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Therapeutic Apheresis and Dialysis

Satoshi Tanida, Tsutomu Mizoshita, Keiji Ozeki, Takahito Katano, Mamoru Tanaka, Hirotada Nishie, Takaya Shimura, Yasuyuki Okamoto, Eiji Kubota, Hiromi Kataoka, Takashi Joh
Ustekinumab is applied to induce clinical remission in patients with Crohn's disease. Granulocyte and monocyte absorptive apheresis depletes activated myeloid lineage leukocytes and has been applied for active Crohn's disease. This study retrospectively examined the efficacy and safety of combining intensive granulocyte and monocyte absorptive apheresis and ustekinumab for remission induction therapy in refractory Crohn's disease. Between June and September 2017, three consecutive cases (two females) with refractory Crohn's disease were treated with intensive granulocyte and monocyte absorptive apheresis plus ustekinumab...
May 23, 2018: Therapeutic Apheresis and Dialysis
Takatoshi Kakuta, Mari Ishida, Masafumi Fukagawa
Measurement of circulating parathyroid hormone (PTH) levels is essential for optimal management of mineral and bone disorders (MBD) in chronic kidney disease (CKD) patients. There are two major types of PTH assays currently in use: intact parathyroid hormone (i-PTH) and whole PTH (w-PTH) assays. The i-PTH assay is the current standard, and considerable information regarding the management of CKD-MBD has been obtained with this method. However, several limitations have been found with the i-PTH assay. One limitation is that i-PTH assay also measures fragments other than full-length PTH (1-84)...
May 20, 2018: Therapeutic Apheresis and Dialysis
Satoko Miyamoto, Atsushi Ohkubo, Hiroshi Seshima, Hiroko Yamamoto, Ayako Itagaki, Takuma Maeda, Naoki Kurashima, Takayasu Mori, Soichiro Iimori, Shotaro Naito, Eisei Sohara, Tatemitsu Rai, Shinichi Uchida, Tomokazu Okado
Selective plasma exchange has been shown to be effective in various diseases, but no studies have assessed the benefits of daily treatment. We aimed to investigate the removal dynamics of immunoglobulins, fibrinogen, and factor XIII on three consecutive days in three patients. For mean processed plasma volumes of 1.06 × plasma volume, reductions of 79.6%, 49.3%, and 8.6% were seen for immunoglobulins G, A, and M, respectively. The reductions for fibrinogen and factor XIII were 18.4% and 13.0%, respectively...
May 20, 2018: Therapeutic Apheresis and Dialysis
Atsushi Ohkubo, Naoki Kurashima, Tomokazu Okado
No abstract text is available yet for this article.
May 20, 2018: Therapeutic Apheresis and Dialysis
Tomasz Piatek, Joanna Giebultowicz, Marieke Rüth, Horst-Dieter Lemke, Florian Bonn, Piotr Wroczynski, Piotr Malkowski, Jacek Rozga
Currently there is no direct therapy for liver failure. We have previously described selective plasma exchange therapy using a hemofilter permeable to substances that have a molecular mass of up to 100 kDa. The proof-of-concept studies and a Phase I study in patients with decompensated cirrhosis demonstrated that hemofiltration using an albumin-leaking membrane is safe and effective in removing target molecules, alleviating severe encephalopathy and improving blood chemistry. In this study a novel large-pore filter for similar clinical application is described...
May 16, 2018: Therapeutic Apheresis and Dialysis
Motoko Tanaka, Hirotaka Komaba, Masafumi Fukagawa
Anemia is a common complication of chronic kidney disease (CKD). There are various causes of renal anemia such as decreased production of erythropoietin, resistance to erythropoietin, shortened survival of red blood cells, and bone marrow fibrosis. Secondary hyperparathyroidism (SHPT) is a less recognized, but potentially significant cause of renal anemia in CKD patients. Parathyroid hormone (PTH) has been regarded as a uremic toxin that has multiple adverse effects, and its elevated levels have been associated with renal anemia in hemodialysis patients...
May 16, 2018: Therapeutic Apheresis and Dialysis
Takahiro Kawaji, Toshikazu Sakai, Kazuhiro Moriyama, Yoshitaka Hara, Tomoyuki Nakamura, Naohide Kuriyama, Yasuyo Shimomura, Yu Kato, Hidefumi Komura, Chizuru Yamashita, Yasuyoshi Kurimoto, Daisuke Hasegawa, Osamu Nishida
We aimed to investigate the effects of blood purification and cold saline injection sites on the transpulmonary thermodilution values. We measured the cardiac output of eight pigs in every combination of cold saline injection (left jugular and femoral veins) and blood purification sites (right jugular and femoral veins), with or without blood purification. We examined the influence of the difference between the presence and absence of blood purification, vascular sites for blood purification, and sites for cold saline injection on the transpulmonary thermodilution values...
May 10, 2018: Therapeutic Apheresis and Dialysis
Shoichi Nishise, Yuji Takeda, Hidetoshi Nara, Yasuhiko Abe, Yu Sasaki, Hironobu Asao, Yoshiyuki Ueno
Circulating levels of soluble intercellular adhesion molecule-1 (sICAM-1) and vascular adhesion molecule-1 (sVCAM-1) are elevated in patients with inflammatory bowel disease. Cellulose acetate (CA) beads are used as carriers for granulocyte and monocyte (GM) adsorptive apheresis (GMA). We investigated the effect of CA beads on sICAM-1 and sVCAM-1 plasma concentrations in vitro. Because GM adsorption to CA beads increased with a rise in the incubation temperature in our previous study, peripheral blood was incubated with and without CA beads at 5, 25, 37, or 43 °C and plasma sICAM-1 and sVCAM-1 was measured...
May 9, 2018: Therapeutic Apheresis and Dialysis
Hideki Fujii
Although parathyroid hormone is known to be related with calcium and phosphate metabolism, it has been also reported to have several effects on the cardiovascular system including heart and vessels. However, the detailed pathophysiological mechanisms remain unclear. Clinical studies have indicated that parathyroid hormone is associated with cardiovascular events and mortality not only in patients with chronic kidney disease but also in those without chronic kidney disease. As a possible mechanism, it is thought that parathyroid hormone is associated with the renin-angiotensin-aldosterone system and has direct effects on the cardiovascular system...
April 30, 2018: Therapeutic Apheresis and Dialysis
Hirotaka Komaba, Masafumi Fukagawa
Protein-energy wasting (PEW), a syndrome involving adverse changes in nutrition and body composition, is a serious problem associated with morbidity and mortality in patients with end-stage renal disease (ESRD). The pathogenesis of PEW is multifactorial, and the underlying mechanisms are not fully understood. However, recent translational work has provided compelling evidence for a causal role of parathyroid hormone (PTH) in the pathogenesis of adipose tissue browning and increased energy expenditure, a critical component of PEW in ESRD...
April 30, 2018: Therapeutic Apheresis and Dialysis
Tomohiko Matsuura, Takaya Abe, Mitsutaka Onoda, Daiki Ikarashi, Jun Sugimura, Toshiaki Komaki, Nariyuki Sasaki, Yumiko Takasawa, Tetsuo Kato, Kunihiro Yoshioka, Shigeru Ehara, Wataru Obara
Patients who undergo hemodialysis often suffer from cardiovascular disease (CVD), and evaluation of coronary artery calcification is extremely important. These evaluations are typically conducted using a noninvasive method including electron beam computed tomography (CT) or multi-detector CT, and the Agatston method to calculate the coronary artery calcification score (CACS). However, it is difficult to use for patients undergoing dialysis. Because patients undergoing dialysis is too strong in coronary artery calcification, and results become incorrect...
March 30, 2018: Therapeutic Apheresis and Dialysis
Kamal Hassan, Yotam Elimeleh, Mona Shehadeh, Fadi Hassan, Irina Rubinchik
This cross-sectional study examined possible associations of peritoneal glucose load with male sexual dysfunction and depression in peritoneal dialysis patients. Compared to patients with peritoneal glucose load ≤3 g/kg per day, those with load >3 g/kg per day had higher Beck Depression Inventory scores, (18.9 ± 5.4 vs. 11.4 ± 5.8, P = 0.002) and lower International Index of Erectile Function scores, serum total testosterone and DHEA [(15.4 ± 6.4 vs. 45.1 ± 20.7, P < 0...
March 30, 2018: Therapeutic Apheresis and Dialysis
Yoko Nishizawa, Chieko Higuchi, Takashi Nakaoka, Hisako Omori, Tetsuya Ogawa, Hiroshi Sakura, Kosaku Nitta
While vascular calcification is an important factor regulating prognosis in dialysis patients, its components have not been adequately studied. We analyzed in vivo components of calcification in the coronary arteries of dialysis patients using the effective atomic number from dual-energy computed tomography. In dialysis patients (hemodialysis, N = 10; peritoneal dialysis, N = 12), average of median effective atomic number was 13.8 in the hemodialysis group, and 13.7 in the peritoneal dialysis group...
March 30, 2018: Therapeutic Apheresis and Dialysis
Abdullah Al-Hwiesh, Ibrahiem Abdul-Rahman, Fredric Finkelstein, Jose Divino-Filho, Hatem Qutub, Nadia Al-Audah, Abdalla Abdelrahman, Nazeeh El-Fakhrany, Mohammed Nasr El-Din, Tamer El-Salamony, Abdulsalam Noor, Mohammed Al-Shahrani, Khalid Al-Otaibi
Few studies have discussed the role of peritoneal dialysis (PD) in managing acute kidney injury (AKI) in critically ill patients. The present study compares the outcome of AKI in intensive care unit (ICU) patients randomized to treatment with tidal PD (TPD) or continuous venovenous hemodiafiltration (CVVHDF). One hundred and twenty-five ICU patients with AKI were randomly allotted to CVVHDF, (Group A, N = 62) or TPD, (group B, N = 63). Cause and severity of renal injury were assessed at the time of initiating dialysis...
March 25, 2018: Therapeutic Apheresis and Dialysis
Yoshinari Oka, Masashi Miyazaki, Yasumasa Monobe
No abstract text is available yet for this article.
March 23, 2018: Therapeutic Apheresis and Dialysis
Clemente N Sousa, Inês Ligeiro, Paulo Teles, Lúcia Paixão, Vanessa Ff Dias, António F Cristovão
Teaching/educating patients with end stage renal disease (ESRD) and identifying their self-care behaviors for vascular network preservation are very important. However, the self-care behaviors regularly performed by patients are still unknown. We compared self-care behaviors for vascular network preservation performed by patients who are/are not followed-up by the nephrologist. The study design was a prospective, observational and comparative study. Inclusion criteria were as follows: ESRD patients (at stages 4 or 5); at least 18 years old; in pre-dialysis with at least a 6-month follow-up period by the nephrologist or who started dialysis in emergency and were not followed-up by the nephrologist; with no memory problems; and medically stable...
March 23, 2018: Therapeutic Apheresis and Dialysis
Ying Zhang, Xianglei Kong, Lijun Tang, Yong Wei, Dongmei Xu
Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double-blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit...
April 2018: Therapeutic Apheresis and Dialysis
Kamonwan Tangvoraphonkchai, Andrew Davenport
Hemodialysis patients (HD) commonly report fatigue. Muscle wasting (sarcopenia) and extracellular water (ECW) excess have been reported to be associated with fatigue in other conditions. We wished to determine whether muscle loss and ECW excess were associated with fatigue in HD patients. Patients completed the Multidimensional Fatigue Inventory (MFI), Beck Depression Inventory-II (BDI-II), Patient Health Questionnaires (PHQ-9) and recorded their post-dialysis recovery time. Sessional dialysis data were recorded along with pre- and post-dialysis multi-frequency bioimpedance assessments (MFBIA)...
April 2018: Therapeutic Apheresis and Dialysis
Detlef H Krieter, Florian Lange, Horst-Dieter Lemke, Florian Bonn, Christoph Wanner
Technical problems during clinical lipid apheresis interfere with fractionator performance. Therefore, a large animal model was established to characterize a new plasma fractionation membrane. Four sheep were randomized, controlled, and crossover subjected to double ofiltration lipoprotein apheresis with three specimens of FractioPESR having slightly different HDL sieving coefficients (SK ) (FPESa, 0.30, FPESb, 0.26, and FPESc, 0.22) versus a control fractionator (EVAL). SK and reduction ratios were determined for LDL, HDL, fibrinogen, IgG, and albumin...
April 2018: Therapeutic Apheresis and Dialysis
Suree Yoowannakul, Lauren S Harris, Andrew Davenport
Peritoneal protein clearance (PPCl) depends upon vascular supply and size selective permeability. Some previous reports suggested PPCl can distinguish fast peritoneal membrane transport due to local or systemic inflammation. However, as studies have been discordant, we wished to determine factors associated with an increased PPCl. Consecutive patients starting peritoneal dialysis (PD) who were peritonitis-free were studied. Data included a baseline peritoneal equilibration test (PET), measurement of dialysis adequacy, 24-h dialysate PPCl and body composition measured by multifrequency bioimpedance...
April 2018: Therapeutic Apheresis and Dialysis
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