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  • 1
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    Tubular Biomarkers and Chronic Kidney Disease Progression in SPRINT Participants
    S. Karger AG ; 2020
    In:  American Journal of Nephrology Vol. 51, No. 10 ( 2020), p. 797-805
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 51, No. 10 ( 2020), p. 797-805
    Kurzfassung: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Kidney tubular atrophy on biopsy is a strong predictor of chronic kidney disease (CKD) progression, but tubular health is poorly quantified by traditional measures including estimated glomerular filtration rate (eGFR) and albuminuria. We hypothesized that urinary biomarkers of impaired tubule function would be associated with faster eGFR declines in persons with CKD. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We measured baseline urine concentrations of uromodulin, β2-microglobulin (β2m), and α1-microglobulin (α1m) among 2,428 participants of the Systolic Blood Pressure Intervention Trial with an eGFR & #x3c;60 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 . We used linear mixed models to evaluate biomarker associations with annualized relative change in eGFR, stratified by randomization arm. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 At baseline, the mean age was 73 ± 9 years and eGFR was 46 ± 11 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 . In the standard blood pressure treatment arm, each 2-fold higher urinary uromodulin was associated with slower % annual eGFR decline (0.34 [95% CI: 0.08, 0.60]), whereas higher urinary β2m was associated with faster % annual eGFR decline (−0.10 [95% CI: −0.18, −0.02] ) in multivariable-adjusted models including baseline eGFR and albuminuria. Associations were weaker and did not reach statistical significance in the intensive blood pressure treatment arm for either uromodulin (0.11 [−0.13, 0.35], 〈 i 〉 p 〈 /i 〉 value for interaction by treatment arm = 0.045) or β2m (−0.01 [−0.08, 0.08], 〈 i 〉 p 〈 /i 〉 value for interaction = 0.001). Urinary α1m was not independently associated with eGFR decline in the standard (0.01 [−0.22, 0.23]) or intensive (0.03 [−0.20, 0.25] ) arm. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Among trial participants with hypertension and CKD, baseline measures of tubular function were associated with subsequent declines in kidney function, although these associations were diminished by intensive blood pressure control.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000509978
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2020
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    Obesity, Anthropometric Measures and Chronic Kidney Disease Complications
    S. Karger AG ; 2012
    In:  American Journal of Nephrology Vol. 36, No. 3 ( 2012), p. 219-227
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 36, No. 3 ( 2012), p. 219-227
    Kurzfassung: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Anthropometric measures such as body mass index (BMI) and waist circumference (WC) have differential associations with incident chronic kidney disease (CKD) and mortality. We examined the associations of BMI and WC with various CKD complications. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We conducted a cross-sectional analysis of 2,853 adult participants with CKD in the National Health and Nutrition Examination Surveys 1999–2006. The associations of BMI and WC (both as categorical and continuous variables) with CKD complications such as anemia, secondary hyperparathyroidism, hyperphosphatemia, metabolic acidosis, hypoalbuminemia and hypertension were examined using logistic regression models while adjusting for relevant confounding variables. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 When examined as a continuous variable, an increase in BMI by 2 points and in WC by 5 cm was associated with higher odds of secondary hyperparathyroidism, hypoalbuminemia and hypertension among those with CKD. CKD participants with BMI ≥30 have higher odds of hypoalbuminemia and hypertension than those with BMI 〈 30. CKD participants with high WC ( 〉 102 cm in men and 〉 88 cm in women) have higher odds of hypoalbuminemia and hypertension and lower odds of having anemia than those with low WC. CKD participants with BMI 〈 30 and high WC (vs. BMI 〈 30 and low WC) were not associated with any increase in CKD complications. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Anthropometric measures such as BMI and WC are associated with secondary hyperparathyroidism, hypoalbuminemia and hypertension among adults with CKD. Higher WC among those with BMI 〈 30 is not associated with CKD complications.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000341862
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2012
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    Cognitive Performance before and during Hemodialysis: A Randomized Cross-Over Trial
    S. Karger AG ; 2013
    In:  Nephron Clinical Practice Vol. 124, No. 3-4 ( 2013-12-3), p. 151-158
    Details
    In: Nephron Clinical Practice, S. Karger AG, Vol. 124, No. 3-4 ( 2013-12-3), p. 151-158
    Kurzfassung: 〈 b 〉 〈 i 〉 Background and Aims: 〈 /i 〉 〈 /b 〉 Hemodialysis (HD) patients are educated and counseled during the HD procedure. There are few studies assessing whether cognitive performance varies with dialysis. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Using a randomized cross-over design, 40 patients were assigned to one of two sequences: testing 1 h before dialysis followed 1 month later by testing during the first hour of dialysis (n = 21) versus testing during the first hour of dialysis followed 1 month later by 1 h before dialysis (n = 19). Cognitive tests were administered at each testing period. Mixed regression models evaluated for a dialysis effect (difference between test performance before vs. during dialysis) while adjusting for potential learning (difference between first and second tests). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In models accounting for period of testing, there was no difference in test performance between 1 h before versus during the first hour of HD for all administered cognitive tests (p 〉 0.05). A learning effect was detected between first and second test administration in two tests, specifically, the Word List Learning and the Digit Symbol Substitution Test. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 We found no difference in cognitive performance depending on the time of testing, suggesting that cognitive tests performed during the first hour of dialysis are a valid assessment of cognitive performance.
    Materialart: Online-Ressource
    ISSN: 1660-2110
    URL: Article
    DOI: 10.1159/000356393
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2013
    ZDB Id: 2098336-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Overall Adverse Event Profile of Vadadustat versus Darbepoetin Alfa for the Treatment of Anemia Associated with Chronic Kidney Disease in Phase 3 Trials
    S. Karger AG ; 2022
    In:  American Journal of Nephrology Vol. 53, No. 10 ( 2022), p. 701-710
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 53, No. 10 ( 2022), p. 701-710
    Kurzfassung: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Anemia frequently occurs in chronic kidney disease (CKD), is associated with poor quality of life and cardiovascular outcomes, and its treatment represents a considerable economic burden to the healthcare system. Although effective, the current standard of care for the treatment of anemia in chronic kidney disease patients with erythropoiesis-stimulating agents requires chronic/ongoing injections, making the treatment less accessible or desirable to patients not treated by in-center maintenance hemodialysis. Furthermore, safety concerns, including an increased risk of cardiovascular events and mortality, have emerged from their use in studies targeting hemoglobin concentrations in the normal or near-normal range. The orally active hypoxia-inducible factor prolyl hydroxylase inhibitor vadadustat may offer advantages over erythropoiesis-stimulating agents by correcting anemia via pathways activating endogenous erythropoietin production. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 To comprehensively analyze the safety profile of vadadustat in patients with dialysis-dependent and non-dialysis-dependent CKD-related anemia, we pooled the safety populations from each of the four trials in the phase 3 clinical program ( 〈 i 〉 n 〈 /i 〉 = 7,373) and compared the risk of treatment-emergent adverse events (TEAEs) for each treatment arm. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In patients randomized to vadadustat versus darbepoetin alfa, rates of TEAEs (88.9% vs. 89.3%), treatment-emergent serious adverse events (58.0% vs. 59.3%), and TEAEs leading to death (16.1% vs. 16.2%) were similar, as were rates of adverse events of special interest, including cardiovascular-, hepatic-, and neoplasm-related adverse events. 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 Among patients with CKD-related anemia treated with vadadustat, we observed similar rates of adverse events relative to those treated with darbepoetin alfa.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000528443
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2022
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    Association between Baseline Kidney Function and Change in CRP: An Analysis of the Cardiovascular Health Study
    S. Karger AG ; 2010
    In:  Nephron Clinical Practice Vol. 115, No. 2 ( 2010-4-22), p. c114-c121
    Details
    In: Nephron Clinical Practice, S. Karger AG, Vol. 115, No. 2 ( 2010-4-22), p. c114-c121
    Kurzfassung: 〈 i 〉 Background: 〈 /i 〉 In cross-sectional analyses, C-reactive protein (CRP) levels are inversely related to levels of kidney function. The relationship between kidney function and subsequent changes in CRP is unknown. 〈 i 〉 Methods: 〈 /i 〉 We studied 4,364 individuals from the Cardiovascular Health Study, a longitudinal cohort of community-dwelling older adults. Baseline eGFRcys was estimated using cystatin C. CRP was measured at baseline and after 3 and 7 years of follow-up; slopes of change in CRP were calculated. 〈 i 〉 Results: 〈 /i 〉 The mean (SD) age of the cohort was 72 (5.2) years; mean (SD) eGFRcys was 78.9 (18.4) ml/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 . The median (interquartile range IQR) baseline CRP was 2.39 (1.22, 4.33) mg/l; the median (IQR) yearly change in CRP was –0.0051 (–0.020 to 0.27) mg/l/year. After adjustment for demographic characteristics and the initial level of CRP, each standard deviation lower baseline eGFR was associated with a small and non-significant yearly increase in CRP (0.032 mg/l/year; 95% CI: –0.005 to 0.070, p = 0.094). 〈 i 〉 Conclusions: 〈 /i 〉 We did not find a relationship between eGFR and subsequent changes in CRP. The association between kidney function and CRP in cross-sectional analyses may reflect unmeasured confounding by atherosclerosis; alternatively, the burden of comorbidity and interval mortality in this population may have masked a stronger longitudinal association between kidney function and change in CRP. Further study in younger populations may clarify whether impaired kidney function leads to change in inflammation over time.
    Materialart: Online-Ressource
    ISSN: 1660-2110
    URL: Article
    DOI: 10.1159/000312874
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2010
    ZDB Id: 2098336-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
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    Blood Pressure and Cognitive Decline in Prevalent Hemodialysis Patients
    S. Karger AG ; 2019
    In:  American Journal of Nephrology Vol. 49, No. 6 ( 2019), p. 460-469
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 49, No. 6 ( 2019), p. 460-469
    Kurzfassung: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Hypertension is associated with cognitive decline in the general population. It is unclear what impact blood pressure (BP) has on cognitive decline in patients receiving maintenance hemodialysis (HD). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Using a longitudinal cohort of 314 prevalent HD patients without dementia at baseline, we examined the association of predialysis systolic BP (SBP) and diastolic BP (DBP), pulse pressure, and intradialytic SBP change (pre minus post), averaged for a month, with cognitive decline. Cognitive function was determined by a neurocognitive battery, administered yearly. Individual cognitive test results were reduced into 2 domain scores using principal components analysis (by definition mean of 0 and SD of 1), representing memory and executive function. Joint models, allowing for characterization of cognitive score slopes and including adjustment for potential confounders, were utilized to account for competing risks from death, dropout, or kidney transplantation. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Mean age was 62 years; 54% were men, 23% were black, and 90% had at least a high school education. During median follow-up of 2.1 years (25th–75th: 1.0–4.5), 191 had at least one follow-up test, 148 died, and 43 received kidney transplants. Low predialysis DBP and high pulse pressure were both associated with steeper executive function decline (each 10 mm Hg lower DBP = –0.03 SD [–0.01 to –0.05] per year steeper decline) in executive function (each 10 mm Hg higher pulse pressure = –0.03 SD [–0.06 to –0.01] steeper decline) but not for memory function. SBP and intradialytic change were not associated with steeper decline for either memory or executive function. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 No relationship was seen between SBP or intradialytic change in BP with cognitive decline. In prevalent HD patients, lower predialysis DBP and wider predialysis pulse pressure are associated with steeper cognitive decline in executive function but not memory.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000500041
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2019
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
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    Fibroblast Growth Factor 23: A Biomarker of Kidney Function Decline
    S. Karger AG ; 2018
    In:  American Journal of Nephrology Vol. 47, No. 4 ( 2018), p. 242-250
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 47, No. 4 ( 2018), p. 242-250
    Kurzfassung: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Fibroblast growth factor 23 (FGF-23) is a hormone that regulates phosphorus levels and vitamin D metabolism. Previous studies have shown FGF-23 to be a risk factor for incident end-stage renal disease; however, there are less data on the association of FGF-23 with earlier kidney-related outcomes. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Serum FGF-23 was assayed using an intact ELISA assay in 2,496 participants of the Healthy Aging and Body Composition Study, a cohort of well-functioning older adults. Kidney function was estimated by assaying cystatin C at baseline and years 3 and 10. The associations between FGF-23 and decline in kidney function (defined by estimated glomerular filtration rate (eGFR) decline ≥30% or ≥3 mL/min/year) and incident chronic kidney disease (CKD; incident eGFR & #x3c;60 mL/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 and ≥1 mL/min/year decline) were evaluated. Models were adjusted for demographics, baseline eGFR, urine albumin/creatinine ratio, comorbidity, and serum calcium, phosphorus, 25(OH) vitamin D and parathyroid hormone. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The mean (SD) age was 75 (3) years, with 52% female and 38% black. There were 405 persons with 30% decline, 702 with & #x3e;3 mL/min/year decline, and 536 with incident CKD. In fully adjusted continuous models, doubling of FGF-23 concentrations was not associated with kidney function decline (OR [95% CI] = 0.98 [0.82–1.19] for ≥30% decline and OR 1.17 [95% CI 1.00–1.37] for ≥3 mL/min/year decline), or incident CKD (incident rate ratio [IRR] 1.05 [95% CI 0.91–1.22]). In adjusted quartile analysis, the highest quartile of FGF-23 was significantly associated with incident CKD (IRR 1.27 [95% CI 1.02–1.58] for highest vs. lowest quartile). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Higher FGF-23 concentrations were not consistently associated with decline in kidney function or incident CKD in community-dwelling older adults.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000488361
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2018
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Rate of Kidney Function Decline in Older Adults: A Comparison Using Creatinine and Cystatin C
    S. Karger AG ; 2009
    In:  American Journal of Nephrology Vol. 30, No. 3 ( 2009), p. 171-178
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 30, No. 3 ( 2009), p. 171-178
    Kurzfassung: 〈 i 〉 Background/Aims: 〈 /i 〉 The aim of this study was to determine the decline in the estimated glomerular filtration rate (eGFR) in elderly persons and to compare estimates based on creatinine and cystatin C. 〈 i 〉 Methods: 〈 /i 〉 In the Cardiovascular Health Study, GFR changes in an elderly cohort were estimated from serum creatinine and cystatin C measured at baseline, year 3 and year 7 in 4,380 participants (age 72 ± 5 years at entry). Outcomes were mean eGFR decline, incident chronic kidney disease (CKD) and rapid decline in eGFR (annual loss 〉 3 ml/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 ). 〈 i 〉 Results: 〈 /i 〉 Mean annual eGFR loss as estimated from creatinine was 0.4 ± 3.6 ml/min/1.73 m 〈 sup 〉 2 〈 /sup 〉 , with 16% of the participants experiencing a rapid decline. Mean eGFR loss as estimated from cystatin C was 1.8 ± 2.6, with 25% of the participants experiencing a rapid decline (p 〈 0.001 for both). Among participants without baseline CKD, incident CKD was detected at year 7 in 10% (n = 263) using creatinine and 19% (n = 544) using cystatin C (p 〈 0.001). Increasing age was the strongest predictor of rapid decline; adjusted odds ratios were 1.38 (1.16–1.65), 1.62 (1.31–1.99) and 2.96 (2.28–3.84) for participants aged 70–74, 75–79 and 80+ at baseline, compared with those aged 65–69. 〈 i 〉 Conclusion: 〈 /i 〉 In elderly persons, cystatin C estimated substantially larger declines in kidney function than creatinine did. Defining the optimal measurement of kidney function in elderly persons should be a high priority for future research.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000212381
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2009
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Cognitive Function and Dialysis Adequacy: No Clear Relationship
    S. Karger AG ; 2011
    In:  American Journal of Nephrology Vol. 33, No. 1 ( 2011), p. 33-38
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 33, No. 1 ( 2011), p. 33-38
    Kurzfassung: 〈 i 〉 Background/Aims: 〈 /i 〉 Cognitive impairment is common in hemodialysis patients and may be impacted by multiple patient and treatment characteristics. The impact of dialysis dose on cognitive function remains uncertain, particularly in the current era of increased dialysis dose and flux. 〈 i 〉 Methods: 〈 /i 〉 We explored the cross-sectional relationship between dialysis adequacy and cognitive function in a cohort of maintenance hemodialysis patients. Adequacy was defined as the average of the 3 most proximate single pool Kt/V assessments. A detailed neurocognitive battery was administered during the 1st hour of dialysis. Multivariable linear regression models were adjusted for age, sex, education, race and other clinical and demographic characteristics. 〈 i 〉 Results: 〈 /i 〉 Among 273 patients who underwent cognitive testing, the mean (SD) age was 63 (17) years and the median dialysis duration was 13 months, 47% were woman, 22% were African American, and 48% had diabetes. The mean (SD) Kt/V was 1.51 (0.24). In univariate, parsimonious and multivariable models, there were no significant relationships between decreased cognitive function and lower Kt/V. 〈 i 〉 Conclusion: 〈 /i 〉 In contrast to several older studies, there is no association between lower Kt/V and worse cognitive performance in the current era of increased dialysis dose. Future studies should address the longitudinal relationship between adequacy of dialysis and cognitive function to confirm these findings.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000322611
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2011
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Depression and All-Cause Mortality in Hemodialysis Patients
    S. Karger AG ; 2014
    In:  American Journal of Nephrology Vol. 40, No. 1 ( 2014), p. 12-18
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 40, No. 1 ( 2014), p. 12-18
    Kurzfassung: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 There are limited data regarding the relationship between depression and mortality in hemodialysis (HD) patients. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Among 323 patients receiving maintenance HD, depression symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale, with a score of ≥16 consistent with depression. Adjusted Cox proportional-hazards models with additional analyses incorporating antidepressant medication use were used to evaluate the association between depression and mortality. Baseline CES-D scores were used for the primary analyses, while secondary time-dependent analyses incorporated subsequent CES-D results. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The mean age was 62.9 ± 16.5 years, 46% of the subjects were women and 22% were African-American. The mean baseline CES-D score was 10.7± 8.3, and 83 (26%) participants had CES-D scores ≥16. During a median (25th, 75th) follow-up of 25 (13, 43) months, 154 participants died. After adjusting for age, sex, race, primary cause of kidney failure, dialysis vintage and access, baseline depression was associated with an increased risk of all-cause mortality (HR 1.51 and 95% CI 1.06-2.17). This attenuated with further adjustment for cardiovascular disease, smoking, Kt/V, serum albumin, log C-reactive protein and use of antidepressants (HR 1.21 and 95% CI 0.82-1.80). When evaluating time-dependent CES-D, depression remained associated with increased mortality risk in the fully adjusted model (HR 1.44 and 95% CI 1.00-2.06). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Greater symptoms of depression are associated with an increased risk of mortality in HD patients, particularly when accounting for the most proximate assessment. This relationship was attenuated with adjustment for comorbid conditions, suggesting a complex relationship between clinical characteristics and depression symptoms. Future studies should evaluate whether treatment for depression impacts mortality among HD patients.
    Materialart: Online-Ressource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000363539
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2014
    ZDB Id: 1468523-1
    Standort Signatur Einschränkungen Verfügbarkeit
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