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Blood Purification

Kianoush Kashani, Claudio Ronco
Acute kidney injury (AKI) is a common complication of acute illnesses with significant impact on the mortality and morbidity. Early recognition of AKI allows clinicians to provide prophylactic interventions and to improve the outcomes of this deadly syndrome. Growing utilization and capabilities of electronic health records allow AKI risk stratification and early recognition with a potential effect on the processes of care and outcomes. We evaluate the current level of evidence on the impact of the AKI e-alert on the processes of care and outcomes...
October 14, 2016: Blood Purification
Xiaohong Chen, Bo Shen, Jianzhou Zou, Zhonghua Liu, Wenlv Lv, Xuesen Cao, Jiawei Yu, Yuxin Nie, Jiarui Xu, Li Wang, Xiaoqiang Ding
AIMS: To examine the association between red blood cell distribution width (RDW) and mortality in hemodialysis (HD) patients. METHODS: Three hundred fifty six patients on HD for >3 months were enrolled and followed for 2 years. Patients were divided into 2 groups according to the median RDW value. Patient survival and risk factors for mortality were investigated. RESULTS: The 2-year survival rate was significantly lower in the high-RDW group (>14...
October 6, 2016: Blood Purification
Srinivas Subramanian, Muhammad Masoom Javaid
No abstract text is available yet for this article.
October 6, 2016: Blood Purification
Carlotta Caprara, Gilbert R Kinsey, Valentina Corradi, Wenjun Xin, Jennie Z Ma, Elisa Scalzotto, Francesca K Martino, Mark D Okusa, Federico Nalesso, Fiorenza Ferrari, Mitchell Rosner, Claudio Ronco
AIMS: The study aimed to determine whether the available literature supports a positive or negative influence of dialysis on regulatory T-cells (Tregs). METHODS: We performed a systematic search and a meta-analysis. Mean differences in Tregs number of chronic kidney disease stages G5 on dialysis patients (CKD G5D) and healthy controls (HCs) were compared. Random effects model was applied. The software used was general package for meta-analysis (version 4.3-0, depends R (≥2...
October 1, 2016: Blood Purification
Maurizio Bossola, Enrico Di Stasio, Maurizio Sanguinetti, Brunella Posteraro, Manuela Antocicco, Gilda Pepe, Enrica Mello, Francesca Bugli, Carlo Vulpio
BACKGROUND: This study aims to evaluate, in patients on chronic hemodialysis (PHD), the levels of endotoxin through a chemiluminescent bioassay based on the oxidative burst reaction of activated neutrophils to complement coated LPS-IgM immune complexes and define the variables possibly correlated. METHODS: In 61 PHD, we measured serum endotoxin activity (EA) with the Endotoxin Activity Assay (EAA™) and we defined the possible association with demographic, clinical and laboratory variables...
August 31, 2016: Blood Purification
Alessandro Domenici, Anna Giuliani, Francesca Sivo, Clorinda Falcone, Giorgio Punzo, Paolo Menè
This study compares 5 different tidal automated peritoneal dialysis (APD) prescriptions. Six low-average and 6 high-average transporters performed 3 separate sessions with 5 different schedules: (A) 50% tidal with initial fill volume (FV) 2 liters, (B) 50% tidal with 2.2 liters initial FV, (C) 2.2 liters initial FV with 70% tidal, (D) as in B, with one complete renewal of the initial FV at midsession, (E) 2.2 liters FV with breakpoint modality. Urea, creatinine and phosphate peritoneal clearances, sodium removal and ultrafiltration (UF) were compared using analysis of variance...
August 30, 2016: Blood Purification
Amir Kazory
Enhanced removal of sodium has often been cited as an advantage of ultrafiltration (UF) therapy over diuretic-based medical treatment in the management of acute decompensated heart failure. However, so far clinical studies have rarely evaluated the precise magnitude of sodium removal, and this assumption is largely based on the physiologic mechanisms and anecdotal observations that predate the contemporary management of heart failure. Recent data suggest that patients treated with UF experience substantial reduction in urinary sodium excretion possibly due to prolonged intravascular volume contraction...
August 30, 2016: Blood Purification
Guglielmo Consales, Lucia Zamidei, Giuliano Michelagnoli
No abstract text is available yet for this article.
August 30, 2016: Blood Purification
Til Leimbach, Joachim Kron, Wolfgang Pommer, Birgit Urbach, Susanne Kron
BACKGROUND: An increasing number of patients start dialysis when they are over 80 years or reaches their eighties on dialysis. The burden of dialysis can affect their quality of life. METHODS: Clinical and social data of all patients aged 80 years or older who underwent chronic dialysis treatment in a single center were analyzed. RESULTS: Fifty-nine patients aged between 80 and 92 years were in chronic dialysis treatment on December 31, 2015...
August 30, 2016: Blood Purification
Julien Demiselle, Virginie Besson, Johnny Sayegh, Jean-François Subra, Jean-François Augusto
BACKGROUND: Total artificial heart (TAH) device is sometimes necessary to treat end stage heart failure (HF). After surgery, renal impairment can occur with the need of renal replacement therapy. METHOD: We report the case of a 51-year-old man who was treated with conventional hemodialysis (HD) while on support with TAH. RESULTS: The patient underwent HD while on TAH support during 14 months. He benefited from conventional HD, 6 sessions per week...
August 30, 2016: Blood Purification
(no author information available yet)
No abstract text is available yet for this article.
June 3, 2016: Blood Purification
Faruk Turgut, Sana Sungur, Ramazan Okur, Mustafa Yaprak, Muge Ozsan, Ihsan Ustun, Cumali Gokce
BACKGROUND: Bisphenol A (BPA) has been implicated as an 'endocrine disruptor'. We aimed at exploring the association between serum BPA levels and patient characteristics, particularly the presence of diabetes mellitus, and laboratory parameters in hemodialysis patients. METHODS: This study included 47 chronic hemodialysis patients. Patient characteristics were recorded. Blood was drawn before and after hemodialysis session. Serum BPA levels were measured by the high-performance-liquid-chromatography and laboratory parameters were measured by using standard methods...
May 19, 2016: Blood Purification
Jochen G Raimann, Viviane Calice-Silva, Stephan Thijssen, Fabiana Baggio Nerbass, Marcos A Vieira, Pascal Dabel, Rhys Evans, John Callegari, Mary Carter, Nathan W Levin, James F Winchester, Peter Kotanko, Roberto Pecoits-Filho
BACKGROUND: Acute kidney injury (AKI) is a growing global concern and often reversible. Saliva urea nitrogen (SUN) measured by a dipstick may allow rapid diagnosis. We studied longitudinal agreement between SUN and blood urea nitrogen (BUN) and the diagnostic performance of both. METHODS: Agreement between SUN and BUN and diagnostic performance to diagnose AKI severity in AKI patients in the United States and Brazil were studied. Bland-Altman analysis and linear mixed effects models were employed to test the agreement between SUN and BUN...
April 22, 2016: Blood Purification
Sawako Kato, Bengt Lindholm, Yukio Yuzawa, Yoshinari Tsuruta, Kana Nakauchi, Kaoru Yasuda, Sachiyo Sugiura, Kunio Morozumi, Naotake Tsuboi, Shoichi Maruyama
AIMS: The aim of the study was to clarify the relationship between serum ferritin and infectious risks. METHODS: We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. RESULTS: Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82...
April 20, 2016: Blood Purification
Raghavan Murugan, Eric Hoste, Ravindra L Mehta, Sara Samoni, Xiaoqiang Ding, Mitchell H Rosner, John A Kellum, Claudio Ronco
Fluid management during continuous renal replacement therapy (CRRT) in critically ill patients is a dynamic process that encompasses 3 inter-related goals: maintenance of the patency of the CRRT circuit, maintenance of plasma electrolyte and acid-base homeostasis and regulation of patient fluid balance. In this article, we report the consensus recommendations of the 2016 Acute Disease Quality Initiative XVII conference on 'Precision Fluid Management in CRRT'. We discuss the principles of fluid management, describe various prescription methods to achieve circuit integrity and introduce the concept of integrated fluid balance for tailoring fluid balance to the needs of the individual patient...
2016: Blood Purification
J Cerdá, I Baldwin, P M Honore, G Villa, John A Kellum, Claudio Ronco
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research...
2016: Blood Purification
Sean M Bagshaw, Madarasu Rajasekara Chakravarthi, Zaccaria Ricci, Ashita Tolwani, M Neri, S De Rosa, John A Kellum, Claudio Ronco
Continuous renal replacement therapy (CRRT) remains the dominant form of renal support among critically ill patients worldwide. Current clinical practice on CRRT prescription mostly relies on high quality studies suggesting no impact of CRRT dose on critically ill patients' outcomes. Recent clinical practice guidelines have been developed based on these studies recommending a static prescribed CRRT dose of 20-25 ml/kg/h. There is a rationale for renewed attention to CRRT prescription/practice based on the concept of dynamic solute control adapted to the changing clinical needs of critically ill patients...
2016: Blood Purification
Marlies Ostermann, Michael Joannidis, Antonello Pani, Matteo Floris, Silvia De Rosa, John A Kellum, Claudio Ronco
When and in whom to initiate continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) remains a highly controversial topic with large practice variation around the world. Even within countries, practice variation exists and recommendations for clinical practice are not specific. In this article, we report the consensus recommendations for timing and patient selection for CRRT - the results of the 2016 Acute Disease Quality Initiative XVII conference on 'precision CRRT'. We suggest that these recommendations could serve to develop the best clinical practice and standards of care for use of CRRT in patients with AKI...
2016: Blood Purification
John A Kellum, Claudio Ronco
No abstract text is available yet for this article.
2016: Blood Purification
Rita Jacobs, Patrick M Honore, Inne Hendrickx, Herbert D Spapen
No abstract text is available yet for this article.
2016: Blood Purification
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