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Hemodiafiltration

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https://www.readbyqxmd.com/read/28717089/an-autopsy-case-of-fulminant-hepatitis-in-a-patient-with-multiple-sclerosis-treated-by-interferon-beta-1a
#1
Yuichi Yamazaki, Aya Suzuki, Kimitoshi Hirayanagi, Yusuke Tsukagoshi, Ryota Uehara, Kazuhiko Horiguchi, Tatsuya Ohyama, Takuya Tomaru, Norio Horiguchi, Sumihito Nobusawa, Hayato Ikota, Ken Sato, Satoru Kakizaki, Motoyasu Kusano, Yoshio Ikeda, Hideaki Yokoo, Masanobu Yamada
A 44-year-old woman with multiple sclerosis (MS) receiving interferon (IFN)-beta-1a treatment was admitted to a local hospital for severe icterus and liver injury. She was transferred to our university hospital because fulminant hepatitis (FH) was suspected. She was diagnosed with acute-type FH based on hepatic coma, severe liver injury and liver failure, and she received plasma exchange and continuous hemodiafiltration therapy. On hospital day 6, she died from liver failure despite intensive care. An autopsy revealed histological findings consistent with FH...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28707330/the-impact-of-dialysis-modality-and-membrane-characteristics-on-intradialytic-hypotension
#2
Samir Patel, Jochen G Raimann, Peter Kotanko
The risk of intradialytic hypotension (IDH) is determined by various factors, among them dialysis modality and dialyzer membrane. We conducted a literature search in PubMed on November 1, 2016 and selected relevant randomized controlled and cross-over trials, and prospective and retrospective cohort studies published in English that investigated the association between IDH and dialysis modality and membrane, respectively. This literature search revealed 669 publications on dialysis modality, 64 on dialysis membrane, and 24 on acetate/bicarbonate dialysate...
July 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28701841/continuous-renal-replacement-therapy-applications-on-extracorporeal-membrane-oxygenation-circuit
#3
Ayse Filiz Yetimakman, Murat Tanyildiz, Selman Kesici, Esra Kockuzu, Benan Bayrakci
BACKGROUND AND AIMS: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. MATERIALS AND METHODS: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28685358/asymmetric-triacetate-membrane-keeps-high-water-flux-during-ultrafiltration-in-vitro-study
#4
Yoshihiro Tange, Shingo Takesawa, Shigenori Yoshitake
Membrane fouling is a primary challenge encountered during the administration of hemodialysis (HD) and hemodiafiltration (HDF). A high-flux membrane is suitable for dialyzer reuse, since it is used repeatedly. Water flux is a benchmark used to assess the effectiveness of the dialysis membrane during treatment and it is usually evaluated to determine whether membrane fouling has occurred. Polysulfone (PS) membrane has good biocompatibility and solute permeability; however, polyethersulfone (PES) is often used as a hemodiafilter membrane because of better hydrophilicity compared to PS...
July 6, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28682030/-hemodialysis-and-cardiovascular-outcome
#5
Laura Panicali, Fabiana Brigante, Elena Mancini
Hemodialysis patients often present multiple comorbidities and have a high mortality rate (15-20% per year), mostly due to cardiovascular events. Besides predisposing pathological conditions related to uremia (heart failure, coronary heart disease, left ventricular hypertrophy, arrhythmias), they also have specific risk factors linked to the hemodialysis (HD) treatment in itself: chronic inflammation, fluid overload, autonomic nervous system dysfunction, arterovenous fistula. These factors may affect the hemodynamic compensatory systems (vascular refilling, arteriolar and venous tone, autonomic nervous system response) to fluid removal, with high risk of intra-dialysis hypotension (IDH) episodes or arrhythmic events...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28679995/thrombotic-microangiopathy-due-to-malignant-hypertension-complicated-with-late-onset-bleeding-after-renal-biopsy
#6
Saki Ameda, Hiroyuki Kuroda, Michiko Yamada, Ken Sato, Shogo Miura, Hiroya Sakano, Takanori Shibata, Naoki Uemura, Tomoyuki Abe, Shigeyuki Fujii, Masahiro Maeda, Miri Fujita, Masayoshi Kobune, Junji Kato
A 47-year-old man presented at a local ophthalmological hospital with blurred vision. He had been diagnosed with hypertensive retinopathy and renal failure and was referred to our hospital for treatment. A renal biopsy was done to evaluate pathology of high proteinuria, hematuria, and rapidly progressive glomerulonephritis. Blood pressure remained high despite antihypertensive therapy; anemia and thrombocytopenia gradually progressed. Thrombotic microangiopathy (TMA) was suspected based on red blood cell fragmentation due to hemolytic anemia, thrombocytopenia, and renal failure...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28676904/differences-in-cvvh-vs-cvvhdf-in-the-management-of-sepsis-induced-acute-kidney-injury-in-critically-ill-patients
#7
Vedran Premuzic, Nikolina Basic-Jukic, Bojan Jelakovic, Petar Kes
We hypothesized that patients with sepsis and AKI, especially patients without preserved renal function, and treated with continuous veno-venous hemodiafiltration (CVVHDF), have lower risk for mortality than patients treated with continuous veno-venous hemofiltration (CVVH). Patients were included if they fulfilled the diagnosis of severe sepsis or septic shock, suffered AKI and received continuous renal replacement therapy (CRRT) in intensive care unit. There were 62 patients treated by CVVH and 75 treated by CVVHDF...
July 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28665446/first-experience-on-bilirubin-removal-with-a-hemoadsorption-column-lixelle%C3%A2-in-a-child-with-cardiogenic-liver-injury
#8
Gabriella Bottari, Andrea Moscatelli, Enrico E Verrina, Franco Lerzo, Fabio S Taccone
INTRODUCTION: Hyperbilirubinemia may have deleterious effects on many organs, even after the neonatal age. Blood purification is effective in the treatment of hyperbilirubinemia. Recently some reports suggest the potential role of hemoadsorption columns in this setting. METHODS: We present the case of a 6-year-old child with severe hyperbilirubinemia due to congestive liver dysfunction, complicated by persistent inflammation, immunosuppression and catabolism syndrome (PICS)...
June 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28600736/blood-pressure-management-in-children-on-dialysis
#9
F Paglialonga, S Consolo, A Edefonti, G Montini
Hypertension is a leading cause of cardiovascular complications in children on dialysis. Volume overload and activation of the renin-angiotensin-aldosterone system play a major role in the pathophysiology of hypertension. The first step in managing blood pressure (BP) is the careful assessment of ambulatory BP monitoring. Volume control is essential and should start with the accurate identification of dry weight, based on a comprehensive assessment, including bioimpedance analysis and intradialytic blood volume monitoring (BVM)...
June 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28571019/high-flux-dialysis-clinical-biochemical-and-proteomic-comparison-with-low-flux-dialysis-and-on-line-hemodiafiltration
#10
Carlo Donadio, Angeliki Kanaki, Nadia Sami, Danika Tognotti
Hemodiafiltration on-line (on-line HDF) is a more efficient treatment than low-flux hemodialysis (HD). Unfortunately, it cannot be proposed to all patients. The aim of this study was to evaluate the safety, efficiency, and mechanisms of removal of toxins with high-flux HD vs. low-flux HD and on-line HDF. Randomized cross-over study designed to evaluate efficiency and tolerability of high-flux HD vs. low-flux HD in aged patients; to compare by means of biochemical and proteomic analyses the efficiency and mechanisms of removal of toxins with high-flux HD vs...
2017: Blood Purification
https://www.readbyqxmd.com/read/28559700/arterial-stiffness-hemodialysis-versus-hemodiafiltration
#11
Adrian-Bogdan Ghigolea, Mirela Gherman-Caprioara, Argentina Raluca Moldovan
BACKGROUND AND AIMS: Arterial stiffness seems to be influenced by the dialysis method, but studies are sparse and the results discordant. High substitution volume online hemodiafiltration appears to have beneficial cardiovascular effects in dialysis patients, but its effects on arterial stiffness are not investigated. We aimed to analyze arterial stiffness parameters in high substitution volume post-dilution online hemodiafiltration and compare results to high-flux hemodialysis. METHODS: We studied arterial stiffness parameters using the oscillometric method (Arteriograph IrDA, TensioMed, Budapest, Hungary) in 23 non-diabetic patients on high substitution volume online postdilution hemodiafiltration and 23 non-diabetic patients on high-flux hemodialysis...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28557718/combination-clearance-therapy-and-barbiturate-coma-for-severe-carbamazepine-overdose
#12
Asya Agulnik, Daniel P Kelly, Rebecca Bruccoleri, Christopher Yuskaitis, Darius Ebrahimi-Fakhari, Mustafa Sahin, Michele M Burns, Daniel S Kohane
A 15-year-old female subject presented comatose, in respiratory failure and shock, after the intentional ingestion of ∼280 extended-release 200-mg carbamazepine tablets with a peak serum concentration of 138 µg/mL (583.74 µmol/L). The patient developed clinical seizures and an EEG pattern of stimulus-induced rhythmic, periodic, or ictal discharges, suggestive of significant cortical dysfunction. Due to the extremely high drug serum concentration and clinical instability, a combination of therapies was used, including lipid emulsion therapy, plasmapheresis, hemodialysis, continuous venovenous hemodiafiltration, and endoscopic intestinal decontamination...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28555165/tissue-hypoperfusion-hypercoagulopathy-and-kidney-and-liver-dysfunction-after-ingestion-of-a-naphazoline-containing-antiseptic
#13
Yuko Ono, Nozomi Ono, Kazuaki Shinohara
Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28554308/lipid-metabolism-in-patients-with-end-stage-renal-disease-a-five-year-follow-up-study
#14
Magdaléna Dušejovská, Barbora Staňková, Marek Vecka, Jana Rychlíková, Magdaléna Mokrejšová, Ivan Rychlík, Aleš Žák
BACKGROUND: Patients with end-stage renal disease (ESRD) exhibit high morbidity as well as mortality for atherosclerotic cardiovascular diseases (CVD). Therefore, we investigated differences in individual lipoprotein classes and subclasses in ESRD patients under chronic high volume hemodiafiltration (HV-HDF) in comparison with a control group. We also assessed the prognosis of these patients and analyzed these parameters after 5 years follow-up. METHODS: 57 patients and 50 controls were enrolled...
May 29, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28540893/comparison-of-intradialytic-hemodynamic-tolerance-between-on-line-hemodiafiltration-and-acetate-free-biofiltration-with-profiled-potassium-dialysate-concentration
#15
George Kosmadakis, Enrique Da Costa Correia, Frederic Somda, Didier Aguilera
Intradialytic hypotensive episodes are deleterious for hemodialysis (HD) patients. Acetate-free biofiltration with profiled potassium (AFBK) dialysate concentration may improve their cardiovascular stability. The aim of the present crossover study was to compare intradialytic hemodynamic tolerance and biological parameters between online hemodiafiltration (olHDF) and AFBK. Ten frail HD patients (8 males) with a mean age of 66.71- ± 12.31 years were studied for three months on olHDF and AFBK. There was a significant reduction of the hypotensive episodes during the AFBK period compared to the olHDF period...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28535525/expanded-hemodialysis-a-new-therapy-for-a-new-class-of-membranes
#16
Claudio Ronco, Gaetano La Manna
A wide spectrum of molecules is retained in end-stage kidney disease, normally defined as uremic toxins. These solutes have different molecular weights and radii. Current dialysis membranes and techniques only remove solutes in the range of 50-15,000 Da, with limited or no capability to remove solutes in the middle to high molecular weight range (up to 50,000 Da). Improved removal has been obtained with high cut-off (HCO) membranes, with albumin loss representing a limitation to their practical application...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28534129/insomnia-muscular-cramps-and-pruritus-have-low-intensity-in-hemodialysis-patients-with-good-dialysis-efficiency-low-inflammation-and-arteriovenous-fistula
#17
Olga Hilda Orasan, Aniela Pop Saplontai, Angela Cozma, Simona Racasan, Ina Maria Kacso, Crina Claudia Rusu, Diana Moldovan, Dacian Tirinescu, Alina Potra, Ioan Mihai Patiu, Remus Aurel Orasan
INTRODUCTION: Insomnia, muscular cramps, pruritus and postdialysis recovery time (RT) are quality-of-life parameters that affect hemodialysis (HD) patients physically and mentally. METHODS: We included 171 end-stage renal disease patients: 115 on high-flux HD and 56 on online hemodiafiltration (HDF). Patients were asked "How long does it take you to recover from a dialysis session?" and they evaluated intensity (absent, mild, medium and severe) of insomnia, muscular cramps and pruritus in the past 4 weeks...
May 22, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28508963/hemodiafiltration-for-hepatic-encephalopathy-induced-by-budd-chiari-syndrome-in-a-patient-with-end-stage-kidney-disease
#18
Takuya Wakamatsu, Suguru Yamamoto, Kenya Kamimura, Takeshi Nakatsue, Noriaki Iino, Seitaro Iguchi, Yoshikatsu Kaneko, Shin Goto, Junichiro James Kazama, Ichiei Narita
A 36-year-old woman who was undergoing dialysis for end-stage kidney disease (ESKD) was admitted to our hospital with consciousness disorder. She was diagnosed with Budd-Chiari syndrome due to antiphospholipid syndrome at the age of 28 years. Her kidney function and leg edema gradually deteriorated. After initiation of hemodialysis (HD), transient loss of consciousness due to hepatic encephalopathy during HD treatment occurred frequently. Her kidney replacement therapy was changed to online hemodiafiltration (HDF), which dramatically improved her hepatic coma...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28501302/measuring-the-patient-response-to-dialysis-therapy-hemodiafiltration-and-clinical-trials
#19
Mark R Marshall
There is a strong biological plausibility for benefit from removal of larger uremic toxins and increasing positive clinical experience with hemodiafiltration. However, evidence supporting hemodiafiltration is not definitive with studies that are often limited by serious methodological shortcomings. Morena et al. show that hemodiafiltration may prevent intradialytic hypotension, albeit in a study that also has some shortcomings. Ongoing research for hemodiafiltration is still needed through high-quality clinical trials that adhere to standards for clinical trial conduct and reporting...
June 2017: Kidney International
https://www.readbyqxmd.com/read/28483384/-online-hemodiafiltration-practical-aspects-safety-and-efficacy
#20
Bernard Canaud, Leïla Chénine, Hélène Leray-Moraguès, Laure Patrier, Annie Rodriguez, A Gontier-Picard, Marion Moréna
Purification of high molecular uremic toxins by conventional hemodialysis is limited. It remains associated with a high morbidity and excessively high mortality. Online hemodiafiltration using a high permeability hemodiafilter, an ultrapure dialysate, and which tends to maximize substitution volumes, provides a high efficiency and low bio-incompatibility renal supplementation. Regular use of online hemodiafiltration is associated with reduced morbidity (reduction of intradialytic hypotension episodes, improved blood pressure control, reduced inflammatory profile, better anemia correction and prevention of β2-microglobulin-associated amyloidosis)...
May 2017: Néphrologie & Thérapeutique
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