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Hemodiafiltration

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https://www.readbyqxmd.com/read/27925243/hemodiafiltration-a-technique-for-physiological-correction-of-priming-solution-in-pediatric-cardiac-surgery-an-in-vitro-study
#1
Pankaj Garg, Arvind Kumar Bishnoi, Kartik Patel, Vivek Wadhawa, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
Pediatric cardiopulmonary bypass (CPB) circuit invariably requires priming with packed red blood cells (PRBCs). Metabolic composition of stored PRBCs is unphysiological and becomes worse with increasing duration of storage. It is recommended to correct these abnormalities before initiation of CPB. We tested the hypothesis that hemodiafiltration of the prime with 0.45% saline is sufficient for reducing the metabolic load and reaching a physiologic state. In an in vitro study, 100 mL of blood each from 45 units of PRBCs stored for 3-20 days were used for priming the 45 neonatal CPB circuits...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27914671/current-practice-in-continuous-renal-replacement-therapy-an-epidemiological-multicenter-study
#2
T M Tomasa Irriguible, J Sabater Riera, E Poch López de Briñas, J Fort Ros, M J Lloret Cora, J Roca Antònio, A Navas Pérez, P Ortiz Ballujera, L Servià Goixart, F J González de Molina Ortiz, C Rovira Anglès, A Roglan Piqueras, M Rodríguez López
OBJECTIVE: The aim of the study is to ascertain the most relevant aspects of the current management of renal replacement therapy (RRT) in critically ill patients, and to analyze renal function recovery and mortality in patients undergoing RRT. METHODS: A non-interventional three-month observational study was made in 2012, with a follow-up period of 90 days, in 21 centers in Catalonia (Spain). Demographic information, severity scores and clinical data were obtained, as well as RRT parameters...
November 30, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27910004/dabigatran-overdose-a-case-report-of-acute-hepatitis-extracorporeal-treatment
#3
Mariagrazia Porru, Antonella Mameli, Maria E Cianchetti, Mario Musu, Paola Schirru, Maria F Ruberto, Doris Barcellona, Francesco Marongiu
Dabigatran is an oral, direct thrombin inhibitor approved by international regulatory agencies for stroke prevention in patients with paroxysmal or persistent non-rheumatic atrial fibrillation (AF). The benefits of dabigatran are widely described, but its use in the geriatric population is not without risk. Chronic kidney disease is a common comorbidity with AF, and thus frequent checks of renal function in elderly patients are recommended. We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration...
December 1, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27903998/survival-benefit-of-hemodiafiltration-compared-with-prolonged-high-flux-hemodialysis
#4
Petar S Djuric, Aleksandar Jankovic, Jovan Popovic, Jelena Tosic Dragovic, Ana Bulatovic, Zivka Djuric, Milos Mitrovic, Nada Dimkovic
INTRODUCTION:  Patients on dialysis have a high rate of death, mainly of cardiovascular cause. Nephrologists are actively looking for ways to improve patients' outcomes, and alternative dialysis strategies, such as long conventional hemodialysis and hemodiafiltration, are currently being investigated. The aim of this study was to compare anemia, nutrition, inflammation, mineral metabolism, and 3-year survival rates between patients treated with hemodiafiltration and prolonged high-flux hemodialysis (HFH)...
November 2016: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/27863531/effects-of-continuous-renal-replacement-therapy-on-linezolid-pharmacokinetic-pharmacodynamics-a-systematic-review
#5
Gianluca Villa, Paola Di Maggio, A Raffaele De Gaudio, Andrea Novelli, Riccardo Antoniotti, Enrico Fiaccadori, Chiara Adembri
BACKGROUND: Major alterations in linezolid pharmacokinetic/pharmacodynamic (PK/PD) parameters might be expected in critically ill septic patients with acute kidney injury (AKI) who are undergoing continuous renal replacement therapy (CRRT). The present review is aimed at describing extracorporeal removal of linezolid and the main PK-PD parameter changes observed in critically ill septic patients with AKI, who are on CRRT. METHOD: Citations published on PubMed up to January 2016 were systematically reviewed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement...
November 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27859427/citrate-buffered-dialysis-solution-citrasate-allows-avoidance-of-anticoagulation-during-intermittent-hemodiafiltration-at-the-cost-of-decreased-performance-and-systemic-biocompatibility
#6
Pavlina Richtrova, Jan Mares, Lukas Kielberger, Ladislav Trefil, Jaromir Eiselt, Tomas Reischig
Reportedly, citrate-based dialysis solution enables heparin dose tapering or even complete exclusion, particularly in postdilution hemodiafiltration (HDF). The aim of the study was to verify this strategy in predilution setting and to assess its short-term safety, efficacy, and biocompatibility. Ten regular hemodialysis patients were assigned to predilution HDF on acetate- and citrate-based dialysis solutions (0.8 mmol/l trisodium citrate) at random order. Acetate HDF was performed using routine dose of heparin while citrate HDF was heparin free...
November 10, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27850929/1293-effect-of-continuous-venovenous-hemodiafiltration-on-amino-acid-delivery-and-clearance-in-children
#7
Richard Lion, Molly Vega, Michael Braun, Moreshwar Desai, Sridevi Deveraj, O'Brian Smith, Ayse Akcan-Arikan
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27832332/a-successfully-treated-case-of-cardiac-arrest-after-caesarean-section-complicated-by-pheochromocytoma-crisis-and-amniotic-fluid-embolism
#8
Kenichiro Mita, Kayo Tsugita, Yoshikazu Yasuda, Yasunari Matsuki, Yurie Obata, Yuka Matsuki, Seiichi Kamisawa, Kenji Shigemi
Both pheochromocytoma and amniotic fluid embolism (AFE) are important causes of maternal mortality. We present a case of a 29-year-old woman who developed cardiac arrest after Caesarean section, complicated by both pheochromocytoma crisis and AFE. After resuscitation, the patient developed multiple organ dysfunction, rhabdomyolysis and disseminated intravascular coagulation (DIC). After institution of multidisciplinary interventions (including the use of an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous hemodiafiltration, and neuroprotective therapeutic hypothermia) the patient made a full recovery without any apparent neurological deficit...
November 10, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27803814/is-anticoagulation-discontinuation-achievable-with-citrate-dialysate-during-hdf-sessions
#9
Thibault Dolley-Hitze, Emmanuel Oger, Didier Hamel, Marie-Laure Lombart, Isabelle Hermès
Citrate dialysate has been developed for few years to replace acetate and HCl concentrates. In Online Postdilution Hemodiafiltration (OL-POST-HDF), several issues are remaining concerning the possibility of stopping anticoagulation during sessions and the side effects of citrate solutions on calcium metabolism. This 1-year monocentric retrospective study included all patients exposed to citrate in OL-POST-HDF with nadroparin decrease for more than one month. Clotting events, serum calcium, PTH, hemoglobin, CRP, depuration parameters, and treatments administrated were recorded for analysis...
2016: International Journal of Nephrology
https://www.readbyqxmd.com/read/27791259/are-all-dialyzers-compatible-with-the-convective-volumes-suggested-for-postdilution-online-hemodiafiltration
#10
Jacky Potier, Guillaume Queffeulou, Julien Bouet
INTRODUCTION: The recent analysis of 4 randomized controlled trials has confirmed the lower mortality risk for postdilution online hemodiafiltration (OL-HDF) compared to hemodialysis, and above all for patients with the highest delivered body surface area standardized convective volume (CV/BSA >23 L/1.73 m²/session). Since the impact of the dialyzers used in these trials has never been studied, we retrospectively analyzed clinical tests carried out with 19 commonly used dialyzers...
November 11, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27783636/online-haemodiafiltration-improves-inflammatory-state-in-dialysis-patients-a-longitudinal-study
#11
Ines Rama, Ines Llaudó, Pere Fontova, Gema Cerezo, Carlos Soto, Casimiro Javierre, Miguel Hueso, Nuria Montero, Alberto Martínez-Castelao, Juan Torras, Josep M Grinyó, Josep M Cruzado, Nuria Lloberas
BACKGROUND: Patients undergoing conventional hemodialysis (C-HD) present a greater immuno-inflammatory state probably related to uremia, sympathetic nervous system (SNS) activation and /or membrane bioincompatibility, which could improve with a technique-switching to online hemodiafiltration (OL-HD). The antigen-independent pathway activation of this modified immunologic state turns dendritic cells (DC) into an accurate cell model to study these patients. The aim of this study is to further evaluate the immune-inflammatory state of patients in C-HD assessed by DC maturation...
2016: PloS One
https://www.readbyqxmd.com/read/27780586/hemodialysis-patients-receiving-a-greater-kt-dose-than-recommended-have-reduced-mortality-and-hospitalization-risk
#12
Francisco Maduell, Rosa Ramos, Javier Varas, Alejandro Martin-Malo, Manuel Molina, Rafael Pérez-Garcia, Daniele Marcelli, Francesc Moreso, Pedro Aljama, Jose Ignacio Merello
Achieving an adequate dialysis dose is one of the key goals for dialysis treatments. Here we assessed whether patients receiving the current cleared plasma volume (Kt), individualized for body surface area per recommendations, had improved survival and reduced hospitalizations at 2 years of follow-up. Additionally, we assessed whether patients receiving a greater dose gained more benefit. This prospective, observational, multicenter study included 6129 patients in 65 Fresenius Medical Care Spanish facilities...
December 2016: Kidney International
https://www.readbyqxmd.com/read/27761981/dialysate-bicarbonate-variation-in-maintenance-hemodiafiltration-patients-impact-on-serum-bicarbonate-intradialytic-hypotension-and-interdialytic-weight-gain
#13
Márcio Viegas, Cristina Cândido, Joana Felgueiras, José Clemente, Sara Barros, Rostislav Farbota, Filipa Vera, Antero Matos, Francisco Sousa
Introduction The dialysate bicarbonate (DB) influences the acid-base balance in dialysis patients. Very low and high serum bicarbonate (SB) have been related with a higher mortality. Acid-base balance also has been associated with hemodynamic effects in these patients. The trial aim was to compare the effect of DB concentration variation on SB levels in maintenance hemodiafiltration (HDF) patients and the effect on intradialytic hypotension and interdialytic weight gain. Methods  A prospective study, with 9 months of follow-up, involving 93 patients, divided in two groups: group 1 and group 2 with a DB of 34 mmol/L and 30 mmol/L, respectively, with monitoring of pre and post HDF SB, intradialytic hypotension, and interdialytic weight gain...
October 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27717781/1-3-%C3%A3-d-glucan-testing-is-highly-specific-in-patients-undergoing-dialysis-treatment
#14
Juergen Prattes, Daniel Schneditz, Florian Prueller, Eva Jaindl, Notburga Sauseng, Martin Hoenigl, Gernot Schilcher, Robert Krause
BACKGROUND: The aim of this combined in-vitro and in-vivo study was to investigate whether state of the art dialysis modalities produce false positive serum 1,3-ß-d-Glucan (BDG) levels. METHODS: Dialysis fluid for simulated dialysis treatments was spiked with BDG from different sources. Samples were taken from the dialysate and dialyzer blood compartments at various time points. In addition, serum samples were obtained in three groups of patients without invasive fungal disease: a...
October 4, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27703388/cost-effectiveness-analysis-of-online-hemodiafiltration-versus-high-flux-hemodialysis
#15
Francesco Ramponi, Claudio Ronco, Giacomo Mason, Enrico Rettore, Daniele Marcelli, Francesca Martino, Mauro Neri, Alejandro Martin-Malo, Bernard Canaud, Francesco Locatelli
BACKGROUND: Clinical studies suggest that hemodiafiltration (HDF) may lead to better clinical outcomes than high-flux hemodialysis (HF-HD), but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD. METHODS: The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1) estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2) simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3) application of state-specific health-related quality of life coefficients and differential costs derived from the literature...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27698760/part-of-plasmapheresis-with-plasma-filtration-adsorption-combined-with-continuous-hemodiafiltration-in-the-treatment-of-severe-acute-liver-failure
#16
Maoqin Li, Zhidong Wang, Yining Wang, Changhong Du, Songhai Li, Zaixiang Shi, Bo Lu
The present study is a retrospective analysis of 11 cases with severe acute liver failure combined with multiple organ dysfunction syndrome (MODS) performed during the period June, 2012 to December, 2014. After part of plasmapheresis with plasma filtration adsorption combined with continuous hemodiafiltration treatment, good curative effects were obtained and the main clinical symptoms and biochemical index were significantly improved. Following treatment, 8 of the 11 patients survived at a survival rate of 72...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27668164/cardiac-arrest-caused-by-nafamostat-mesilate
#17
Hyo Shik Kim, Kyung Eun Lee, Ji Hyun Oh, Chan Sung Jung, Dughyun Choi, Yunsuek Kim, Jin Seok Jeon, Dong Cheol Han, Hyunjin Noh
A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding from the incision and drainage site. Sudden cardiac arrest occurred after 15 minutes of dialysis. The patient was treated in the intensive care unit for 5 days. Continuous veno-venous hemodiafiltration was started without any anticoagulant in the intensive care unit...
September 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27637480/levels-of-dna-damage-in-peripheral-blood-lymphocytes-of-patients-undergoing-standard-hemodialysis-vs-on-line-hemodiafiltration-a-comet-assay-investigation
#18
Zuray Corredor, Lara Rodríguez-Ribera, Irene Silva, Juan Manuel Díaz, José Ballarín, Ricard Marcos, Elisabet Coll, Susana Pastor
Chronic kidney disease (CKD) patients exhibit high levels of genetic damage. Part of this genetic damage is supposed to be caused by the hemodialysis (HD) therapy. Different and more efficient HD procedures could reduce the genetic damage and improve health status of CKD patients. In the present study, we analyzed if changing to online hemodiafiltration (OL-HDF) has a beneficial effect on the levels of genetic damage. The levels of genetic damage (DNA breaks and oxidatively damaged DNA) were analyzed in peripheral blood lymphocytes by using the comet assay...
September 15, 2016: Mutation Research. Genetic Toxicology and Environmental Mutagenesis
https://www.readbyqxmd.com/read/27598005/4-pyridoxic-acid-in-the-spent-dialysate-contribution-to-fluorescence-and-optical-monitoring
#19
Sigrid Kalle, Risto Tanner, Jürgen Arund, Ruth Tomson, Merike Luman, Ivo Fridolin
AIM: In this work we estimated the contribution of the fluorescence of 4-pyridoxic acid (4-PA) to the total fluorescence of spent dialysate with the aim of evaluating the on-line monitoring of removal of this vitamin B-6 metabolite from the blood of patients with end-stage renal disease (ESRD). METHODS: Spectrofluorometric analysis of spent dialysate, collected from hemodialysis and hemodiafiltration sessions of 10 patients receiving regularly pyridoxine injections after dialysis treatment, was performed in the range of Ex/Em 220-500 nm...
2016: PloS One
https://www.readbyqxmd.com/read/27589376/dialyzability-of-oxycodone-and-its-metabolites-in-chronic-noncancer-pain-patients-with-end-stage-renal-disease
#20
Boaz Gedaliahu Samolsky Dekel, Gabriele Donati, Alessio Vasarri, Anna Laura Croci Chiocchini, Alberto Gori, Giuseppe Cavallari, Gianfranco Di Nino, Laura Mercolini, Michele Protti, Roberto Mandrioli, Rita Maria Melotti, Gaetano La Manna
OBJECTIVES: Opioids are the preferred analgesic drugs to treat severe chronic pain conditions among dialysis patients; however, knowledge about their dialyzability features is limited. Oxycodone is increasingly used for the treatment of chronic pain conditions as oral controlled release (CR) tablets; however, evidence about this drug and its metabolites' dialyzability is lacking. METHODS: We assessed, during 4-hour dialysis sessions, the effect of standard hemodialysis (HD) and online hemodiafiltration (HDF) methods on the plasma concentration of oxycodone and its metabolites in n = 20 chronic pain patients with end-stage renal disease who were stably treated with oral CR oxycodone...
September 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
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