Intestinal-renal syndrome: Mirage or reality?

Blood Purification

Volumn 31, Issue 1-3, 2011, Pages 70-76

  Ritz, Eberhard ^a  

^a Nierenzentrum   (Germany)

Author keywords

Cardiovascular stability; Endotoxin; Hemodialysis; Myocardial stunning

Indexed keywords

ACETYLCYSTEINE; BACTERIUM LIPOPOLYSACCHARIDE; ETANERCEPT; INTERLEUKIN 1; INTERLEUKIN 6; POLYMYXIN B; PROBIOTIC AGENT; TUMOR NECROSIS FACTOR ALPHA; TUMOR NECROSIS FACTOR ALPHA ANTIBODY; UREMIC TOXIN;

ABDOMINAL INFECTION; BACTERIAL METABOLISM; BLOOD VOLUME; CATABOLISM; CONFERENCE PAPER; CONGESTIVE HEART FAILURE; CYTOKINE RELEASE; DIET SUPPLEMENTATION; DISEASE ASSOCIATION; ENDOTOXIN DETECTION; HEART FAILURE; HEART FUNCTION; HEART MUSCLE ISCHEMIA; HEART MUSCLE PERFUSION; HEMODIALYSIS PATIENT; HUMAN; HYPOTENSION; INTESTINE FLORA; INTESTINE FUNCTION; INTESTINE ISCHEMIA; INTESTINE MUCOSA; INTESTINE PERFUSION; KIDNEY FAILURE; LIFE EXPECTANCY; MALNUTRITION; METABOLITE; NONHUMAN; PATHOGENESIS; PRIORITY JOURNAL; SEPSIS; STUNNED HEART MUSCLE; UREMIA; WASTING SYNDROME;

ENDOTOXINS; HEART FAILURE; HUMANS; INTESTINES; KIDNEY FAILURE, CHRONIC; MYOCARDIAL STUNNING; RENAL DIALYSIS; UREMIA;

EID: 78651425794     PISSN: 02535068     EISSN: None     Source Type: Journal    
DOI: 10.1159/000321848     Document Type: Conference Paper

References (95)

1. Fishberg AM: Hypertension and Nephritis, ed 5. Philadelphia, Lea and Febiger, 1954, p 43.
2. Volhard F, Becher E: Die klinischen Methoden der Nierenfunktionsprü fung. Berlin, Urban and Schwarzenberg, 1929, p 48.
3. Schepers E, Glorieux G, Vanholder R: The gut: the forgotten organ in uremia? Blood Purif 2010; 29: 130-136.
4. Schepers E, Meert N, Glorieux G, Goeman J, Van der Eycken J, Vanholder R: P-cresylsulphate, the main in vivo metabolite of p-cresol, activates leucocyte free radical production. Nephrol Dial Transplant 2007; 22: 592-596.
5. Bammens B, Evenepoel P, Keuleers H, Verbeke K, Vanrenterghem Y: Free serum concentrations of the protein-bound retention solute p-cresol predict mortality in hemodialysis patients. Kidney Int 2006; 69: 1081-1087.
6. Meijers BK, Bammens B, De Moor B, Verbeke K, Vanrenterghem Y, Evenepoel P: Free p-cresol is associated with cardiovascular disease in hemodialysis patients. Kidney Int 2008; 73: 1174-1180.
7. Bammens B, Evenepoel P, Verbeke K, Vanrenterghem Y: Removal of middle molecules and protein-bound solutes by peritoneal dialysis and relation with uremic symptoms. Kidney Int 2003; 64: 2238-2243.
8. Tsubakihara Y, Takabatake Y, Oka K, Shoji T, Togawa M, Okada N, Takahito I, Imai E: Effects of the oral adsorbent AST-120 on tryptophan metabolism in uremic patients. Am J Kidney Dis 2003; 41:S38-S41.
9. Motojima M, Hosokawa A, Yamato H, Muraki T, Yoshioka T: Uremic toxins of organic anions up-regulate PAI-1 expression by induction of NF-kappaB and free radical in proximal tubular cells. Kidney Int 2003; 63: 1671-1680.
10. Dou L, Bertrand E, Cerini C, Faure V, Sampol J, Vanholder R, Berland Y, Brunet P: The uremic solutes p-cresol and indoxyl sulfate inhibit endothelial proliferation and wound repair. Kidney Int 2004; 65: 442-451.
11. Nii-Kono T, Iwasaki Y, Uchida M, Fujieda A, Hosokawa A, Motojima M, Yamato H, Kurokawa K, Fukagawa M: Indoxyl sulfate induces skeletal resistance to parathyroid hormone in cultured osteoblastic cells. Kidney Int 2007; 71: 738-743.
12. Perl J, Bargman JM: The importance of residual kidney function for patients on dialysis: a critical review. Am J Kidney Dis 2009; 53: 1068-1081.
13. Ueda H, Shibahara N, Takagi S, Inoue T, Katsuoka Y: AST-120, an oral adsorbent, delays the initiation of dialysis in patients with chronic kidney diseases. Ther Apher Dial 2007; 11: 189-195.
14. Ueda H, Shibahara N, Takagi S, Inoue T, Katsuoka Y: AST-120 treatment in pre-dialysis period affects the prognosis in patients on hemodialysis. Ren Fail 2008; 30: 856-860.
15. Schulman G, Agarwal R, Acharya M, Berl T, Blumenthal S, Kopyt N: A multicenter, randomized, double-blind, placebo-controlled, dose-ranging study of AST-120 (Kremezin) in patients with moderate to severe CKD. Am J Kidney Dis 2006; 47: 565-577.
16. Simenhoff ML, Saukkonen JJ, Burke JF, Wesson LG Jr, Schaedler RW, Gordon SJ: Bacterial populations of the small intestine in uremia. Nephron 1978; 22: 63-68.
17. Magnusson M, Magnusson KE, Sundqvist T, Denneberg T: Increased intestinal permeability to differently sized polyethylene glycols in uremic rats: effects of low- and highprotein diets. Nephron 1990; 56: 306-311. (Pubitemid 20330099)
18. Magnusson M, Magnusson KE, Sundqvist T, Denneberg T: Impaired intestinal barrier function measured by differently sized polyethylene glycols in patients with chronic renal failure. Gut 1991; 32: 754-759.
19. de Almeida Duarte JB, de Aguilar-Nascimento JE, Nascimento M, Nochi RJ Jr: Bacterial translocation in experimental uremia. Urol Res 2004; 32: 266-270.
20. Vaziri ND, Dure-Smith B, Miller R, Mirahmadi MK: Pathology of gastrointestinal tract in chronic hemodialysis patients: an autopsy study of 78 cases. Am J Gastroenterol 1985; 80: 608-611.
21. Hida M, Aiba Y, Sawamura S, Suzuki N, Satoh T, Koga Y: Inhibition of the accumulation of uremic toxins in the blood and their precursors in the feces after oral administration of Lebenin, a lactic acid bacteria preparation, to uremic patients undergoing hemodialysis. Nephron 1996; 74: 349-355.
22. Miskowiak J: Continuous intestinal dialysis for uraemia by intermittent oral intake of non-absorbable solutions. An experimental study. Scand J Urol Nephrol 1991; 25: 71-74.
23. Friedman EA: Can the bowel substitute for the kidney in advanced renal failure? Curr Med Res Opin 2009; 25: 1913-1918.
24. Ranganathan N, Patel BG, Ranganathan P, Marczely J, Dheer R, Pechenyak B, Dunn SR, Verstraete W, Decroos K, Mehta R, Friedman EA: In vitro and in vivo assessment of intraintestinal bacteriotherapy in chronic kidney disease. ASAIO J 2006; 52: 70-79.
25. Prakash S, Chang TM: Microencapsulated genetically engineered live E. coli DH5 cells administered orally to maintain normal plasma urea level in uremic rats. Nat Med 1996; 2: 883-887. (Pubitemid 26296758)
26. Zuber M, Steinmann E, Huser B, Ritz R, Thiel G, Brunner F: Incidence of arrhythmias and myocardial ischaemia during haemodialysis and haemofiltration. Nephrol Dial Transplant 1989; 4: 632-634.
27. London GM, Guerin AP, Marchais SJ, Pannier B, Safar ME, Day M, Metivier F: Cardiac and arterial interactions in end-stage renal disease. Kidney Int 1996; 50: 600-608.
28. Ritz E, Rambausek M, Mall G, Ruffmann K, Mandelbaum A: Cardiac changes in uraemia and their possible relationship to cardiovascular instability on dialysis. Nephrol Dial Transplant 1990; 5(suppl 1):93-97.
29. Amann K, Ritz E: Microvascular disease - the Cinderella of uraemic heart disease. Nephrol Dial Transplant 2000; 15: 1493-1503.
30. Zimmerli LU, Mark PB, Steedman T, Foster JE, Berg GA, Dargie HJ, Jardine AG, Delles C, Dominiczak AF: Vascular function in patients with end-stage renal disease and/or coronary artery disease: a cardiac magnetic resonance imaging study. Kidney Int 2007; 71: 68-73.
31. Robinson TG, Carr SJ: Cardiovascular autonomic dysfunction in uremia. Kidney Int 2002; 62: 1921-1932.
32. Chesterton LJ, Selby NM, Burton JO, Fialova J, Chan C, McIntyre CW: Categorization of the hemodynamic response to hemodialysis: the importance of baroreflex sensitivity. Hemodial Int 2010; 14: 18-28.
33. Kremastinos D, Paraskevaidis I, Voudiklari S, Apostolou T, Kyriakides Z, Zirogiannis P, Toutouzas P: Painless myocardial ischemia in chronic hemodialysed patients: a real event? Nephron 1992; 60: 164-170.
34. Mohi-ud-din K, Bali HK, Banerjee S, Sakhuja V, Jha V: Silent myocardial ischemia and high-grade ventricular arrhythmias in patients on maintenance hemodialysis. Ren Fail 2005; 27: 171-175.
35. Burton JO, Korsheed S, Grundy BJ, McIntyre CW: Hemodialysis-induced left ventricular dysfunction is associated with an increase in ventricular arrhythmias. Ren Fail 2008; 30: 701-709.
36. Heyndrickx GR, Millard RW, McRitchie RJ, Maroko PR, Vatner SF: Regional myocardial functional and electrophysiological alterations after brief coronary artery occlusion in conscious dogs. J Clin Invest 1975; 56: 978-985.
37. Braunwald E, Kloner RA: The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation 1982; 66: 1146-1149.
38. Barnes E, Dutka DP, Khan M, Camici PG, Hall RJ: Effect of repeated episodes of reversible myocardial ischemia on myocardial blood flow and function in humans. Am J Physiol Heart Circ Physiol 2002; 282:H1603-H1608.
39. McIntyre CW, Burton JO, Selby NM, Leccisotti L, Korsheed S, Baker CS, Camici PG: Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clin J Am Soc Nephrol 2008; 3: 19-26.
40. McIntyre CW: Effects of hemodialysis on cardiac function. Kidney Int 2009; 76: 371-375.
41. Burton JO, Jefferies HJ, Selby NM, McIntyre CW: Hemodialysis-induced repetitive myocardial injury results in global and segmental reduction in systolic cardiac function. Clin J Am Soc Nephrol 2009; 4: 1925-1931.
42. Burton JO, Jefferies HJ, Selby NM, McIntyre CW: Hemodialysis-induced cardiac injury: determinants and associated outcomes. Clin J Am Soc Nephrol 2009; 4: 914-920.
43. Dasselaar JJ, Slart RH, Knip M, Pruim J, Tio RA, McIntyre CW, de Jong PE, Franssen CF: Haemodialysis is associated with a pronounced fall in myocardial perfusion. Nephrol Dial Transplant 2009; 24: 604-610.
44. McIntyre CW: Haemodialysis-induced myocardial stunning in chronic kidney disease - a new aspect of cardiovascular disease. Blood Purif 2010; 29: 105-110.
45. Sandek A, Rauchhaus M, Anker SD, von Haehling S: The emerging role of the gut in chronic heart failure. Curr Opin Clin Nutr Metab Care 2008; 11: 632-639.
46. Anker SD, von Haehling S: Inflammatory mediators in chronic heart failure: an overview. Heart 2004; 90: 464-470. (Pubitemid 38406929)
47. Anker SD, Egerer KR, Volk HD, Kox WJ, Poole-Wilson PA, Coats AJ: Elevated soluble CD14 receptors and altered cytokines in chronic heart failure. Am J Cardiol 1997; 79: 1426-1430.
48. Anker SD, Ponikowski PP, Clark AL, Leyva F, Rauchhaus M, Kemp M, Teixeira MM, Hellewell PG, Hooper J, Poole-Wilson PA, Coats AJ: Cytokines and neurohormones relating to body composition alterations in the wasting syndrome of chronic heart failure. Eur Heart J 1999; 20: 683-693.
49. Genth-Zotz S, von Haehling S, Bolger AP, Kalra PR, Wensel R, Coats AJ, Anker SD: Pathophysiologic quantities of endotoxininduced tumor necrosis factor-alpha release in whole blood from patients with chronic heart failure. Am J Cardiol 2002; 90: 1226-1230.
50. Peschel T, Schonauer M, Thiele H, Anker SD, Schuler G, Niebauer J: Invasive assessment of bacterial endotoxin and inflammatory cytokines in patients with acute heart failure. Eur J Heart Fail 2003; 5: 609-614.
51. Parks DA, Jacobson ED: Physiology of the splanchnic circulation. Arch Intern Med 1985; 145: 1278-1281.
52. Takala J: Determinants of splanchnic blood flow. Br J Anaesth 1996; 77: 50-58.
53. Riddington DW, Venkatesh B, Boivin CM, Bonser RS, Elliott TS, Marshall T, Mountford PJ, Bion JF: Intestinal permeability, gastric intramucosal pH, and systemic endotoxemia in patients undergoing cardiopulmonary bypass. JAMA 1996; 275: 1007-1012.
54. Ding J, Magnotti LJ, Huang Q, Xu DZ, Condon MR, Deitch EA: Hypoxia combined with Escherichia coli produces irreversible gut mucosal injury characterized by increased intestinal cytokine production and DNA degradation. Shock 2001; 16: 189-195.
55. Springer J, Filippatos G, Akashi YJ, Anker SD: Prognosis and therapy approaches of cardiac cachexia. Curr Opin Cardiol 2006; 21: 229-233.
56. Magnusson M, Magnusson KE, Denneberg T: Impaired gut barrier in experimental chronic uremic rats. Miner Electrolyte Metab 1992; 18: 288-292.
57. Reid JA, Annamalai G, Lau LL, Soong CV: Intra-mucosal acidosis as a predictor of cardiac outcome following abdominal aortic aneurysm surgery. Eur J Vasc Endovasc Surg 2004; 28: 353-356.
58. Sandek A, Bauditz J, Swidsinski A, Buhner S, Weber-Eibel J, von Haehling S, Schroedl W, Karhausen T, Doehner W, Rauchhaus M, Poole-Wilson P, Volk HD, Lochs H, Anker SD: Altered intestinal function in patients with chronic heart failure. J Am Coll Cardiol 2007; 50: 1561-1569. (Pubitemid 47532323)
59. Kumar A, Brar R, Wang P, Dee L, Skorupa G, Khadour F, Schulz R, Parrillo JE: Role of nitric oxide and cGMP in human septic seruminduced depression of cardiac myocyte contractility. Am J Physiol 1999; 276:R265-R276.
60. Cain BS, Meldrum DR, Dinarello CA, Meng X, Joo KS, Banerjee A, Harken AH: Tumor necrosis factor-alpha and interleukin-1beta synergistically depress human myocardial function. Crit Care Med 1999; 27: 1309-1318.
61. Kraut EJ, Chen S, Hubbard NE, Erickson KL, Wisner DH: Tumor necrosis factor depresses myocardial contractility in endotoxemic swine. J Trauma 1999; 46: 900-906.
62. Parker MM: Pathophysiology of cardiovascular dysfunction in septic shock. New Horiz 1998; 6: 130-138.
63. Tavernier B, Li JM, El-Omar MM, Lanone S, Yang ZK, Trayer IP, Mebazaa A, Shah AM: Cardiac contractile impairment associated with increased phosphorylation of troponin I in endotoxemic rats. FASEB J 2001; 15: 294-296.
64. Hocherl K, Schmidt C, Kurt B, Bucher M: Activation of the PGI(2)/IP system contributes to the development of circulatory failure in a rat model of endotoxic shock. Hypertension 2008; 52: 330-335.
65. 2+ handling and shortening in sepsis. Crit Care Med 2005; 33: 598-604.
66. Hassoun SM, Marechal X, Montaigne D, Bouazza Y, Decoster B, Lancel S, Neviere R: Prevention of endotoxin-induced sarcoplasmic reticulum calcium leak improves mitochondrial and myocardial dysfunction. Crit Care Med 2008; 36: 2590-2596.
67. Kumar A, Parrillo JE: Cytokines and septic myocardial depression: nitric oxide versus sphingosine/ceramide? Crit Care Med 1999; 27: 1391-1393. (Pubitemid 29379387)
68. Oddis CV, Finkel MS: Cytokine-stimulated nitric oxide production inhibits mitochondrial activity in cardiac myocytes. Biochem Biophys Res Commun 1995; 213: 1002-1009.
69. Panaro MA, Gagliardi N, Saponaro C, Calvello R, Mitolo V, Cianciulli A: Toll-like receptor 4 mediates LPS-induced release of nitric oxide and tumor necrosis factor-alpha by embryonal cardiomyocytes: biological significance and clinical implications in human pathology. Curr Pharm Des 2010; 16: 766-774.
70. Haque R, Kan H, Finkel MS: Effects of cytokines and nitric oxide on myocardial E-C coupling. Basic Res Cardiol 1998; 93(suppl 1):86-94.
71. Loke KE, Laycock SK, Mital S, Wolin MS, Bernstein R, Oz M, Addonizio L, Kaley G, Hintze TH: Nitric oxide modulates mitochondrial respiration in failing human heart. Circulation 1999; 100: 1291-1297.
72. Loke KE, McConnell PI, Tuzman JM, Shesely EG, Smith CJ, Stackpole CJ, Thompson CI, Kaley G, Wolin MS, Hintze TH: Endogenous endothelial nitric oxide synthase-derived nitric oxide is a physiological regulator of myocardial oxygen consumption. Circ Res 1999; 84: 840-845.
73. Wagenmakers AJ: Muscle function in critically ill patients. Clin Nutr 2001; 20: 451-454.
74. Mayers I, Hurst T, Puttagunta L, Radomski A, Mycyk T, Sawicki G, Johnson D, Radomski MW: Cardiac surgery increases the activity of matrix metalloproteinases and nitric oxide synthase in human hearts. J Thorac Cardiovasc Surg 2001; 122: 746-752.
75. Oddis CV, Finkel MS: Cytokines and nitric oxide synthase inhibitor as mediators of adrenergic refractoriness in cardiac myocytes. Eur J Pharmacol 1997; 320: 167-174.
76. Valgimigli M, Merli E, Malagutti P, Soukhomovskaia O, Cicchitelli G, Antelli A, Canistro D, Francolini G, Macri G, Mastrorilli F, Paolini M, Ferrari R: Hydroxyl radical generation, levels of tumor necrosis factor-alpha, and progression to heart failure after acute myocardial infarction. J Am Coll Cardiol 2004; 43: 2000-2008.
77. Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, Liebenthal C, Niebauer J, Hooper J, Volk HD, Coats AJ, Anker SD: Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 2000; 102: 3060-3067.
78. Sharma R, Bolger AP, Li W, Davlouros PA, Volk HD, Poole-Wilson PA, Coats AJ, Gatzoulis MA, Anker SD: Elevated circulating levels of inflammatory cytokines and bacterial endotoxin in adults with congenital heart disease. Am J Cardiol 2003; 92: 188-193.
79. Chung ES, Packer M, Lo KH, Fasanmade AA, Willerson JT: Randomized, doubleblind, placebo-controlled, pilot trial of infliximab, a chimeric monoclonal antibody to tumor necrosis factor-alpha, in patients with moderate-to-severe heart failure: results of the anti-TNF Therapy Against Congestive Heart Failure (ATTACH) trial. Circulation 2003; 107: 3133-3140.
80. Mann DL, McMurray JJ, Packer M, Swedberg K, Borer JS, Colucci WS, Djian J, Drexler H, Feldman A, Kober L, Krum H, Liu P, Nieminen M, Tavazzi L, van Veldhuisen DJ, Waldenstrom A, Warren M, Westheim A, Zannad F, Fleming T: Targeted anticytokine therapy in patients with chronic heart failure: results of the Randomized Etanercept Worldwide Evaluation (RENEWAL). Circulation 2004; 109: 1594-1602.
81. Finkel MS, Oddis CV, Jacob TD, Watkins SC, Hattler BG, Simmons RL: Negative inotropic effects of cytokines on the heart mediated by nitric oxide. Science 1992; 257: 387-389.
82. Wollert KC, Drexler H: The role of interleukin- 6 in the failing heart. Heart Fail Rev 2001; 6: 95-103.
83. Tsutamoto T, Hisanaga T, Wada A, Maeda K, Ohnishi M, Fukai D, Mabuchi N, Sawaki M, Kinoshita M: Interleukin-6 spillover in the peripheral circulation increases with the severity of heart failure, and the high plasma level of interleukin-6 is an important prognostic predictor in patients with congestive heart failure. J Am Coll Cardiol 1998; 31: 391-398.
84. Jug B, Salobir BG, Vene N, Sebestjen M, Sabovic M, Keber I: Interleukin-6 is a stronger prognostic predictor than high-sensitive C-reactive protein in patients with chronic stable heart failure. Heart Vessels 2009; 24: 271-276.
85. Torre-Amione G, Anker SD, Bourge RC, Colucci WS, Greenberg BH, Hildebrandt P, Keren A, Motro M, Moye LA, Otterstad JE, Pratt CM, Ponikowski P, Rouleau JL, Sestier F, Winkelmann BR, Young JB: Results of a non-specific immunomodulation therapy in chronic heart failure (ACCLAIM trial): a placebo-controlled randomised trial. Lancet 2008; 371: 228-236.
86. Schmidt H, Muller-Werdan U, Nuding S, Hoffmann T, Francis DP, Hoyer D, Rauchhaus M, Werdan K: Impaired chemoreflex sensitivity in adult patients with multiple organ dysfunction syndrome - the potential role of disease severity. Intensive Care Med 2004; 30: 665-672.
87. Schmidt H, Muller-Werdan U, Hoffmann T, Francis DP, Piepoli MF, Rauchhaus M, Prondzinsky R, Loppnow H, Buerke M, Hoyer D, Werdan K: Autonomic dysfunction predicts mortality in patients with multiple organ dysfunction syndrome of different age groups. Crit Care Med 2005; 33: 1994-2002.
88. Dantzker DR: The gastrointestinal tract. The canary of the body? JAMA 1993; 270: 1247-1248.
89. Martinez-Pellus AE, Merino P, Bru M, Canovas J, Seller G, Sapina J, Fuentes T, Moro J: Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Role of type of flow and protective effect of selective digestive decontamination. Intensive Care Med 1997; 23: 1251-1257.
90. Novelli G, Ferretti G, Poli L, Pretagostini R, Ruberto F, Perrella SM, Levi S, Morabito V, Berloco PB: Clinical results of treatment of postsurgical endotoxin-mediated sepsis with polymyxin-B direct hemoperfusion. Transplant Proc 2010; 42: 1021-1024.
91. Cruz DN, Antonelli M, Fumagalli R, Foltran F, Brienza N, Donati A, Malcangi V, Petrini F, Volta G, Bobbio Pallavicini FM, Rottoli F, Giunta F, Ronco C: Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA 2009; 301: 2445-2452.
92. Antonelli M, Fumagalli R, Cruz DN, Brienza N, Giunta F: PMX endotoxin removal in the clinical practice: results from the EUPHAS trial. Contrib Nephrol 2010; 167: 83-90.
93. Charra B, Calemard E, Ruffet M, Chazot C, Terrat JC, Vanel T, Laurent G: Survival as an index of adequacy of dialysis. Kidney Int 1992; 41: 1286-1291.
94. Komenda P, Chan C, Pauly RP, Levin A, Copland M, Pierratos A, Sood MM: The evaluation of a successful home hemodialysis program: establishing a prospective framework for quality. Clin Nephrol 2009; 71: 467-474.
95. Pauly RP, Maximova K, Coppens J, Asad RA, Pierratos A, Komenda P, Copland M, Nesrallah GE, Levin A, Chery A, Chan CT: Patient and technique survival among a Canadian multicenter nocturnal home hemodialysis cohort. Clin J Am Soc Nephrol 2010; 5: 1815- 1820.