Calcimimetic agents, vascular calcification prevention 276 Calcium parathyroid hormone regulation Subject Index 357

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1 Subject Index Advanced glycation end products (AGEs) atherosclerosis role 168 dietary sources 202, 203 formation 168 platelet phosphatidylserine externalization induction 171, 172 signaling 173 toxicity 317 Albumin, removal of protein-bound solutes Alcohol, cardiovascular disease risks in dialysis patients 225 Aluminum binders 269, 270 Anemia patients 227, 235 Study management 62, 64 Angiotensin-converting enzyme (ACE) inhibitors, cardiovascular disease benefits in hemodialysis patients 4 Anthropometry, total body water estimation 159 Apo E4, cardiovascular disease risks in dialysis patients 223 Arterial compliance definition 307, 308 flow-mediated dilatation 309 pulse wave analysis aortic pressure reconstruction 312 aortic pulse analysis 311, 312 augmentation index 312, 313 finger plethysmography 312 physiological considerations 310 tonometry 312 transfer function 311 pulse wave velocity Artificial kidney, see Wearable artificial kidney Atherosclerosis advanced glycation end product role 169 malnutrition, inflammation, and atherosclerosis syndrome 200, 201 oxidative stress role platelet phosphatidylserine externalization role 169 vascular calcification, see Vascular calcification Beta-blockers, cardiovascular disease benefits in hemodialysis patients 5 Biocompatibility, cardiovascular disease risks in dialysis patients 234 Bioelectrical impedance analysis (BIA), see also Segmental bioimpedance body fluid volume assessment equations 153, 154 techniques 152 definition 163 electrical properties of tissues 151, 152 postdialysis target body weight optimization 150, 151 spectroscopy

2 vector bioelectrical impedance analysis accuracy 154 impedance correlation with ultrafiltration 159 optimal current frequency 159 principles tissue hydration classification 158, 159 vector patterns adequate versus inadequate vector trajectories 158 hemodialysis cycle 155, 156 normal versus abnormal vector trajectories steady state 154, 155 volume-dependent hypertension and hypotension 159 wet-dry weight prescription 160 Biopharmaceutical definition 289 generic versions, see Biosimilars immunogenicity 291, 292 production and characterization 290, 291 stability 291 structural complexity 289, 290 Biosimilars definition 289 regulation 292, 293 Blood flow, control and monitoring in hemodialysis 25 Blood viscosity, shear rate effects Body size, HEMO Study subgroup analysis 75 Body weight obesity and cardiovascular disease risks in dialysis patients 224 postdialysis target body weight optimization, see Bioelectrical impedance analysis Bone morphogenetic protein-7 (BMP-7), deficiency and vascular calcification 281, 282 Calcimimetic agents, vascular calcification prevention 276 Calcium parathyroid hormone regulation vascular calcification, see Vascular calcification Calcium channel blockers, cardiovascular disease benefits in hemodialysis patients 5 3-Carboxy-4-methyl-5-propyl-2- furanpropionic acid (CMPF) morbidity role in dialysis 177, 178 removal of protein-bound solute 178, 179 Central venous pressure, total body water estimation 159, 160 Coffee, caffeine consumption and cardiovascular mortality in dialysis patients 204, 205 Congestive heart failure (CHF), slow continuous intravenous plasmapheresis clinical feasibility study Continuous renal replacement therapy (CRRT) advantages 325, 326 artificial kidney, see Wearable artificial kidney slow continuous intravenous plasmapheresis, see Slow continuous intravenous plasmapheresis slow continuous ultrafiltration, see Slow continuous ultrafiltration Convection diffusion interference 15, 16 solute convective flux equation 122 C-reactive protein (CRP) cardiovascular disease direct promotion by C-reactive protein risk detection end-stage renal disease 189, 190 general population 188, 189 gene polymorphisms 191, 192 interleukin-6 level correlation in end-stage renal disease 186 statin reduction 189, p-cresol patients 234 morbidity role in dialysis 177, 178, 318, 319 removal of protein-bound solute Subject Index 357

3 Depression cardiovascular disease impact in hemodialysis patients 3, 226 Study findings 65 Diabetes, cardiovascular disease risks in dialysis patients 224 Dialysate channeling prevention 15 control and monitoring composition flow 25 delivery system 20, 21 water quality, see Water treatment Study (DOPPS) anemia management 62, 64 background 58, 59, 94, 95 depression findings 65 nutrition and mineral metabolism practices statin outcomes 64, 65 vascular access use and outcomes 65, 66 Dialysis Outcomes Quality Initiative (DOQI), development 94 Diet, see Nutrition Diffusion convection interference 15, 16 diffusivity coefficient 12, 13 effects on sieving 12, 13 solute diffusive flux equation 12 Dilutometry, total body water estimation 160 Dinucleoside polyphosphates, uremic toxicity 320 Dyslipidemia, cardiovascular disease risks in dialysis patients 223, 224, 234 Electrocardiography, potassium removal rates and arrhythmia effects 297, 299, 300, 302, 303 End-stage renal disease (ESRD) cardiovascular mortality 92 demographic trends 6, 91 epidemiology 90, 91 geographic distribution 91 mortality determinants 92, 93 Exercise, inactivity and cardiovascular disease risks in dialysis patients 225 Extracorporeal circuit hemoconcentration measurement 38 overview pressure measurement 39, 40 solute concentration measurement local measurement 36 perturbation 36, 37 resolution 36 sampling rate 36 sodium 37, 38 temperature monitoring 38, 39 Fetuin, see 2 -Heremans-Schmid glycoprotein Fluid overload, cardiovascular disease risks in dialysis patients 222, 223 Generic drug, definition Hemodiafiltration (HDF), see also Mid-dilution hemodiafiltration advantages 108 hemodialysis comparison studies 112 predilution versus postdilution 108, 109 sequential hemofiltrationhemodiafiltration, see Sequential hemofiltration-hemodiafiltration Hemodialysis machines, see also Extracorporeal circuit control and monitoring 24, 25 dialysate delivery system 20, 21 disinfection 22 extracorporeal circuit hazards and safety overview 18, 19 ultrafiltration control 21, 22, 25 Hemofiltration (HF) advantages 52 comparative trial with ultrapure bicarbonate dialysis blood chemistry intratreatment hemodynamics 54, 57 morbidity 54, 57 study design 52, 53 survival 53, 54 Subject Index 358

4 sequential hemofiltrationhemodiafiltration, see Sequential hemofiltration-hemodiafiltration HEMO Study background dialysis dose expressions 77, 78 high-flux dialysis findings 84 86, 11 secondary end points subgroup analysis body size 75 comorbidity 72, 73 prevalent versus incident patients 74, 75 sex differences 75, Heremans-Schmid glycoprotein (AHSG), deficiency and vascular calcification 282, 283 Homocysteine patients 204, 221, 222 vitamin D deficiency and secondary hypertension 268 Infection, cardiovascular disease risks in dialysis patients 227, 228 Inflammation, see also C-reactive protein patients 185, 186, 227, 228 causes in end-stage renal disease 190, 191 genetic susceptibility in end-stage renal disease 191, 192 malnutrition, inflammation, and atherosclerosis syndrome 200, 201 nutrition interactions diet effects on inflammation inflammation effect on nutritional status 201, 202 pathogenesis 201 statin reduction 189, water quality effects 42, 43 Interleukin-6 (IL-6) C-reactive protein level correlation in end-stage renal disease 186 gene polymorphisms 191 Internal filtration (IF) governing principles mathematical modeling applications 34 design and implementation 30, 31 simulations Interventional nephrology (IN) challenges 135, 136 needs 132, 133 overview 131, 132 percutaneous balloon angioplasty access stenosis management 143, 144 complication rates 146, 147 percutaneous bone biopsy 134, 135 peritoneal dialysis catheter placement 133, 134 professional organizations 135 program establishment 133 renal ultrasound 133 thrombectomy for access thrombosis 144, 145 tunneled catheter procedures 134, 145, 146 vascular access responsibilities complication management 127, 128, 134, documentation and quality measures 128, 129 education and training 129 first access placement 123, 126, 127, 134 organization of care 128 patient education 139, 140 planning 140 predialysis period access surgeon referral 122, 123 ultrasound evaluation 122, 126 surveillance and monitoring 123, 124 vascular mapping Kidney Disease: Improving Global Outcomes (KDIGO) development goals 95 website 96 Kidney Disease Outcomes Quality Initiative (K/DOQI), development 94 KoA definition 11 variation with flow distribution 12 Subject Index 359

5 Kt/V control and monitoring 25 inadequacy and cardiovascular disease risks in dialysis patients 224 long nocturnal hemodialysis 104 wearable artificial kidney 330, 331 Lanthanum carbonate, vascular calcification prevention 276 Left ventricular hypertrophy (LVH), kidney disease relationship 93 Leptin patients 234 malnutrition role in hemodialysis patients 202 morbidity role in dialysis patients 177 Lipopolysaccharide (LPS) effects on monocyte phenotype and apoptosis endotoxin removal from dialysis water 235 Lipoprotein(a), cardiovascular disease risks in dialysis patients 223 Long nocturnal hemodialysis Kt/V 104 morbidity mortality 101, 102, 104 rationale 100 study design 101 switching to short hemodialysis 103 Matrix Gla protein (MGP), deficiency and vascular calcification 283, 284 Mediterranean diet, cardiovascular benefits 205 Membraneless dialysis ambulatory dialyzer prospects apparatus performance 349 concept 344 microfluidic transport molecular transport studies in blood 351 plasmapheresis prospects 351 preventing cells from sheath fluid entry 348 recirculating sheath concept Membrane Permeability Outcome (MPO) study background 87 baseline data analysis 87, 88 Membranes cardiovascular risk factor 234, 235 functions 344 limitations in dialysis 344 Mid-dilution hemodiafiltration (MD HDF) advantages compared with high-flux hemodialysis 112, 113 clearance outcomes 110 rationale 108, 109 study design 109, 110 Monocytes apoptosis 212, 213 CD14 expression in hemodialysis 211, 213, 215 CD16 expression in hemodialysis 211, 213 cytokine measurements 211, 213 lipopolysaccharide effects on phenotype and apoptosis telomere shortening and senescence in hemodialysis flow cytometry overview 209, 210 Mortality determinants in end-stage renal disease 92, 93 hemodialysis patients 2, 3, 83, 84, 296 long nocturnal hemodialysis 101, 102, 104 Nocturnal hemodialysis, see Long nocturnal hemodialysis Nutrition advanced glycation end product intake 202, 203 caffeine reduction 204, 205 Nutrition (continued) Study practices inflammation interactions diet effects on inflammation inflammation effect on nutritional status 201, 202 isoflavones 205 Subject Index 360

6 malnutrition, inflammation, and atherosclerosis syndrome 200, 201 omega-3 fatty acids and cardiovascular disease prevention in dialysis patients 225 uremic malnutrition and cardiovascular disease risks in dialysis patients 226, 227 vitamins 203, 204 Obesity, cardiovascular disease risks in dialysis patients 224 Oxidative stress, see also Reactive oxygen species antioxidant defenses 249, 250 biomarkers cell damage mechanisms 245, 246 nutrition and inflammation interactions 203, 204 pathogenesis Alzheimer s disease 256 atherosclerosis autoimmune disease 257 stroke 256, 257 uremic syndrome 253, 254, 256 reactive oxygen species contributors 244, 245 signaling Ozone formation 242 Parathyroid hormone (PTH) calcium regulation derangements and cardiovascular disease risks in dialysis patients 6, 226 elevation in renal failure 267, 268 phosphate regulation 262 renal osteodystrophy management 269, 270 Phenylacetic acid, uremic toxicity 319, 320 Phosphate binders 264, 265, 276 homeostasis control 263, 264 parathyroid hormone regulation 262 parathyroid hyperplasia regulation 262, 263 removal, wearable artificial kidney 331 Platelets, phosphatidylserine externalization advanced glycation end product induction 171 atherosclerosis role 169 end-stage renal disease patients patient serum incubation effects 170 patient studies 170 measurement 169, 170 Potassium derangements and arrhythmias 296, 297 removal rates and arrhythmia effects electrocardiography 297, 299 premature ventricular contractions 299, 300, 302, 303 statistical analysis 299, 304 study design removal, wearable artificial kidney 331 Premature ventricular contractions (PVCs), potassium removal rates and arrhythmia effects 299, 300, 302, 303 Pulse wave analysis aortic pressure reconstruction 312 aortic pulse analysis 311, 312 augmentation index 312, 313 finger plethysmography 312 physiological considerations 310 tonometry 312 transfer function 311 Reactive oxygen species (ROS), see also Oxidative stress antioxidant defenses 249, 250 biological species 241, 242 cell damage mechanisms 245, 246 free radical formation 240, 241 oxidative stress contributors 244, 245 reduction potentials 243, 244 sources 246, 247 Renal osteodystrophy, integrated management 269, 270 Risk factors, cardiovascular disease in dialysis patients, see also specific risk factors dialysis components dialyzer and membrane 234, 235 monitoring 236, 237 treatment modality 235, 236 water quality 235 Subject Index 361

7 Risk factors, (continued) modifiable risk factors potentially modifiable risk factors 227, 228 total risk assessment Scribner, Belding, observations on first hemodialysis 1, 2 Segmental bioimpedance body composition assessment 163, 164 calf measurements 165, 166 definition 163 dry weight assessment Sequential hemofiltration-hemodiafiltration (SHF-HDF) advantages 118, 119 ease of operation 118 rationale 116 study design 116, 117 treatment efficacy quantification 117, 118 Sevelamer, vascular calcification prevention 276 Sheath dialysis, see Membraneless dialysis Slow continuous intravenous plasmapheresis (SCIP) animal studies 335, 336 backflush cycle 340 clinical feasibility study in congestive heart failure indications Slow continuous ultrafiltration (SCUF) animal studies 335, 336 indications 339 Smoking, cardiovascular disease risks in dialysis patients 220, 221 Sodium, measurement in extracorporeal circuit 37, 38 Solute clearance, factors affecting it 11 Soy, cardiovascular benefits 205 Statins cardiovascular disease benefits in hemodialysis patients 4 Study outcomes 64, 65 inflammation reduction 189, Stress, cardiovascular disease risks in dialysis patients 226 Telomere shortening cellular senescence 209 monocytes in hemodialysis flow cytometry overview 209, 210 Ultrafiltration (UF) control and monitoring 21, 22, 25, 236, 237 mechanisms along low-flux and high-flux dialyzers 28, 29 Ultrasound renal ultrasound 133 vascular access evaluation 122, 126 vascular calcification 274 Uremia definition 175 oxidative stress role in uremic syndrome 253, 254, 256 protein-bound solutes in uremic syndrome removal role toxicity 318, 319 toxins and toxicity advanced glycation end products 318 dinucleoside polyphosphates 320 guanidino compounds peptides 320, 321 phenylacetic acid 319, 320 Vascular access (VA) Study use and outcomes 65, 66 interdisciplinary approach 125 nephrologist responsibilities, see also Interventional nephrology complication management 127, 128 documentation and quality measures 128, 129 education and training 129 first access placement 123, 126, 127 organization of care 128 predialysis period access surgeon referral 122, 123 ultrasound evaluation 122, 126 surveillance and monitoring 123, 124 prospects for study 129, 130 Subject Index 362

8 Vascular calcification cardiovascular mortality outcomes 274, 275 detection 274 distribution within artery 272 pathology and etiopathogenesis bone morphogenetic protein-7 deficiency 281, Heremans-Schmid glycoprotein deficiency 282, 283 matrix Gla protein deficiency 283, 284 overview 273, 274, 280, 281, 284, 285 prevention calcimimetic agents 276 calcium-based phosphate binders 276 lanthanum carbonate 276 Sevelamer 276 Vector bioelectrical impedance analysis, see Bioelectrical impedance analysis Vitamin C, deficiency and inflammation 203 Vitamin D deficiency and secondary hypertension 268 resistance in renal failure 268, 269 Vitamin E, cardiovascular disease benefits in hemodialysis patients 6 Water treatment AAMI (Association for the Advancement of Medical Instrumentation) standards patients 235 disinfection 48 European Pharmacopoeia standards inflammation and water quality 42, 43 optimal system 45, 46 quality assurance 48 reverse osmosis 45, 46 ultrapure dialysate preparation 46, 47 Wearable artificial kidney (WAK) animal studies 327, 328 designs 329, 330 limitations 329 mineral removal 330, 331 requirements 326, 327 weekly Kt/V 330, 331 Subject Index 363

Gambrosol Trio, clinical studies 91 Glitazone, malnutrition-inflammationatherosclerosis

Gambrosol Trio, clinical studies 91 Glitazone, malnutrition-inflammationatherosclerosis Subject Index Acidosis, see Metabolic acidosis Activated carbon, sorbents 337 Adipokines adipose tissue and systemic inflammation 169 functions 167 169 prospects for study in renal patients 171 Adiponectin,