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Online 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/29054458/dosing-optimization-of-meropenem-based-on-a-pharmacokinetic-analysis-in-patients-receiving-hemodiafiltration-and-an-in%C3%A2-vitro-model
#2
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
#3
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/28972690/on-line-hemodiafiltration-at-home
#4
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/28869042/hyperuricemia-is-associated-with-progression-of-chronic-kidney-disease-in-patients-with-reduced-functioning-kidney-mass
#5
Isabel Galán, Marian Goicoechea, Borja Quiroga, Nicolás Macías, Alba Santos, Maria Soledad García de Vinuesa, Úrsula Verdalles, Santiago Cedeño, Eduardo Verde, Ana Pérez de José, Ana García, José Luño
BACKGROUND AND OBJECTIVES: Hyperuricemia plays a major role in the development and progression of chronic kidney disease (CKD). Many large observational studies have indicated that increased serum uric acid level predicts the development and progression of CKD in some population, however this hypothesis has not been yet studied in patients with reduced renal mass. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Retrospective study with a cohort of 324 patients with reduced renal mass from an outpatient basis, followed during 60 (36-98) months...
August 30, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28834362/is-high-volume-online-hemodiafiltration-associated-with-malnutrition
#6
Nicolás Macías, Almudena Vega, Soraya Abad, Alba Santos, Santiago Cedeño, Tania Linares, Ana María García-Prieto, Inés Aragoncillo, Claudia Yuste, Juan Manuel López-Gómez
Chronic malnutrition is a common problem in patients with end-stage renal disease on hemodialysis. Some studies have reported albumin loss into dialysis fluid during postdilution online hemodiafiltration (OL-HDF). The aim of the study was to assess the nutritional status of patients on high-volume OL-HDF and to demonstrate that higher convective clearances are not associated with malnutrition due to possible loss of nutrients with ultrafiltration. Demographic and clinical data, corporal composition with bioimpedance spectroscopy, dialysis features, albumin loss into dialysis fluid and laboratory parameters were collected in twenty-eight patients with ESRD undergoing postdilution OL-HDF with stable convective volumes over 28 L/session...
August 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28795535/update-on-postdialysis-rebound-by-a-new-technology-in-hemodialysis
#7
Alicia García Testal, David Hervás Marín, Rafael García Maset, Pilar Royo Maicas, Inmaculada Soledad Rico Salvador, Pau Olagüe Díaz, Jose Enrique Fernández Najera, Eduardo Torregrosa De Juan, Caterina Benedito Carrera
After dialysis ends, urea continued movement causes rebound postdialysis, with values at about 20%. New techniques have been incorporated into hemodialysis, but their relationship with rebound has not yet been studied. This study aimed to quantify urea rebound at 30-min postdialysis during sessions using polysulfone filters and high-flow versus online hemodiafiltration, and to define its correlation with body composition measured by bioimpedance by a cross-sectional study with 69 patients (December 2015 to January 2016)...
October 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28762633/platelet-activation-and-clotting-cascade-activation-by-dialyzers-designed-for-high-volume-online-hemodiafiltration
#8
Kamonwan Tangvoraphonkchai, Anne Riddell, Andrew Davenport
INTRODUCTION: Hemodialysis patients are pro-thrombotic. Higher volume online postdilutional hemodiafiltration (OL-HDF), with increasing hematocrit increases the risk of clotting in the extracorporeal circuit (ECC). We wished to determine whether OL-HDF increased platelet activation and ECC clotting. METHODS: Coagulation parameters, platelet, white cell, and endothelial activation markers were measured at the start and end of dialysis sessions in 10 patients and also pre- and post-dialyzer after 15 minutes using two different dialyzers designed for high volume OL-HDF; cellulose triacetate (TAGP) and polysulphone (PS), and polyvinylpyrrolidone (PVP)...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28559700/arterial-stiffness-hemodialysis-versus-hemodiafiltration
#9
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/28540893/comparison-of-intradialytic-hemodynamic-tolerance-between-on-line-hemodiafiltration-and-acetate-free-biofiltration-with-profiled-potassium-dialysate-concentration
#10
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/28534129/insomnia-muscular-cramps-and-pruritus-have-low-intensity-in-hemodialysis-patients-with-good-dialysis-efficiency-low-inflammation-and-arteriovenous-fistula
#11
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
#12
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/28483384/-online-hemodiafiltration-practical-aspects-safety-and-efficacy
#13
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
https://www.readbyqxmd.com/read/28459069/modulation-of-myostatin-hepatocyte-growth-factor-balance-by-different-hemodialysis-modalities
#14
Pasquale Esposito, Edoardo La Porta, Marta Calatroni, Maria Antonietta Grignano, Samantha Milanesi, Daniela Verzola, Yuri Battaglia, Marilena Gregorini, Carmelo Libetta, Giacomo Garibotto, Teresa Rampino
Background. In this study we investigated the relevance of myostatin and Hepatocyte Growth Factor (HGF) in patients undergoing hemodialysis HD and the influence of different HD modalities on their levels. Methods. We performed a prospective crossover study in which HD patients were randomized to undergo 3-month treatment periods with bicarbonate hemodialysis (BHD) followed by online hemodiafiltration (HDF). Clinical data, laboratory parameters, and myostatin and HGF serum levels were collected and compared...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28318624/treatment-tolerance-and-patient-reported-outcomes-favor-online-hemodiafiltration-compared-to%C3%A2-high-flux%C3%A2-hemodialysis-in-the-elderly
#15
Marion Morena, Audrey Jaussent, Lotfi Chalabi, Hélène Leray-Moragues, Leila Chenine, Alain Debure, Damien Thibaudin, Lynda Azzouz, Laure Patrier, Francois Maurice, Philippe Nicoud, Claude Durand, Bruno Seigneuric, Anne-Marie Dupuy, Marie-Christine Picot, Jean-Paul Cristol, Bernard Canaud
Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration...
June 2017: Kidney International
https://www.readbyqxmd.com/read/28093894/importance-of-body-water-in-the-efficacy-of-convective-solute-transport-in-online-hemodiafiltration
#16
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...
February 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28024931/a-randomized-single-blind-crossover-trial-of-recovery-time-in-high-flux-hemodialysis-and-hemodiafiltration
#17
RANDOMIZED CONTROLLED TRIAL
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...
June 2017: 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
#18
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...
February 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27803814/is-anticoagulation-discontinuation-achievable-with-citrate-dialysate-during-hdf-sessions
#19
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
#20
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
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