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Online hemodiafiltration

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https://www.readbyqxmd.com/read/27803814/is-anticoagulation-discontinuation-achievable-with-citrate-dialysate-during-hdf-sessions
#1
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
#2
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...
October 22, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27783636/online-haemodiafiltration-improves-inflammatory-state-in-dialysis-patients-a-longitudinal-study
#3
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/27703388/cost-effectiveness-analysis-of-online-hemodiafiltration-versus-high-flux-hemodialysis
#4
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/27637480/levels-of-dna-damage-in-peripheral-blood-lymphocytes-of-patients-undergoing-standard-hemodialysis-vs-on-line-hemodiafiltration-a-comet-assay-investigation
#5
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/27589376/dialyzability-of-oxycodone-and-its-metabolites-in-chronic-noncancer-pain-patients-with-end-stage-renal-disease
#6
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
https://www.readbyqxmd.com/read/27586123/why-choose-high-volume-online-post-dilution-hemodiafiltration
#7
Carlo Basile, Andrew Davenport, Peter J Blankestijn
The mortality rate of patients on maintenance dialysis remains alarmingly high, at approximately 15-20 % per year. Increasing dialyzer urea clearance has not been shown to improve survival and hence interest has shifted towards convective therapies, such as hemodiafiltration (HDF) which can remove middle molecular weight uremic toxins, which have been suggested to increase mortality in patients with end-stage kidney disease. During the last few years, four large prospective randomized controlled trials (RCTs) have been conducted in different European countries to compare survival outcomes in prevalent patients receiving conventional hemodialysis with online post-dilution HDF (OL HDF)...
September 1, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27453712/confronting-practical-problems-for-initiation-of-on-line-hemodiafiltration-therapy
#8
REVIEW
Yang Wook Kim, Sihyung Park
Conventional hemodialysis, which is based on the diffusive transport of solutes, is the most widely used renal replacement therapy. It effectively removes small solutes such as urea and corrects fluid, electrolyte and acid-base imbalance. However, solute diffusion coefficients decreased rapidly as molecular size increased. Because of this, middle and large molecules are not removed effectively and clinical problem such as dialysis amyloidosis might occur. Online hemodiafiltration which is combined by diffusive and convective therapies can overcome such problems by removing effectively middle and large solutes...
June 2016: Electrolyte & Blood Pressure: E & BP
https://www.readbyqxmd.com/read/27230700/dialysis-and-patient-factors-which-determine-convective-volume-exchange-in-patients-treated-by-postdilution-online-hemodiafiltration
#9
Andrew Davenport
Recent reports suggest a survival advantage for dialysis patients treated by postdilutional online hemodiafiltration (OL-HDF) who achieve higher volume convective exchanges. As such, the factors associated with achieving higher convective volume exchange were determined. The convective exchange volumes during the midweek OL-HDF session in a cohort of 653 patients with corresponding bio-impedance measurements of volume status and sessional electronic records were audited. Mean patient age was 64.9 ± 14...
December 2016: Artificial Organs
https://www.readbyqxmd.com/read/27182679/hemodiafiltration-with-endogenous-reinfusion-improved-microinflammation-and-endothelial-damage-compared-with-online-hemodiafiltration-a-hypothesis-generating-study
#10
Elvira Esquivias-Motta, Alejandro Martín-Malo, Paula Buendia, Maria A Álvarez-Lara, Sagrario Soriano, Rodolfo Crespo, Julia Carracedo, Rafael Ramírez, Pedro Aljama
Hemodiafiltration with endogenous reinfusion (HFR) after ultrafiltrate passage through a resin cartridge combines adsorption, convection, and diffusion. Our prospective single-center crossover study compared HFR and online-hemodiafiltration (OLHDF) effects on two uremic toxins and 13 inflammatory, endothelial status, or oxidative stress markers. After an 8-week run-in period of high-flux hemodialysis, 17 eligible stable dialysis patients (median age 65 years, 10 male) without overt clinical inflammation were scheduled for four 8-week periods in the sequence: HFR/OLHDF/HFR/OLHDF...
May 16, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27100440/acute-effects-of-hemodiafiltration-versus-conventional-hemodialysis-on-endothelial-function-and-inflammation-a-randomized-crossover-study
#11
RANDOMIZED CONTROLLED TRIAL
Ping Jia, Wei Jin, Jie Teng, Hao Zhang, Jianzhou Zou, Zhonghua Liu, Bo Shen, Xuesen Cao, Xiaoqiang Ding
Endothelial dysfunction and chronic inflammatory process are prevalent in patients with end-stage renal disease (ESRD) on maintenance hemodialysis (HD). The aim of this study was to evaluate the acute and short-term effects of online hemodiafiltration (OL-HDF) versus conventional HD on endothelial function and inflammation. A prospective, randomized, crossover trial. Twenty stable ESRD patients undergoing chronic HD treatments were randomly assigned with a 1:1 ratio to conventional HD and to OL-HDF both for 2 weeks (either HD followed by OL-HDF or OL-HDF followed by HD)...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27028295/risk-factors-for-mortality-in-end-stage-kidney-disease-patients-under-online-hemodiafiltration-three-year-follow-up-study
#12
Pedro de Sousa-Martins, Alexandra Moura, José Madureira, Pablo Alija, José Gerardo Oliveira, Martin Lopez, Madalena Filgueiras, Leonilde Amado, Maria Sameiro-Faria, Vasco Miranda, Edgar Mesquita, Laetitia Teixeira, Verónica Poveda, Luísa Lobato, Alice Santos-Silva, Elísio Costa
The aim of this work was to evaluate the predictors of mortality in a group of end-stage kidney disease (ESRD) patients under dialysis, by performing a three-year follow-up study. From the 236 patients included in this study, 54 patients died during the three-year follow-up period. Our data showed that the risk of death was higher in patients presenting lower levels of mean cell hemoglobin concentration, transferrin, and albumin. Our study showed that poor nutritional status and an inflammatory-induced iron depleted erythropoiesis are important factors for mortality in these patients...
September 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/26768810/an-overview-of-regular-dialysis-treatment-in-japan-as-of-31-december-2013
#13
Ikuto Masakane, Shigeru Nakai, Satoshi Ogata, Naoki Kimata, Norio Hanafusa, Takayuki Hamano, Kenji Wakai, Atsushi Wada, Kosaku Nitta
A nationwide survey of 4325 dialysis facilities was conducted at the end of 2013, among which 4268 (98.7%) responded. The number of new dialysis patients was 38,095 in 2013. Since 2008, the number of new dialysis patients has remained almost the same without any marked increase or decrease. The number of dialysis patients who died in 2013 was 30,751. The dialysis patient population has been growing every year in Japan; it was 314,438 at the end of 2013. The number of dialysis patients per million at the end of 2013 was 2470...
December 2015: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/26580275/isonatric-dialysis-biofeedback-in-hemodiafiltration-with-online-regeneration-of-ultrafiltrate-in-hypertensive-hemodialysis-patients-a-randomized-controlled-study
#14
Louise Chevalier, Christian Tielemans, Frederic Debelle, Dominique Vandervelde, Christine Fumeron, Lise Mandart, Jean-Claude Stolear, Isabelle Simon, Yahsou Delmas, Angelo Testa, Olivier Mat, Sophie Tezenas du Montcel, Lucile Mercadal
UNLABELLED: Dialysis biofeedback in hemodiafiltration with online regeneration of ultrafiltrate (HFR) could help to improve arterial hypertension. We evaluated the impact of isonatric HFR (HFR-iso) on hypertension control compared to conventional HFR. Forty-seven hemodialysis patients were included and randomized (ratio 2/1) HFR-iso versus HFR during 24 dialysis sessions. In the HFR-iso group (32 patients, 768 dialysis sessions), the predialytic systolic blood pressure (BP) decreased from S1 to S24 of 9 ± 20 mm Hg and increased of 5 ± 24 mm Hg in the HFR group (15 patients, 360 dialysis sessions), variation that differed between the 2 groups (x0394;S1-S24, p = 0...
2016: Blood Purification
https://www.readbyqxmd.com/read/26565938/what-is-the-optimum-dialysate-flow-in-post-dilution-online-haemodiafiltration
#15
Marta Albalate Ramón, Patricia de Sequera Ortiz, Rafael Pérez-García, Elena Corchete Prats, Roberto Alcázar Arroyo, Mayra Ortega Díaz, Marta Puerta Carretero
INTRODUCTION: In post-dilution online hemodiafiltration (OL-HDF), the only recommendation concerning the dialysate, or dialysis fluid, refers to its purity. No study has yet determined whether using a high dialysate flow (Qd) is useful for increasing Kt or ultrafiltration-infusion volume. OBJECTIVE: Study the influence of Qd on Kt and on infusion volume in OL-HDF. MATERIAL AND METHODS: This was a prospective crossover study. There were 37 patients to whom 6 sessions of OL-HDF were administered at 3 different Qds: 500, 600 and 700ml/min...
November 2015: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/26467262/determination-of-the-critical-absolute-blood-volume-for-intradialytic-morbid-events
#16
Susanne Kron, Daniel Schneditz, Til Leimbach, Jutta Czerny, Sabine Aign, Joachim Kron
The reduction of blood volume below a critical threshold is assumed to trigger intradialytic morbid events (IME). Recently, we presented a simple method to determine the absolute blood volume during routine hemodialysis (HD) carried out without blood sampling and without injection of dyes or radiolabeled markers. Such information could be used to detect excessive volume reduction during HD and to prevent IME. Therefore, we performed a pilot study in IME-prone patients to identify the absolute blood volume at which they developed clinical symptoms...
April 2016: Hemodialysis International
https://www.readbyqxmd.com/read/26352299/higher-convection-volume-exchange-with-online-hemodiafiltration-is-associated-with-survival-advantage-for-dialysis-patients-the-effect-of-adjustment-for-body-size
#17
Andrew Davenport, Sanne A E Peters, Michiel L Bots, Bernard Canaud, Muriel P C Grooteman, Gulay Asci, Francesco Locatelli, Francisco Maduell, Marion Morena, Menso J Nubé, Ercan Ok, Ferran Torres, Mark Woodward, Peter J Blankestijn
Mortality remains high for hemodialysis patients. Online hemodiafiltration (OL-HDF) removes more middle-sized uremic toxins but outcomes of individual trials comparing OL-HDF with hemodialysis have been discrepant. Secondary analyses reported higher convective volumes, easier to achieve in larger patients, and improved survival. Here we tested different methods to standardize OL-HDF convection volume on all-cause and cardiovascular mortality compared with hemodialysis. Pooled individual patient analysis of four prospective trials compared thirds of delivered convection volume with hemodialysis...
January 2016: Kidney International
https://www.readbyqxmd.com/read/26344509/is-there-an-optimal-dose-of-hemodiafiltration
#18
Francisco Maduell
BACKGROUND: Retrospective randomized clinical studies have shown that online hemodiafiltration (OL-HDF) is associated with a lower risk reduction of mortality than standard hemodialysis. SUMMARY: In all of these large randomized studies, the convective volume seemed to be an important issue, but the optimal OL-HDF dose has not yet been defined. This article, to make a EUDIAL working group position, reviews the association between survival and convective volume, the minimum recommended replacement volume, the importance of the infusion flow rate, and the main limiting factors in achieving a high convective volume...
2015: Blood Purification
https://www.readbyqxmd.com/read/26344508/clinical-expectation-of-online-hemodiafiltration-a-japanese-perspective
#19
REVIEW
Tadao Akizawa, Fumihiko Koiwa
Many pieces of evidence of online hemodiafiltration (HDF) have been reported, and the clinical advantage of postdilution online HDF with sufficient substitution is now established. After the approval of online HDF in 2012, the number of online HDF patients has been dramatically increasing in Japan and reached 10% of the total dialysis population at the end of 2013. One of the marked characteristics of Japanese online HDF is a widespread use of predilution treatment and, in 2013, 90.8% of online HDFs were carried out with the predilution mode...
2015: Blood Purification
https://www.readbyqxmd.com/read/26299171/assessment-of-dialyzer-surface-in-online-hemodiafiltration-objective-choice-of-dialyzer-surface-area
#20
Francisco Maduell, Raquel Ojeda, Marta Arias-Guillén, Giannina Bazan, Manel Vera, Néstor Fontseré, Elisabeth Massó, Miquel Gómez, Lida Rodas, Mario Jiménez-Hernández, Gastón Piñeiro, Nayra Rico
INTRODUCTION: Online hemodiafiltration (OL-HDF) is currently the most effective technique. Several randomized studies and meta-analyses have observed a reduction in mortality as well as a direct association with convective volume. Currently, it has not been well established whether a larger dialyzer surface area could provide better results in terms of convective and depurative effectiveness. The aim of this study was to assess the effect of larger dialyzer surface areas on convective volume and filtration capacity...
2015: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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