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Hemodiafiltration

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https://www.readbyqxmd.com/read/29337451/-nephrology
#1
Sophie De Seigneux, Belen Ponte, Karine Hadaya, Yassine Bouatou, Patrick Saudan
New antidiabetic drugs which slow effectively the course of diabetic nephropathy are now available. There is no benefit of prophylactic hydratation to prevent contrast nephropathy in patients with moderate chronic kidney disease. In elderly hemodialysis patients, hemodiafiltration seems better tolerated than conventional hemodialysis, although there is a similar dialysis-induced myocardial stress with both methods. Role of de novo donor-specific antibodies is better characterized, which may subsequently lead to new treatments of graft rejection...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29310372/acute-kidney-injury-due-to-povidone-iodine-ingestion-a-case-report
#2
Chang Seong Kim, Sung Sun Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
RATIONALE: Povidone-iodine is a broad-spectrum antiseptic applied topically to treat wounds and prevent their infection. There have been several case reports of acute kidney injury (AKI) in burn patients after povidone-iodine irrigation and in patients receiving the substance as a sclerotherapy agent for management of lymphocele after renal transplantation. However, biopsy-confirmed AKI after ingestion of povidone-iodine has not previously been described. PATIENT CONCERNS: A 47-year-old man who had apparently ingested povidone-iodine solution and presented with nausea, vomiting, and reduced urine output...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29273022/on-line-hemodiafiltration-did-not-induce-an-overproduction-of-oxidative-stress-and-inflammatory-cytokines-in-intensive-care-unit-acute-kidney-injury
#3
Kada Klouche, Laurent Amigues, Marion Morena, Vincent Brunot, Anne Marie Dupuy, Audrey Jaussent, Marie Christine Picot, Noémie Besnard, Delphine Daubin, Jean Paul Cristol
BACKGROUND: Though on-line intermittent hemodiafiltration (OL-IHDF) is a routine therapy for chronic dialysis patients, it is not yet widespread used in critically ill patients. This study was undergone to evaluate efficiency and tolerance of OL-IHDF and to appreciate inflammatory consequences of its use in intensive care unit (ICU)-acute kidney injury (AKI) patients. METHODS: In this prospective cohort study conducted in a medical academic ICU in France, 30 AKI patients who underwent OL-IHDF were included...
December 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29234179/vitamin-e-coated-polysulfone-membrane-based-hemodiafiltration-attenuates-inflammation-in-a-rat-model-of-lipopolysaccharide-induced-systemic-inflammation
#4
Yoshihiro Hatanaka, Satoru Inoue, Koji Goto, Norihisa Yasuda, Seigo Hidaka, Takaaki Kitano
Background: Acute blood purification (ABP) therapy is used regularly in the clinical setting and reportedly alleviates organ failure associated with severe systemic inflammatory responses, leading to reduced mortality. The present study aimed to determine whether there is a difference in efficacy between polysulfone (PS) membranes, which are currently used regularly in the clinical setting, and vitamin E-coated polysulfone (VEPS) membranes, which are anticipated to exhibit the antioxidant and anti-inflammatory properties of vitamin E...
September 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29225810/achieving-high-convection-volumes-in-postdilution-online-hemodiafiltration-a-prospective-multicenter-study
#5
Camiel L M de Roij van Zuijdewijn, Isabelle Chapdelaine, Menso J Nubé, Peter J Blankestijn, Michiel L Bots, Constantijn J A M Konings, Ton K Kremer Hovinga, Femke M Molenaar, Neelke C van der Weerd, Muriel P C Grooteman
Background. Available evidence suggests a reduced mortality risk for patients treated with high-volume postdilution hemodiafiltration (HDF) when compared with hemodialysis (HD) patients. As the magnitude of the convection volume depends on treatment-related factors rather than patient-related characteristics, we prospectively investigated whether a high convection volume (defined as ≥22 L/session) is feasible in the majority of patients (>75%). Methods. A multicenter study was performed in adult prevalent dialysis patients...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29221927/st2-as-a-novel-prognostic-marker-in-end-stage-renal-disease-patients-on-hemodiafiltration
#6
Evgenija Homsak, Robert Ekart
BACKGROUND: Patients with end-stage renal disease (ESRD) are prone to severe heart failure (HF) and to several life-threatening events. Therefore, the ability to assess disease prognosis and the risk of short-term events or death is of great importance. The role of soluble ST2 (sST2) as a potential new prognostic marker in ESRD patients is not yet known. The aim of our study was to assess the prognostic value of sST2 in ESRD patients on hemodiafiltration (HDF) and compare it with NT-proBNP, an established prognostic marker for HF and renal disease...
December 5, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29186592/beta-2-microglobulin-clearance-in-high-flux-dialysis-and-convective-dialysis-modalities-a-meta-analysis-of-published-studies
#7
Maria-Eleni Roumelioti, Gregory Trietley, Thomas D Nolin, Yue-Harn Ng, Zhi Xu, Ahmed Alaini, Rocio Figueroa, Mark L Unruh, Christos P Argyropoulos
Background: Recent meta-analyses suggest that higher removal of beta-2 microglobulin (β2M) with either high-flux (HFD) dialysis or hemodiafiltration (HDF) may be associated with decreased total and cardiovascular mortality in dialysis patients. However, there are limited data about the performance of high flux dialyzers and/or convective therapies in removing β2M. Methods: This is a random effects meta-analysis and meta-regression of data extracted from randomized controlled trials and observational studies in hemodialysis, hemofiltration and HDF regarding the efficiency of high flux dialyzers to remove β2M...
November 27, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29166634/sodium-prescription-in-the-prevention-of-intradialytic-hypotension-new-insights-into-an-old-concept
#8
Gabriele Donati, Mauro Ursino, Alessandra Spazzoli, Nicolò Natali, Roberto Schillaci, Diletta Conte, Andrea Angeletti, Anna Laura Croci Chiocchini, Irene Capelli, Olga Baraldi, Gaetano La Manna
BACKGROUND: Sodium prescription in patients with intradialytic hypotension remains a challenge for the attending nephrologist, as it increases dialysate conductivity in hypotension-prone patients, thereby adding to dietary sodium levels. METHODS: New sodium prescription strategies are now available, including the use of a mathematical model to compute the sodium mass to be removed during dialysis as a physiological controller. RESULTS: This review describes the sodium load of patients with end-stage renal disease on chronic hemodialysis (HD) and discusses 2 strategies to remove excess sodium in patients prone to intradialytic hypotension, namely, Profiled HD and the hemodiafiltration Aequilibrium System...
November 23, 2017: Blood Purification
https://www.readbyqxmd.com/read/29161688/plasma-beta-trace-protein-as-a-marker-of-residual-renal-function-the-effect-of-different-hemodialysis-modalities-and-intra-individual-variability-over-time
#9
Amaryllis H van Craenenbroeck, Ann-Christin Bragfors-Helin, Abdul Rashid Qureshi, Bengt Lindholm, Bodil Sjöberg, Björn Anderstam, Olof Heimburger, Peter Stenvinkel, Peter Bárány
BACKGROUND/AIMS: Beta-trace protein (BTP) is a low-molecular-weight molecule, which may be used to assess residual renal function (RRF) in dialysis patients. Here we evaluated the influence of hemodialysis (HD) and hemodiafiltration (HDF) on plasma BTP, and analyzed the inter- and intra-individual variability of plasma BTP over time in HD and peritoneal dialysis (PD) patients. METHODS: In 12 prevalent HD patients, the effect of a single session of low-flux HD, high-flux HD and HDF on plasma BTP was studied...
November 22, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29148024/blue-planet-dialysis-novel-water-sparing-strategies-for-reducing-dialysate-flow
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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