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Hemodiafiltration

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https://www.readbyqxmd.com/read/29148024/blue-planet-dialysis-novel-water-sparing-strategies-for-reducing-dialysate-flow
#1
Alejandra Molano-Triviño, Benjamin Wancjer, Mauro M Neri, Akash N Karopadi, Mitchell Rosner, Claudio Ronco
INTRODUCTION: Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. METHODS: We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux...
November 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29133076/comparison-of-the-hemodynamic-tolerance-and-the-biological-parameters-of-four-acetate-free-hemodialysis-methods
#2
George Kosmadakis, Enrique Da Costa Correia, Julie Albaret, Frédéric Somda, Didier Aguilera
PURPOSE: Acetate in hemodialysis solutions exerts inflammatory, vasodilatatory and cardio-depressive effects. Citrate has been proposed as an optimal substitute. The aim of the present trial was the comparison of the hemodynamic and biological parameters on a group of patients dialysed consecutively with 4 acetate-free haemodialysis techniques. METHODS: In a prospective crossover manner, we measured the hemodynamic and biological effects of four acetate-free hemodialysis methods: he acetate-free biofiltration with variable potassium (AFBK) and three methods with a citrate buffer: onventional hemodialysis (HD), on-line hemodiafiltration (HDF) and on-line hemofiltration (HF)...
November 10, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29130577/factors-affecting-the-patency-of-arteriovenous-fistulas-for-hemodialysis-single-center-experience
#3
Radojica V Stolic, Goran Z Trajkovic, Mirjana M Kostic, Branko Mihailovic, Aleksandar N Jovanovic, Bratislav D Lazic, Ivana R Matijasević, Maša D Jaksić, Zlatica M Mirkovic, Tanja N Smilic, Javorka S Mitic
INTRODUCTION: Arteriovenous fistulas (AVFs) are the preferred form vascular access for hemodialysis (HD), as they have a low rate of complications and durable function. The aim of our investigation was to analyze the factors that might influence the function of AVFs. METHODS: Data were taken from the computerized patient record system in the Clinic of Urology and Nephrology, Clinical Center, Kragujevac, Serbia, for a 2-year period. We analyzed patients who had requested re-creation of AVFs as a secondary procedure...
November 12, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29123848/a-case-of-type-2-diabetes-mellitus-with-metformin-associated-lactic-acidosis-initially-presenting-the-appearance-of-a-sulfonylurea-related-hypoglycemic-attack
#4
Kota Nishihama, Kanako Maki, Yuko Okano, Rei Hashimoto, Yasuhiro Hotta, Mei Uemura, Taro Yasuma, Toshinari Suzuki, Toyomi Hayashi, Eiji Ishikawa, Yutaka Yano, Esteban C Gabazza, Masaaki Ito, Yoshiyuki Takei
Case: A 64-year-old Japanese woman with diabetes mellitus was admitted for hypoglycemia. Her diabetes had been under good control with glimepiride, voglibose, exenatide, and metformin for a few years. Although overt proteinuria was observed, the serum creatinine values were within normal range during the routine outpatient follow-up. Hypoglycemic attack caused by glimepiride and loss of appetite by urinary tract infection were diagnosed. Then, metformin-associated lactic acidosis with acute renal failure caused by dehydration was detected...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29115027/clinical-features-of-pediatric-autoimmune-hepatitis-in-japan-a-nationwide-survey
#5
Tsuyoshi Sogo, Atsushi Takahashi, Ayano Inui, Tomoo Fujisawa, Hiromasa Ohira, Hajime Takikawa
AIM: The purpose of this study was to determine the characteristics of children with autoimmune hepatitis (AIH) in Japan. METHODS: Questionnaires, which asked about patients newly diagnosed with AIH from 2009 to 2013 were sent to hospitals certified as training facilities for pediatrics in January 2015. RESULTS: A total of 35 patients were enrolled. The median age at diagnosis was 10 years (ranging from 3 months to 15 years), and the male-to-female ratio was 2:3...
November 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29089189/metformin-intoxication-vasopressin-s-key-role-in-the-management-of-severe-lactic-acidosis
#6
Francesca Galiero, Giovanni Consani, Gianni Biancofiore, Stefano Ruschi, Francesco Forfori
Vasopressin is a potent vasopressor used for improving organ perfusion during cardiac arrest, septic and catecholamine-resistant shock; with reference to this, it is useful for the treatment of vasoplegic shock because, restoring organ perfusion pressure by contraction of vascular smooth muscle through a non-catecholamine receptor pathway, it can be employed when catecholamines are ineffective. A 49-yr-old woman was admitted to the Emergency Department after having intentionally taken 95.2g of metformin, 1...
October 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29054458/dosing-optimization-of-meropenem-based-on-a-pharmacokinetic-analysis-in-patients-receiving-hemodiafiltration-and-an-in%C3%A2-vitro-model
#7
Yuta Yokoyama, Kakine Nishino, Kazuaki Matsumoto, Yuki Inomoto, Kaori Matsuda, Rin-Nosuke Nakamura, Nobuhiro Yasuno, Junko Kizu
The purpose of this study was to estimate the in vivo pharmacokinetics of meropenem during intermittent-infusion hemodiafiltration (I-HDF) and clarify its optimal dosage and dosing interval in patients receiving I-HDF. The clearance of meropenem by online hemodiafiltration (OL-HDF) and I-HDF was predicted using an in vitro system and assessed to establish whether the results obtained are applicable to clinical cases. In the in vivo study, the mean volume of distribution (Vd), non-I-HDF clearance (CLnon-I-HDF), and I-HDF clearance (CLI-HDF) were 15...
October 17, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29041011/hemodiafiltration-reduces-all-cause-and-cardiovascular-mortality-in-incident-hemodialysis-patients-a-propensity-matched-cohort-study
#8
Francisco Maduell, Javier Varas, Rosa Ramos, Alejandro Martin-Malo, Rafael Pérez-Garcia, Isabel Berdud, Francesc Moreso, Bernard Canaud, Stefano Stuard, Adelheid Gauly, Pedro Aljama, Jose Ignacio Merello
BACKGROUND: The majority of studies suggesting that online hemodiafiltration reduces the risk of mortality compared to hemodialysis (HD) have been performed in dialysis-prevalent populations. In this report, we conducted an epidemiologic study of mortality in incident dialysis patients, comparing post-dilution online hemodiafiltration and high-flux HD, with propensity score matching (PSM) used to correct indication bias. METHODS: Our study cohort comprised 3,075 incident dialysis patients treated in 64 Spanish Fresenius Medical Care clinics between January 2009 and December 2012...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29040687/mortality-risk-in-patients-on-hemodiafiltration-versus-hemodialysis-a-real-world-comparison-from-the-dopps
#9
Francesco Locatelli, Angelo Karaboyas, Ronald L Pisoni, Bruce M Robinson, Joan Fort, Raymond Vanholder, Hugh C Rayner, Werner Kleophas, Stefan H Jacobson, Christian Combe, Friedrich K Port, Francesca Tentori
Background: With its convective component, hemodiafiltration (HDF) provides better middle molecule clearance compared with hemodialysis (HD) and is postulated to improve survival. A previous analysis of Dialysis Outcomes and Practice Patterns Study (DOPPS) data in 1998-2001 found lower mortality rates for high replacement fluid volume HDF versus HD. Randomized controlled trials have not shown uniform survival advantage for HDF; in secondary (non-randomized) analyses, better outcomes were observed in patients receiving the highest convection volumes...
October 11, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29030713/nationwide-survey-for-acute-liver-failure-and-late-onset-hepatic-failure-in-japan
#10
Masamitsu Nakao, Nobuaki Nakayama, Yoshihito Uchida, Tomoaki Tomiya, Akio Ido, Isao Sakaida, Osamu Yokosuka, Yasuhiro Takikawa, Kazuaki Inoue, Takuya Genda, Masahito Shimizu, Shuji Terai, Hirohito Tsubouchi, Hajime Takikawa, Satoshi Mochida
BACKGROUND: A nationwide survey was performed to clarify the recent status of acute liver failure (ALF) and late-onset hepatic failure (LOHF) in Japan. METHODS: Two-step surveys for patients with ALF and LOHF meeting the Japanese diagnostic criteria were performed annually in 782 hospitals. The clinical features of the patients were then compared to those reported in previous surveys. RESULTS: In total, 1554 and 49 patients with ALF and LOHF, respectively, who were seen between 2010 and 2015 were enrolled...
October 13, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28980449/high-volume-continuous-venovenous-hemodiafiltration-plus-resin-hemoperfusion-improve-severe-metformin-associated-toxicity
#11
Shuangxin Liu, Lixia Xu, Jianchao Ma, Renwei Huang, Ting Lin, Zhuo Li, Huabang Liang, Sijia Li, Ruizhao Li, Li Zhang, Yiming Tao, Zhilian Li, Yuanhan Chen, Zhiming Ye, Bin Zhang, Wenjian Wang, Houqing Xiao, Xinling Liang, Wei Shi
We present the case of a 42-year-old female patient who attempted suicide by taking approximately 100 tablets of metformin (500 mg). Laboratory tests revealed severe lactic acidosis with lactate levels of 24 mmol/L and pH of 7.09. The patient was treated with high-volume continuous venovenous hemodiafiltration (CVVH) and resin-sorbent hemoperfusion. Metformin concentrations were measured by high-performance liquid chromatography (HPLC) during CVVH and hemoperfusion treatment. Before extracorporeal treatment, plasma metformin concentration was 208...
October 5, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28972690/on-line-hemodiafiltration-at-home
#12
Almudena Vega, Soraya Abad, Nicolás Macías, Inés Aragoncillo
Survival with online hemodiafiltration (OL-HDF) is higher than with hemodialysis; frequent hemodialysis has also improved survival and quality of life. Home hemodialysis facilitates frequent therapy. We report our experience with 2 patients with stage 5 CKD who started home hemodialysis with OL-HDF in November 2016. After a training period at the hospital, they started home hemodialysis with OL-HDF after learning how to manage dialysis monitors and how to administer water treatment. We used the "5008-home" (FMC(©) ) monitor, and the Acqua C(©) (Fresenius Medical Care) for water treatment...
October 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28971660/-hemodialysis-present-innovations-for-patients-future
#13
REVIEW
Gai Milo, Ido Bogner, Younes Bathish, Moshe Lewin, Suheir Assady
End-stage renal disease (ESRD) is a major cause of morbidity and mortality worldwide. Survival of ESRD patients depends on renal replacement therapies, such as kidney transplantation and dialysis. Due to the shortage of potential kidney donors and patients' comorbidities, dialysis is the major therapeutic option offered to such patients. In this review, recent advances in hemodialysis and hemodiafiltration, and their potential impact on improving patient survival will be discussed.
September 2017: Harefuah
https://www.readbyqxmd.com/read/28966318/axillofemoral-bypass-markedly-improved-acute-decompensated-heart-failure-and-kidney-injury-in-a-patient-with-severely-calcified-stenosis-of-thoracoabdominal-aorta-atypical-aortic-coarctation
#14
Masato Ishizuka, Shintaro Yamada, Sonoko Maemura, Keisuke Yamamoto, Masataka Takizawa, Hiroki Uozumi, Sachito Minegishi, Jotaro Kobayashi, Hiroshi Ikenouchi
Atypical aortic coarctation (AAC) has been reported to occur anywhere along the aorta, except for the ascending aorta. The associated symptoms include hypotension in the lower half of the body, secondary hypertension in the upper half of the body, and heart failure. Here we present an 80-year-old Asian woman complaining of progressive exertional dyspnea. She was diagnosed with acute decompensated heart failure and kidney injury due to severely calcified stenosis of the thoracoabdominal aorta, the so called AAC...
October 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28960755/adsorption-of-nafamostat-mesilate-on-an69st-membranes-a-single-center-retrospective-and-in-vitro-study
#15
Yoshihiko Nakamura, Shuuji Hara, Hiroki Hatomoto, Shintaro Yamasaki, Takafumi Nakano, Motoyasu Miyazaki, Norihiko Matsumoto, Yuhei Irie, Hiroyasu Ishikura
We examined whether AN69ST (acrylonitrile and methallyl sulfonate copolymer) membranes adsorb nafamostat mesilate. This study retrospectively analyzed 87 continuous hemodiafiltration sessions in vivo. We divided the continuous hemodiafiltration sessions into AN69ST and non-AN69ST groups using the nafamostat mesilate dose and activated clotting time as indicators of nafamostat mesilate adsorption onto the membrane. Furthermore, we studied the in vitro adsorption of nafamostat mesilate from nafamostat mesilate solutions onto four different hemodialysis membranes...
September 28, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28933414/association-between-low-serum-bicarbonate-concentrations-and-cardiovascular-disease-in-patients-in-the-end-stage-of-renal-disease
#16
Vaia D Raikou, Despina Kyriaki
BACKGROUND: Metabolic acidosis, a common condition particularly in the end-stage of renal disease patients, results in malnutrition, inflammation and oxidative stress. In this study, we focused on the association between low serum bicarbonate and cardiovascular disease in patients on intermittent dialysis. METHODS: We studied 52 on-line-pre-dilution hemodiafiltration (on-l HDF) patients, 32 males and 20 females, with a mean age of 58.01 ± 15.4 years old. Metabolic acidosis was determined by serum bicarbonate concentrations less than 22 mmol/L...
November 15, 2016: Diseases (Basel)
https://www.readbyqxmd.com/read/28910802/effects-of-expanded-hemodialysis-therapy-on-clinical-outcomes
#17
Sandip Mitra, Kunaal Kharbanda
The invention of dialysis has been a phenomenal advance in the treatment of kidney failure. The introduction of artificial kidneys in clinical care remains one of the most successful lifesaving interventions in modern medicine. Its glory, however, has been tempered by poor long-term outcomes and a negative qualitative impact on the lives of patients who suffer from an extremely complex, burdensome, and restricted life on dialysis. There remains a huge gap in patient well-being and outcomes between artificial kidney treatments and kidney transplantation...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910800/the-place-of-large-pore-membranes-in-the-treatment-portfolio-of-patients-on-hemodialysis
#18
Wim Van Biesen, Raymond Vanholder, Eva Schepers, Griet Glorieux, Annemieke Dhondt, Sunny Eloot
Cardiovascular disease is a major concern in patients with end-stage kidney disease (ESKD). Inflammation induced by retention of uremic toxins, of which a substantial fraction has a molecular weight in the middle molecular range, has been associated with increased cardiovascular risk. In an attempt to reduce inflammation and thus cardiovascular toxicity in patients with ESKD, hemodiafiltration (HDF) has been promoted to enhance the clearance of middle molecular weight substances during dialysis. However, HDF increases the technical complexity and costs, and requires ultrapure dialysis fluid...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910799/effects-of-hemodialysis-therapy-using-dialyzers-with-medium-cut-off-membranes-on-middle-molecules
#19
Alexander H Kirsch, Alexander R Rosenkranz, Raphael Lyko, Detlef H Krieter
The removal of larger middle molecules, such as free immunoglobulin light chains (FLC), is poor with most currently used dialysis technologies. While hemodiafiltration (HDF) provides enhanced clearance of middle molecules compared to high-flux hemodialysis (HD), this technique is currently not approved in some regions and, hence, not accessible for all patients. The retention of middle molecules is thought to be one factor, which contributes to excessive morbidity and mortality in HD patients. The development of medium cut-off (MCO) dialysis membranes is aimed at a more efficient clearance of larger uremic toxins while retaining albumin and may extend the benefit of enhanced solute removal to more patients...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28910786/the-evolving-patterns-of-uremia-unmet-clinical-needs-in-dialysis
#20
Xueqing Yu
End-stage renal disease (ESRD) has become a challenging health problem worldwide. Currently, ESRD patients treated with hemodialysis mainly undergo low-flux hemodialysis, high-flux hemodialysis (HF-HD), or hemodiafiltration (HDF). The clearance of middle and large molecules is, however, quite insufficient as regards HF-HD, HDF, and on-line HDF. An unsatisfactory prognosis has led to improved dialysis technology and materials; both protein-leaking membranes and high cut-off membranes increase the clearance of uremic toxin, but in clinical application they may induce albumin loss...
2017: Contributions to Nephrology
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