REDUCTION IN MORTALITY & MORBIDITY IN HEMODIALYSIS

美国终末期肾病患者的总死亡率 过去，通过血液透析（HD）治疗的终末期肾病（ESRD）有所增加 十年尽管在技术上取得了许多进步， 与HD相关，与其他 发达国家。 本项目的目标是进行一项试点研究 这将决定实施一个更大的 多中心、前瞻性、随机试验，评估 不同的血液透析技术对发病率和死亡率的影响。 至少 50例慢性HD患者根据共病进行分层，分别来自3个 将临床试验机构随机分为2（4）个析因研究， 透析方式的影响（高效率vs高通量），膜 类型（纤维素vs聚砜）和透析处方（KT/V 0.851.0 vs 1.2-1.4）在3或4小时内递送。 因为某些 患者相关因素，如年龄、性别、营养状况、血液 血压（BP）、糖尿病和HD状况 访问，可以与待测试的治疗相关变量相互作用， 这项研究是一项高质量的医疗保健计划， 所有受试者均以统一的方式进入。 该试点项目的主要成果 研究是确定进行较大的可行性 通过对学习能力的考核，实现招聘、留用 和受试者的依从性;以及评估 发生临床事件，如因医学原因退出 或者由于实验方案的不利影响。

The gross mortality of patients in the United States with end-stage renal disease (ESRD) treated by hemodialysis (HD) has increased over the past decade. This has occurred despite numerous advances in the technology associated with HD, and compares unfavorably with trends in other developed nations. The goal of this project is to conduct a Pilot Study which will determine the feasibility of implementing a larger multi-center, prospective, randomized trial to assess the effects of different hemodialysis techniques upon morbidity and mortality. At least 50 chronic HD patients stratified for comorbid illnesses from each of 3 centers will be randomized into a 2 (4) factorial study examining the effects of dialysis modality (high efficiency vs high flux), membrane type (cellulosic vs polysulfone) and dialysis prescription (KT/V 0.851.0 vs 1.2-1.4) delivered over 3 or 4 hours time. Because certain patient-related factors such as age, gender, nutritional status, blood pressure (BP) , presence of diabetes mellitus and condition of the HD access, can interact with the treatment-related variables to be tested in the study, a program of high quality medical care will be undertaken in a uniform manner for all subjects entered. The major outcome of this Pilot Study is the determination of the feasibility of conducting a larger study, by the assessment of the ability to achieve recruitment, retention and compliance of subjects; and the assessment of the frequency of the occurrence of clinical events such as the withdrawal for medical reasons or due to adverse effects of the experimental protocols.