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Hemodiafiltration

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https://www.readbyqxmd.com/read/28105119/clinical-observation-on-the-treatment-of-acute-liver-failure-by-combined-non-biological-artificial-liver
#1
Maoqin Li, Jingxi Sun, Jiaqiong Li, Zaixiang Shi, Jiyuan Xu, Bo Lu, Shuli Cheng, Yanjun Xu, Xiaomeng Wang, Xianjiang Zhang
The clinical efficacy and safety of different combinations of non-bio artificial liver in the treatment of acute liver failure was examined. A total of 61 cases were selected under blood purification treatment from the patients with severe acute liver failure admitted to the severe disease department of the hospital from December, 2010 to December, 2015. Three types of artificial liver combinations were observed, i.e., plasma exchange plus hemoperfusion plus continuous venovenous hemodiafiltration (PE+HP+CVVHDF), PE+CVVHDF and HP+CVVHDF...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28093894/importance-of-body-water-in-the-efficacy-of-convective-solute-transport-in-online-hemodiafiltration
#2
Nicolás Macías, Alba Santos García, Almudena Vega Martínez, Soraya Abad Estébanez, Marian Goicoechea Diezhandino, Juan Manuel López Gómez
High-volume online hemodiafiltration (OL-HDF) has been associated with improved patient survival compared to conventional hemodialysis in recent trials, where the importance of convective volume (CV) in this benefit is noted. The purpose of this study was to determine the corporal composition parameters influencing the efficacy of CV in the removal of different molecular weight (MW) molecules. Demographic data, corporal composition parameters with bioimpedance spectroscopy, dialysis features and the reduction rates of different MW molecules in a four-hour OL-HDF session were collected in 61 patients...
January 16, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28044236/vascular-adhesion-protein-1-in-hemodialysis-and-hemodiafiltration-patients-effect-of-single-hemodialysis-session-on-its-level-in-regard-to-type-of-anticoagulant
#3
Jolanta Malyszko, Ewa Koc-Zorawska, Piotr Kozminski, Jacek S Malyszko
PURPOSE: Traditional anticoagulants used in intermittent hemodialysis (HD) are unfractionated heparin (UFH) and increasingly low molecular weight heparins (LMWHs). Repeated and prolonged exposure to UFH and/or LMWHs may further disturb hemostasis in uremic patients. Vascular adhesion protein-1 (VAP-1) is secreted by vascular smooth muscle cells, adipocytes and endothelial cells with functional monoamine oxidase activity and is elevated in atherosclerosis, diabetes mellitus and obesity...
January 2, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28033679/peritoneal-dialysis-registry-with-2013-survey-report
#4
Ikuto Masakane, Takeshi Hasegawa, Satoshi Ogata, Naoki Kimata, Shigeru Nakai, Norio Hanafusa, Takayuki Hamano, Kenji Wakai, Atsushi Wada, Kosaku Nitta
Since 2009, the peritoneal dialysis (PD) registry has been carried out as part of the annual nationwide survey conducted by the Statistical Survey Committee of the Japanese Society for Dialysis Therapy with the cooperation of the Japanese Society for Peritoneal Dialysis. In this study, the current status of PD patients is reported on the basis of the results of the survey conducted at the end of 2013. The subjects were PD patients who lived in Japan and participated in the 2013 survey. Descriptive analysis was performed for various items including the current status of the combined use of PD and another dialysis method such as hemodialysis (HD) or hemodiafiltration (HDF), the method of exchanging dialysate, the use of an automated peritoneal dialysis (APD) machine, and the incidences of peritonitis and catheter exit-site infection...
December 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28031678/a-case-of-heparin-induced-thrombocytopenia-type-2-after-repair-of-juxtarenal-abdominal-aortic-aneurysm
#5
Jun Watanabe, Kengo Nishimura, Shigeto Miyasaka, Keisuke Morimoto, Takafumi Hamasaki, Shingo Ishiguro
Heparin-induced thrombocytopenia (HIT) is still a relatively uncommon condition and it is not well known how to administer argatroban during continuous hemodiafiltration (CHDF). A 72-year-old man required CHDF with heparin because of the oliguria and hyperpotassemia directly after the open repair of a juxtarenal abdominal aortic aneurysm. As the postoperative blood platelet count dropped and there was a thrombus in the CHDF circuit, HIT was suspected and nafamostat mesilate, but not heparin, was immediately administered for CHDF...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28028747/non-occlusive-mesenteric-ischemia-accompanied-by-aortic-regurgitation-after-transcatheter-aortic-valve-implantation
#6
Kentaro Meguro, Junro Ishizaki, Tomoyoshi Yanagisawa, Toshimi Koitabashi, Tadashi Kitamura, Junya Ako
An 81-year-old male with severe symptomatic aortic stenosis with ventricular tachycardia was referred for treatment. Balloon aortic valvuloplasty was performed under cardiopulmonary resuscitation. Though transcatheter aortic valve implantation (TAVI) was considered high risk for annulus rupture and aortic regurgitation due to annular calcification, TAVI was performed because of extremely high surgical risk. Moderate-to-severe aortic regurgitation (AR) remained and progression of acidosis could not be managed with continuous hemodiafiltration...
December 27, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28024931/a-randomized-single-blind-crossover-trial-of-recovery-time-in-high-flux-hemodialysis-and-hemodiafiltration
#7
James R Smith, Norica Zimmer, Elizabeth Bell, Bernard G Francq, Alex McConnachie, Robert Mactier
BACKGROUND: The choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD. STUDY DESIGN: Randomized patient-blinded crossover trial. SETTINGS & PARTICIPANTS: 100 patients with end-stage kidney disease were enrolled from 2 satellite dialysis units in Glasgow, United Kingdom...
December 23, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27995744/online-hemodiafiltration-reduces-bisphenol-a-levels
#8
Borja Quiroga, Ricardo J Bosch, Ruth A Fiallos, Marta Sánchez-Heras, Nuria Olea-Herrero, Pilar López-Aparicio, Carmen Muñóz-Moreno, Miguel Angel Pérez-Alvarsan, Gabriel De Arriba
Several uremic toxins have been identified and related to higher rates of morbidity and mortality in dialysis patients. Bisphenol A (BPA) accumulates in patients with chronic kidney disease. The aim of this study is to demonstrate the usefulness of online hemodiafiltration (OL-HDF) in reducing BPA levels. Thirty stable hemodialysis patients were selected to participate in this paired study. During three periods of 3 weeks each, patients were switched from high-flux hemodialysis (HF-HD) to OL-HDF, and back to HF-HD...
December 20, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27951579/evidence-for-the-clinical-advantages-of-predilution-on-line-hemodiafiltration
#9
Ikuto Masakane, Kan Kikuchi, Hideki Kawanishi
BACKGROUND: On-line hemodiafiltration (OL-HDF) is a rapidly developing dialysis modality that is expected to ameliorate the quality of life and survival rate of chronic dialysis patients. There are generally 2 types of dilution methods in OL-HDF: postdilution and predilution. SUMMARY: Postdilution OL-HDF is widely performed worldwide, whereas predilution OL-HDF accounts for >90% of all OL-HDF sessions performed in Japan. The reasons for the preference for predilution are to increase the substitution volume at a lower blood flow rate and to remove larger low-molecular-weight proteins (LMWPs)...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951574/clinical-performance-assessment-of-cordiax-filters-in-hemodialysis-and-hemodiafiltration
#10
Jacky Potier, Sudhir Bowry, Bernard Canaud
In this study, we evaluate the in vivo clinical performances of CorDiax FX 100 and CorDiax FX 1000 filters incorporating a high-flux membrane (Helixone Plus) designed for use in high-flux hemodialysis (HD) as well as in hemodiafiltration (HDF) in 6 stable end-stage kidney disease patients. In the HDF mode, various substitution modalities (post-, pre-, and mixed) were compared. In addition to conventional markers of efficacy of dialysis dose (urea, ionic dialysance, Kt/V), several additional middle- and large-size solute (β2-microglobulin, myoglobin, serum-free light-chain kappa and lambda, α1-microglobulin, and FGF23) compounds were explored in order to cover the spectrum of uremic toxins that are involved in uremia...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951573/a-new-poly-methyl-methacrylate-membrane-dialyzer-nf-with-adsorptive-and-antithrombotic-properties
#11
Wataru Oshihara, Hiroaki Fujieda, Yoshiyuki Ueno
BACKGROUND: Poly(methyl methacrylate) (PMMA) membranes adsorb several kinds of proteins and can remove high-molecular-weight proteins, including uremic toxins, which are not removed efficiently by hemodialysis or hemodiafiltration. However, the antithrombogenicity of PMMA membranes is insufficient due to their adsorptive properties. SUMMARY: Coagulation during hemodialysis occurs because proteins that are adsorbed to the PMMA membrane undergo structural changes and are recognized by platelets, which are then activated by adhesion to the membrane surface...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951571/fundamental-characteristics-of-the-newly-developed-ata%C3%A2-membrane-dialyzer
#12
Takashi Sunohara, Toshiaki Masuda
BACKGROUND: Dialysis membranes are often made from synthetic polymers, such as polysulfone. However, membranes made from cellulose triacetate have superior biocompatibility and have been used since the 1980s. On-line hemodiafiltration treatment accompanied by massive fluid replacement is increasingly being used in Europe and Japan, but cellulose triacetate is not suitable for this treatment. SUMMARY: Our newly developed asymmetric triacetate membrane, the ATA™ membrane, substantially improved the filtration properties and blood compatibility because of the asymmetric structure and smooth surface of this cellulose acetate membrane...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951570/biocompatibility-of-hemodiafilters
#13
Tadashi Tomo
BACKGROUND: Biocompatibility and the efficiency of solute removal are important considerations in blood purification therapy. Improvement of biocompatibility is expected to lead to the prevention of dialysis-related complications (e.g. amyloidosis, arteriosclerosis, and malnutrition) and to the delay of disease progression by alleviating microinflammation. SUMMARY: The biocompatibility of dialyzers is greatly influenced by the interaction between blood and the treatment materials, in which the chemical and physical characteristics of membrane materials play important roles...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951567/evidence-for-targeting-low-molecular-weight-proteins-in-hemodialysis-and-hemodiafiltration
#14
Kenji Tsuchida, Kojiro Nagai, Narushi Yokota, Satoru Yamada, Hiroyuki Michiwaki, Jun Minakuchi
BACKGROUND: With the identification of β2-microglobulin (β2MG) as an active participant in dialysis-related amyloid fibril formation, low-molecular-weight proteins (LMWPs) are now recognized as a distinct class of uremic toxins, and numerous compounds in this category have been identified. The class of LMWPs, although not precisely defined, has a molecular weight range of approximately 1,000-50,000 Da. With this in mind, dialysis prescriptions have been modified to increase the efficiency of uremic solute removal...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951563/preparation-and-quality-management-of-fluids-for-hemodialysis
#15
Hideki Kawanishi, Misaki Moriishi, Naoko Takahashi, Shinichiro Tsuchiya
BACKGROUND: In 2008, the Japanese Society for Dialysis Therapy (JSDT) proposed a standard for the quality of fluids for hemodialysis. The standard was geared toward Japan, where the central dialysis fluid delivery system is routinely used. After establishment of the standard, dialysis fluid quality was markedly improved in facilities across the country. Moreover, the number of on-line hemodiafiltration patients dramatically increased. SUMMARY: However, the 2008 standard specifies only microbiological qualities and does not cover toxic chemicals...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951558/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvements
#16
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951547/are-there-any-downsides-barriers-or-challenges-in-delivering-hemodiafiltration-in-everyday-clinical-practice
#17
Peter J Blankestijn, Muriel Grooteman, Menso Nube
There is considerable evidence to suggest that on-line hemodiafiltration (HDF) is superior to standard hemodialysis when comparing effects on clinical end points, especially when a certain minimum convection volume can be achieved. In this chapter we address the question of whether there are any downsides, challenges, or barriers in delivering on-line HDF in everyday clinical practice. We discuss the subject from a medical/practical point of view and briefly from a financial/economic perspective.
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951546/clinical-effectiveness-of-intermittent-infusion-hemodiafiltration-using-backfiltration-of-ultrapure-dialysis-fluid-compared-with-predilution-on-line-hemodiafiltration
#18
Michio Mineshima, Kei Eguchi, Kanji Shishido, Susumu Takahashi, Tsukasa Kubo, Hiroshi Kawaguchi, Kouzo Shitomi, Keigo Shibagaki, Kiichi Suga, Hirotomo Nagao, Mikihiko Takada, Masahiro Taoka, Takashi Sato
BACKGROUND: In conventional hemodialysis (HD) treatment, excessive water removal sometimes induces a rapid drop in blood pressure. Intermittent infusion hemodiafiltration (I-HDF) has been developed to improve patients' peripheral circulation by repeated intermittent infusion during HD treatment. SUMMARY: A prospective, multicenter, parallel group comparative trial examined the clinical effectiveness of I-HDF compared with predilution on-line HDF (pre-HDF), the most popular on-line HDF therapy in Japan...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951545/what-is-the-optimal-target-convective-volume-in-on-line-hemodiafiltration-therapy
#19
Bernard Canaud, Katrin Koehler, Sudhir Bowry, Stefano Stuard
Conventional diffusion-based dialysis modalities including high-flux hemodialysis are limited in their capacity to effectively remove large uremic toxins and to improve outcomes for end-stage chronic kidney disease (ESKD) patients. By increasing convective solute transport, hemodiafiltration (HDF) enhances solute removal capacity over a broad range of middle- and large-size uremic toxins implicated in the pathophysiology of chronic kidney disease. Furthermore, by offering flexible convection volume, on-line HDF permits customizing the treatment dose to the patient's needs...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27925243/hemodiafiltration-a-technique-for-physiological-correction-of-priming-solution-in-pediatric-cardiac-surgery-an-in-vitro-study
#20
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
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