***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Anemia and malnutrition are significant complications in peritoneal dialysis ( PD ) patients . Previous studies in hemodialysis have shown that and rogens are effective as therapy for anemia ; however , this has not been tested in a r and omized prospect i ve trial in PD patients . Furthermore , the anabolic properties of and rogens may exert additional benefits on the nutritional status in this population . METHODS Twenty-seven stable male patients over 50 years who were under maintenance continuous ambulatory peritoneal dialysis ( CAPD ) therapy were r and omized to receive recombinant human erythropoietin ( rHuEPO ; N = 14 ) or n and rolone decanoate ( ND ; 200 mg/week IM ; N = 13 ) as therapy for anemia . The evolution of hematologic parameters and the impact on both nutritional anthropometric and biochemical variables were evaluated after six months of treatment . RESULTS Hemoglobin and hematocrit experienced similar increases in both groups : from 8.5 + /- 0.9 g/dL and 25.8 + /- 2.7 % to 11.7 + /- 0.6 g/dL and 34.7 + /- 1.6 % ( P < 0.001 ) in patients receiving rHuEPO , and from 8.9 + /- 0.8 and 27 + /- 2.2 % to 11.8 + /- 0.4 g/dL and 35.1 + /- 1.5 % ( P < 0.001 ) in subjects treated with ND . At the end of the study , out of the diverse nutritional variables included in this investigation , only weight and body mass index significantly increased in the rHuEPO group . Conversely , both anthropometric [ weight , body mass index , triceps skinfold , mid-arm circumference ( MAC ) and mid-arm muscle circumference ( MAMC ) ] and biochemical parameters ( serum total proteins , albumin , prealbumin and transferrin ) were significantly increased in patients treated with ND . In this group , serum urea nitrogen , urea net excretion and protein equivalent of nitrogen appearance significantly decreased . These facts , together with an increase in serum creatinine and no changes in dietary intake during the study , suggest a rise in muscle mass related to an anabolic effect of n and rolone decanoate . Interestingly , serum levels of insulin-like growth factor type 1 ( IGF-1 ) increased in patients on the and rogen group compared to subjects treated with rHuEPO . Moreover , there was a positive and significant correlation between the rise in IGF-1 concentrations and the increase in hemoglobin , hematocrit , MAC and MAMC . CONCLUSIONS And rogens therapy improved the anemia in elderly male CAPD patients in a similar manner to that observed with rHuEPO . Furthermore , compared with rHuEPO , and rogen administration was associated with beneficial effects on nutritional status . The mechanism of action of and rogens on hematologic and nutritional parameters might be mediated , at least in part , by IGF-1 Background The main hypothesis of this study is that Oxpentifylline administration will effectively treat erythropoietin- or darbepoietin-resistant anaemia in chronic kidney disease patients . Methods / design Inclusion criteria are adult patients with stage 4 or 5 chronic kidney disease ( including dialysis patients ) with significant anaemia ( haemoglobin ≤ 110 g/L ) for at least 3 months for which there is no clear identifiable cause and that is unresponsive to large doses of either erythropoietin ( ≥ 200 IU/kg/week ) or darbepoetin ( ≥ 1 μg/kg/week ) . Patients will be r and omized 1:1 to receive either placebo ( 1 tablet daily ) or oxpentifylline ( 400 mg daily ) per os for a period of 4 months . During this 4 month study period , haemoglobin measurements will be performed monthly . The primary outcome measure will be the difference in haemoglobin level between the 2 groups at the end of the 4 month study period , adjusted for baseline values . Secondary outcome measures will include erythropoiesis stimulating agent dosage , Key 's index ( erythropoiesis stimulating agent dosage divided by haemoglobin concentration ) , and blood transfusion requirement . Discussion This investigator-initiated multicentre study has been design ed to provide evidence to help nephrologists and their chronic kidney disease patients determine whether oxpentifylline represents a safe and effective strategy for treating erythropoiesis stimulating agent resistance in chronic kidney disease . Trial Registration Australian New Zeal and Clinical Trials Registry Number ACTRN12608000199314 Background Left ventricular ( LV ) hypertrophy is common among patients on hemodialysis . While a relationship between blood pressure ( BP ) and LV hypertrophy has been established , it is unclear which BP measurement method is the strongest correlate of LV hypertrophy . We sought to determine agreement between various blood pressure measurement methods , as well as identify which method was the strongest correlate of LV hypertrophy among patients on hemodialysis . Methods This was a post-hoc analysis of data from a r and omized controlled trial . We evaluated the agreement between seven BP measurement methods : st and ardized measurement at baseline ; single pre- and post-dialysis , as well as mean intra-dialytic measurement at baseline ; and cumulative pre- , intra- and post-dialysis readings ( an average of 12 monthly readings based on a single day per month ) . Agreement was assessed using Lin 's concordance correlation coefficient ( CCC ) and the Bl and Altman method . Association between BP measurement method and LV hypertrophy on baseline cardiac MRI was determined using receiver operating characteristic curves and area under the curve ( AUC ) . Results Agreement between BP measurement methods in the 39 patients on hemodialysis varied considerably , from a CCC of 0.35 to 0.94 , with overlapping 95 % confidence intervals . Pre-dialysis measurements were the weakest predictors of LV hypertrophy while st and ardized , post- and inter-dialytic measurements had similar and strong ( AUC 0.79 to 0.80 ) predictive power for LV hypertrophy . Conclusions A single st and ardized BP has strong predictive power for LV hypertrophy and performs just as well as more re source intensive cumulative measurements , whereas pre-dialysis blood pressure measurements have the weakest predictive power for LV hypertrophy . Current guidelines , which recommend using pre-dialysis measurements , should be revisited to confirm these results CONTEXT Morbidity and mortality rates in hemodialysis patients remain excessive . Alterations in the delivery of dialysis may lead to improved patient outcomes . OBJECTIVE To compare the effects of frequent nocturnal hemodialysis vs conventional hemodialysis on change in left ventricular mass and health-related quality of life over 6 months . DESIGN , SETTING , AND PARTICIPANTS A 2-group , parallel , r and omized controlled trial conducted at 2 Canadian university centers between August 2004 and December 2006 . A total of 52 patients undergoing hemodialysis were recruited . INTERVENTION Participants were r and omly assigned in a 1:1 ratio to receive nocturnal hemodialysis 6 times weekly or conventional hemodialysis 3 times weekly . MAIN OUTCOME MEASURES The primary outcome was change in left ventricular mass , as measured by cardiovascular magnetic resonance imaging . The secondary outcomes were patient-reported quality of life , blood pressure , mineral metabolism , and use of medications . RESULTS Frequent nocturnal hemodialysis significantly improved the primary outcome ( mean left ventricular mass difference between groups , 15.3 g , 95 % confidence interval [ CI ] , 1.0 to 29.6 g ; P = .04 ) . Frequent nocturnal hemodialysis did not significantly improve quality of life ( difference of change in EuroQol 5-D index from baseline , 0.05 ; 95 % CI , -0.07 to 0.17 ; P = .43 ) . However , frequent nocturnal hemodialysis was associated with clinical ly and statistically significant improvements in selected kidney-specific domains of quality of life ( P = .01 for effects of kidney disease and P = .02 for burden of kidney disease ) . Frequent nocturnal hemodialysis was also associated with improvements in systolic blood pressure ( P = .01 after adjustment ) and mineral metabolism , including a reduction in or discontinuation of antihypertensive medications ( 16/26 patients in the nocturnal hemodialysis group vs 3/25 patients in the conventional hemodialysis group ; P < .001 ) and oral phosphate binders ( 19/26 patients in the nocturnal hemodialysis group vs 3/25 patients in the conventional dialysis group ; P < .001 ) . No benefit in anemia management was seen with nocturnal hemodialysis . CONCLUSION This preliminary study revealed that , compared with conventional hemodialysis ( 3 times weekly ) , frequent nocturnal hemodialysis improved left ventricular mass , reduced the need for blood pressure medications , improved some measures of mineral metabolism , and improved selected measures of quality of life . TRIAL REGISTRATION is rct n.org Identifier : IS RCT N25858715 BACKGROUND Intravenous ascorbic acid ( IVAA ) administration is reported to enhance erythropoiesis in hemodialysis ( HD ) patients with functional iron deficiency . We explored the effects of IVAA on erythropoiesis and health-related quality of life ( HRQOL ) in unselected HD patients . METHODS Sixty-one HD patients were divided into two groups ; 30 patients received 100 mg of IVAA ( IVAA group ) and 31 patients did not ( control group ) after each dialysis session . Hematocrit ( Hct ) , reticulocyte hemoglobin content , transferrin saturation , ferritin , weekly recombinant human erythropoietin ( rHuEPO ) dosage , weekly intravenous iron ( IVFE ) dosage , and MOS Short Form 36 ( SF-36 ) scale scores were measured at baseline and after 6 months of treatment . RESULTS Mean changes in Hct in the IVAA and control groups were -0.5 and -0.6 mg/dL , respectively , while mean changes in SF-36 scale scores were : physical functioning -1.6 in the IVAA group and 0.38 in the controls ; role physical ( RP ) 3.8 and 9.4 ; bodily pain 9.7 and 0.81 ; general health perception 3.7 and -0.68 ; vitality 4.3 and -7.5 ; social functioning 2.7 and 0.43 ; role emotional ( RE ) 6.9 and 4.9 ; mental health 3.6 and -1.7 . The IVAA group showed significantly higher adverse events ( chest pain : n=1 , nausea : n=2 and fatigue : n=2 ) compared to the controls ( no event ) . CONCLUSIONS The beneficial effects of IVAA on erythropoiesis and HRQOL were not demonstrated in unselected HD patients . Indication of IVAA for HD patients leaves room for further study BACKGROUND Anaemia is one of the major clinical characteristics of patients with chronic renal failure , and has a considerable effect on morbidity and mortality .  Adequate dialysis is of paramount importance in correcting anaemia by removing small and medium-sized molecules , which may inhibit erythropoiesis . However , high-molecular-weight inhibitors cleared only by means of highly porous membranes have also been found in uraemic serum and it has been cl aim ed from uncontrolled studies that high-flux dialysis could improve anaemia in haemodialysis patients . METHODS We therefore planned this multicentre r and omized controlled trial with the aim of testing whether the use of a large-pore biocompatible membrane for a fixed 12-week follow-up improves anaemia in haemodialysis patients in comparison with the use of a conventional cellulose membrane .  Eighty-four ( 5.3 % ) of a total of 1576 adult haemodialysed patients attending 13 Dialysis Units fulfilled the entry criteria and were r and omly assigned to the experimental  treatment ( 42 patients ) or conventional treatment ( 42 patients ) . RESULTS Haemoglobin levels increased non-significantly from 9.5+/-0.8 to 9.8+/-1.3 g/dl ( dP=0 . 069 ) in the population as a whole , with no significant difference between the two groups ( P:=0.485 ) . Erythropoietin therapy was given to 32/39 patients ( 82 % ) in the conventional group , and 26/35 ( 74 % ) in the experimental group ( P:=0.783 ) with subcutaneous administration to 26/32 patients in conventional and to 23/26 patients in experimental group , P:=0.495 . Dialysis dose ( Kt/V ) remained constant in both groups ( from 1.30+/-0.17 to 1.33+/-0.20 in the conventional group and from 1.28+/-0.26 to 1.26+/-0.21 in the experimental group , P:=0.242 ) . Median pre- and post-dialysis beta(2)-microglobulin levels remained constant in the conventional group ( 31.9 and 34.1 mg/dl at baseline ) and decreased in the experimental group ( pre-dialysis values from 31.1 to 24.7 mg/dl , P:=0.0 
    Output:
    
There was inadequate evidence identified to inform recommendation of any intervention to ameliorate ESA hyporesponsiveness .