renal disease.

Early nephrology care may improve treatment outcomes of patients with end-stage renal disease. We sought to examine if physician access affects early nephrology care defined as visiting a nephrologist 12 to 4 months before initiating dialysis. The study population consisted of elderly patients starting hemodialysis whose demographic characteristics and initial dialysis therapy were derived from form 2728 files of the Centers for Medicare & Medicaid Services.

Effect of dialysis center profit-status on patient survival: a comparison of risk-adjustment and instrumental variable approaches.

Objective: To compare the estimated effects of dialysis center profit status on patient survival using alternative estimation strategies with retrospective data.

Data Sources/study Setting: Patient and provider-level retrospective data from the United States Renal Data System (USRDS), 1996-1999.

Study Design: Observational risk adjustment and instrumental variable methods.

Technology in clinical practice.

Salt and water are the major components of extracellular fluid, and each patient on dialysis has a unique serum sodium activity that is defended to ensure homeostasis. Dialysate use that does not restore extracellular composition to its equilibrium value results in disequilibrium and affects dialysis discomfort, blood pressure, thirst, and weight gain. When dialysate sodium activity exceeds the dialyzable plasma sodium activity, sodium diffuses from the dialysate into the patient.

Peritoneal catheters and exit-site practices toward optimum peritoneal access: a review of current developments.

Objective: This review updates the 1998 International Society for Peritoneal Dialysis (ISPD) recommendations for peritoneal dialysis catheters and exit-site practices (Gokal R, et al. Peritoneal catheters and exit-site practices toward optimum peritonealaccess: 1998 update. Perit Dial Int 1998; 18:11-33.

Does hemodialysis increase protein breakdown? Dissociation between whole-body amino acid turnover and regional muscle kinetics.

Hemodialysis (HD) is a protein catabolic procedure. Whole-body amino acid turnover studies identify dialysate amino acid loss and reduced protein synthesis as the catabolic events; proteolysis is not increased. Regional amino acid kinetics, however, document enhanced muscle protein breakdown as the cause of the catabolism; muscle protein synthesis also increased but to a lesser magnitude than the increment in protein breakdown.

ThurGood: evaluating assembly-to-assembly mapping.

The alignment and mapping of large genomic sequences is the focus of much recent research. However, relatively little has been done so far about testing and validating alignment methods. We introduce criteria and new tools we have developed for alignment evaluation.

Hormonal responses to fasting and refeeding in chronic renal failure patients.

To study anorexia in chronic renal failure (CRF) patients, we measured appetite-related hormones in seven CRF patients and four controls. Plasma concentrations and fractional changes from baseline (values from day 1, 0800) are listed as control vs. CRF (means +/- SE).

Dialysate composition and hemodialysis hypertension.

Dialysis prescriptions have evolved to take advantage of new technology and serve a burgeoning patient population. High-sodium bicarbonate-based dialysate was first formulated in 1982 to enable short, safe, comfortable, high-efficiency hemodialysis (HD). Near-universal adaptation of these high-sodium formulas has virtually eliminated profound dialysis disequilibrium and greatly reduced dialysis discomfort, but has created a syndrome of dialysis salt loading with accentuated postdialysis thirst, interdialytic weight gain, and hypertension.

Whole-genome shotgun assembly and comparison of human genome assemblies.

We report a whole-genome shotgun assembly (called WGSA) of the human genome generated at Celera in 2001. The Celera-generated shotgun data set consisted of 27 million sequencing reads organized in pairs by virtue of end-sequencing 2-kbp, 10-kbp, and 50-kbp inserts from shotgun clone libraries. The quality-trimmed reads covered the genome 5.

Online measurement of urea concentration in spent dialysate during hemodialysis.

Background: We describe online optical measurements of urea in the effluent dialysate line during regular hemodialysis treatment of several patients. Monitoring urea removal can provide valuable information about dialysis efficiency.

Methods: Spectral measurements were performed with a Fourier-transform infrared spectrometer equipped with a flow-through cell.

Near-infrared spectroscopic measurement of urea in dialysate samples collected during hemodialysis treatments.

Single-beam spectra were collected over the combination region of the near-infrared spectrum for 80 samples collected from 15 people over a two-week period. Partial least-squares (PLS) regression was used to generate an optimized calibration model for urea. PLS calibration models accurately measure urea in the spent dialysate matrix.

Sources of Staphylococcus aureus for patients on continuous ambulatory peritoneal dialysis.

Objective: This study was designed to determine whether family members and health care workers are a source of Staphylococcus aureus for patients on peritoneal dialysis.

Design: Over 36 months, cultures were obtained from the nares of patients, family members that cared for the patients' catheters, and health care workers in a dialysis unit. Pulsed-field gel electrophoresis was performed on all S.

Insulin is protein-anabolic in chronic renal failure patients.

To examine the protein anabolic actions of insulin in chronic renal failure, the authors measured four sets of whole body leucine fluxes during insulin alone and insulin with amino acid infusion in nine uremic patients before hemodialysis (B-HD). Seven were restudied 8 wk after initiation of maintenance hemodialysis (HD). Six normal subjects served as control (N).

Response to inadequate dialysis in chronic peritoneal dialysis patients. Results from the 2000 Centers for Medicare and Medicaid (CMS) ESRD Peritoneal Dialysis Clinical Performance Measures (PD-CPM) Project.

Background: It is not known if patient prescriptions are being changed if patients are receiving an inadequate dose of peritoneal dialysis.

Methods: Data from the 2000 Centers for Medicare and Medicaid were used to obtain data on dialysis adequacy and dialysis prescriptions.

Results: A total of 359 of 1,268 (28%) adult peritoneal dialysis patients had a total weekly Kt/V urea (twKt/V) less than 2.

The genome sequence of the malaria mosquito Anopheles gambiae.

Anopheles gambiae is the principal vector of malaria, a disease that afflicts more than 500 million people and causes more than 1 million deaths each year. Tenfold shotgun sequence coverage was obtained from the PEST strain of A. gambiae and assembled into scaffolds that span 278 million base pairs.

Risk factors for early mortality in U.S. peritoneal dialysis patients: impact of residual renal function.

Background: Potential risk factors for 1-year mortality, including the peritoneal component of dialysis dose, residual renal function, demographic data, hematocrit, serum albumin, dialysate-to-plasma creatinine ratio, and blood pressure, were examined in a national cohort of peritoneal dialysis patients randomly selected for the Centers for Medicare and Medicaid Services End-Stage Renal Disease (ESRD) Core Indicators Project.

Methods: The study involved retrospective analysis of a cohort of 1,219 patients receiving chronic peritoneal dialysis who were alive on December 31, 1996.

Results: During the 1-year follow-up period, 275 patients were censored and 200 non censored patients died.

A comparison of whole-genome shotgun-derived mouse chromosome 16 and the human genome.

The high degree of similarity between the mouse and human genomes is demonstrated through analysis of the sequence of mouse chromosome 16 (Mmu 16), which was obtained as part of a whole-genome shotgun assembly of the mouse genome. The mouse genome is about 10% smaller than the human genome, owing to a lower repetitive DNA content. Comparison of the structure and protein-coding potential of Mmu 16 with that of the homologous segments of the human genome identifies regions of conserved synteny with human chromosomes (Hsa) 3, 8, 12, 16, 21, and 22.

Subjects' Awareness of Response Alternatives in Cloze Tasks.

In cloze tasks subjects are asked to supply words for deletions that occur in prose passages. In the present paper this task is related to more general word production tasks. Specifically, one aspect of decisions among several possible response alternatives was studied: the level of awareness of subjects producing competing responses.