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urea dialysate

Susie Q Lew
Urea kinetics (weekly Kt/V) greater than 1.7 generally define adequate peritoneal dialysis (PD). Adequacy of PD depends on residual renal function and PD clearance. Preserving residual renal function and peritoneal membrane characteristics helps to maintain PD adequacy.The dose of PD can be augmented by increasing the total dialysate volume. Greater volume can be achieved by increasing either the fill volume per exchange or the number of exchanges. Increased time on dialysis can be achieved by keeping PD fluid in the peritoneal cavity at all times...
November 2018: Advances in Peritoneal Dialysis
Hilal Seval Abanoz, Buket Kunduhoglu
In this study, the antimicrobial activity of a bacteriocin produced by Enterococcus faecalis KT11, isolated from traditional Kargı Tulum cheese, was determined, and bacteriocin KT11 was partially characterized. The results showed that bacteriocin KT11 was antagonistically effective against various Gram-positive and Gram-negative test bacteria, including vancomycin- and/or methicillin-resistant bacteria. The activity of bacteriocin KT11 was completely abolished after treatment with proteolytic enzymes (proteinase K, α-chymotrypsin, protease and trypsin), which demonstrates the proteinaceous nature of this bacteriocin...
October 2018: Korean Journal for Food Science of Animal Resources
Joanna Stachowska-Pietka, Jan Poleszczuk, Michael F Flessner, Bengt Lindholm, Jacek Waniewski
Background: Ultrafiltration failure (UFF) in peritoneal dialysis (PD) patients is due to altered peritoneal transport properties leading to reduced capacity to remove excess water. Here, with the aim to establish the role of local alterations of the two major transport barriers, peritoneal tissue and capillary wall, we investigate changes in overall peritoneal transport characteristics in UFF patients in relation to corresponding local alterations of peritoneal tissue and capillary wall transport properties...
November 6, 2018: Nephrology, Dialysis, Transplantation
Yuanyuan Shi, Yifeng Wang, Shuai Ma, Tingyan Liu, Huajun Tian, Qiuyu Zhu, Wenji Wang, Yulin Li, Feng Ding
Protein-bound uremic toxins (PBUTs) accumulate at high plasma levels and cause various deleterious effects in end-stage renal disease patients because their removal by conventional hemodialysis is severely limited by their low free-fraction levels in plasma. Here, we assessed the extent to which solute removal can be increased by adding liposomes to the dialysate. The uptake of liposomes by direct incubation in vitro showed an obvious dose-response relationship for p-cresyl sulfate (PCS) and indoxyl sulfate (IS) but not for hippuric acid (HA)...
October 30, 2018: Artificial Organs
Raja Mohammed Kaja Kamal, Ken Farrington, Amanda D Busby, David Wellsted, Humza Chandna, Laura J Mawer, Sivakumar Sridharan, Enric Vilar
Background: Initiating twice-weekly haemodialysis (2×HD) in patients who retain significant residual kidney function (RKF) may have benefits. We aimed to determine differences between patients initiated on twice- and thrice-weekly regimes, with respect to loss of kidney function, survival and other safety parameters. Methods: We conducted a single-centre retrospective study of patients initiating dialysis with a residual urea clearance (KRU) of ≥3 mL/min, over a 20-year period...
October 23, 2018: Nephrology, Dialysis, Transplantation
Surachet Vongsanim, Clara Salame, Simon Eaton, George Grimble, Andrew Davenport
OBJECTIVE: Patients treated by peritoneal dialysis (PD) are at increased risk of muscle wasting, and clinical guidelines recommend assessing dietary intake, by calculating protein equivalent of nitrogen appearance (PNA) to assure protein sufficiency. The PNA equations were developed many years ago, and we wished to re-evaluate them by comparing estimated and measured peritoneal nitrogen losses. DESIGN AND METHODS: This is a cross-sectional observational cohort study...
October 19, 2018: Journal of Renal Nutrition
Shashidhar Cherukuri, Maria Bajo, Giacomo Colussi, Roberto Corciulo, Hafedh Fessi, Maxence Ficheux, Maria Slon, Eric Weinhandl, Natalie Borman
BACKGROUND: Utilization of home hemodialysis (HHD) is low in Europe. The Knowledge to Improve Home Dialysis Network in Europe (KIHDNEy) is a multi-center study of HHD patients who have used a transportable hemodialysis machine that employs a low volume of lactate-buffered, ultrapure dialysate per session. In this retrospective cohort analysis, we describe patient factors, HHD prescription factors, and biochemistry and medication use during the first 6 months of HHD and rates of clinical outcomes thereafter...
October 11, 2018: BMC Nephrology
Wihib Gebregeorgis, Zeenat Yousuf Bhat, Nishigandha Pradhan, Stephen D Migdal, Lakshminarayanan Nandagopal, Reddy Singasani, Tehmina Mushtaq, Ronald Thomas, Yahya M Osman Malik
Background: The Dt/V obtained by using ionic dialysance (D) as a surrogate for urea clearance (K) is a well-validated adjunct measure of hemodialysis adequacy, with a variable level of correlation with urea-based Kt/V. However, this correlation has not been examined based on patients' body size and ultrafiltration (UF) volume during the dialysis session. Methods: Simultaneous evaluations of online Dt/V and single-pool variable-volume urea Kt/V were made. Patients were categorized into three subgroups based on their weight (<60, 60-80 and ≥80 kg), body mass index (<25, 25-30 and >30 kg/m2 ) and UF volume (<1...
October 2018: Clinical Kidney Journal
Satoshi Hibino, Osamu Uemura, Hiroshi Uchida, Hisakazu Majima, Reiko Yamaguchi, Kazuki Tanaka, Azusa Kawaguchi, Satoshi Yamakawa, Naoya Fujita
Large-dose cyclic tidal peritoneal dialysis (TPD) is an original prescription of TPD involving frequent infusion and drainage of the dialysate to increase weekly urea clearance normalized to total body water (Kt/Vurea ) and fluid removal. This study aimed to evaluate the efficiency of solute clearance and fluid removal achieved with large-dose cyclic TPD compared to that achieved with nightly peritoneal dialysis (NPD). Seventeen patients with end-stage renal disease, for whom maintenance PD was changed from NPD to large-dose cyclic TPD, were enrolled...
September 27, 2018: Therapeutic Apheresis and Dialysis
Fayan Meng, Mykola Seredych, Chi Chen, Victor Gura, Sergey Mikhalovsky, Susan Sandeman, Ganesh Ingavle, Tochukwu Ozulumba, Ling Miao, Babak Anasori, Yury Gogotsi
The wearable artificial kidney can deliver continuous ambulatory dialysis for more than 3 million patients with end-stage renal disease. However, the efficient removal of urea is a key challenge in miniaturizing the device and making it light and small enough for practical use. Here, we show that two-dimensional titanium carbide (MXene) with the composition of Ti3 C2 T x , where T x represents surface termination groups such as -OH, -O-, and -F, can adsorb urea, reaching 99% removal efficiency from aqueous solution and 94% from dialysate at the initial urea concentration of 30 mg/dL, with the maximum urea adsorption capacity of 10...
October 23, 2018: ACS Nano
John K Leypoldt, Eric D Weinhandl, Allan J Collins
With dialysis delivery systems that operate at low dialysate flow rates, prescriptions for more frequent hemodialysis (HD) employ dialysate volume as the primary parameter for small solute removal rather than blood-side urea dialyzer clearance (K). Such delivery systems, however, yield dialysate concentrations that almost completely saturate with blood (water), suggesting that the volume of urea cleared (the product of K and treatment time or Kt) can be readily estimated from the prescribed dialysate volume to target small solute removal...
September 25, 2018: Hemodialysis International
Muhammad Nidzhom Zainol Abidin, Pei Sean Goh, Ahmad Fauzi Ismail, Noresah Said, Mohd Hafiz Dzarfan Othman, Hasrinah Hasbullah, Mohd Sohaimi Abdullah, Be Cheer Ng, Siti Hamimah Sheikh Abdul Kadir, Fatmawati Kamal
Portable dialysis is a need to implement daily and nocturnal hemodialysis. To realize portable dialysis, a dialysate regeneration system comprising superior adsorbents is required to regenerate the used dialysate. This study aims to develop a nano-adsorbent, derived from corn starch for urea removal. Oxidized starch nanoparticles (oxy-SNPs) were prepared via liquid phase oxidation, followed by chemical dissolution and non-solvent precipitation. The oxy-SNPs possessed Z-average size of 177.7 nm with carbonyl and carboxyl contents of 0...
December 1, 2018: Carbohydrate Polymers
Surachet Vongsanim, Andrew Davenport
Kidney dialysis patients with sarcopenia have increased mortality. Clinical guidelines recommend peritoneal dialysis (PD) patients have a target daily protein intake to prevent sarcopenia. Protein intake is estimated from total daily urea losses in urine and peritoneal dialysate to assess the protein equivalent of nitrogen appearance rate adjusted for body weight (nPNA). Dietary habits differ among ethnic groups, so we reviewed nPNA and body composition in a multi-ethnic PD population. Body composition was measured with multifrequency bioimpedance in 598 patients (301 white, 136 black, 123 South-Asian, and 38 Asian-Pacific)...
September 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Ali Poorkhalil, Davood Bizari, Hasan Farrokhzad
A new extracorporeal circuit for hemodialysis was designed with the goal of improving the middle and high molecular weight toxins removal. A recirculation pathway was added to the hemodialysis circuit and relevant pressure regulation was performed along the circuit in order to keep the ultrafiltration rate as zero. The influence of increasing the recirculation to dialysate flow rate ratio on the removal of urea, vitamin B12 and hemoglobin was investigated. This removal was also modeled by an analytical method and solved by MATLAB™ software...
September 4, 2018: Artificial Organs
S P Nagaraju, S Kosuru, R Parthasarathy, A S Mareddy, R P Attur, D Rangaswamy, S Prasad, S Kaza, S Shenoy, K Saraf, S L K Laxminarayana, U V Mateti, V Guddattu
We conducted a randomized crossover trial to identify whether the use of citrate dialysate (CD) for bicarbonate hemodialysis is beneficial compared to regular acetate dialysate (AD) in terms of adequacy, reuse, and quality of life. Thirty-two stable end-stage renal disease patients on twice-weekly maintenance hemodialysis were randomly assigned to CD or AD fluid in a single-blinded randomized prospective crossover trial of 1-year duration. The primary outcomes studied were the impact of CD in comparison with AD on hemodialysis adequacy, reuse of dialyzer, and quality of life...
July 2018: Indian Journal of Nephrology
B Grabowska-Polanowska, P Miarka, M Skowron, G Chmiel, A Pietrzycka, I Śliwka
BACKGROUND: The measurement of trimethylamine and isoprene in exhaled breath collected from dialysed patients indicates the changes in concentration of both compounds during dialysis. The aim of the presented study was to confirm diagnostic usefulness of TMA and isoprene detected in breath, as potential biomarkers of hemodialysis efficiency. METHODS: The samples of exhaled breath were collected from 22 dialyzed patients (9 women, 13 men) before and after hemodialysis (HD)...
August 18, 2018: Clinical and Experimental Nephrology
John T Daugirdas
BACKGROUND: Changes in plasma volume during hemodialysis are complex and have been shown to depend on the rate of fluid removal and the degree of fluid overload. We examined changes in total protein concentration during and shortly after a dialysis treatment in archived data from the HEMO study. METHODS: During follow-up months 4 and 36 of the HEMO study, additional blood samples were obtained during a typical dialysis session at 30 and 60 min after dialysis. In 315 studies from 282 patients where complete data were available, we calculated the concentration change in total protein and compared it to the modeled change in both total body water and extracellular fluid space as derived from 2-pool urea kinetic modeling...
2018: American Journal of Nephrology
Nanami Kawaguchi, Kimie Date, Yusuke Suzuki, Chihiro Tomita, Rina Naradate, Tomoko Higami, Kosuke Nakamura, Kyoko Aikawa, Haruko Ogawa
An active recombinant human pancreatic lipase (recHPL) was successfully prepared for the first time from the Escherichia coli expression system using short strep-tag II (ST II). The recHPL-ST II was solubilized using 8 M urea from E. coli lysate and purified on a Strep-Tactin-Sepharose column. After refolding by stepwise dialyses in the presence of glycerol and Ca2+ for 2 days followed by gel filtration, 1.8-6 mg of active recHPL-ST II was obtained from 1 L of culture. The recHPL was non-glycosylated, but showed almost equal specific activity, pH-dependency, and time-dependent stability compared to those of native porcine pancreatic lipase (PPL) at 37 °C...
August 8, 2018: Journal of Biochemistry
Regina Affonso, Carlos Roberto Soares, Maria Teresa Ribela, Paolo Bartolini
Prolactin is a pituitary hormone that is involved diverse physiological functions, such as lactation, reproduction, metabolism, osmoregulation, immunoregulation, and behavior. Its level of glycosylation is low in vivo, which favors its expression in bacterial systems. In the present work recombinant human prolactin (rec-hPRL) was expressed from the p1813-hPRL vector in Escherichia coli strain in inclusion bodies with 530.67 mg of rec-hPRL per liter of induced bacterial culture. The solubilization and renaturation of rec-hPRL followed by two methods described in the literature for this protein: one with detergent and basic pH, and other urea and dialyses was done by studying...
August 1, 2018: Protein Expression and Purification
Maxime Leclerc, Clémence Bechade, Patrick Henri, Elie Zagdoun, Erick Cardineau, Thierry Lobbedez, Maxence Ficheux
We conducted a prospective study to assess the impact of the blood pump flow rate (BFR) on the dialysis dose with a low dialysate flow rate. Seventeen patients were observed for 3 short hemodialysis sessions in which only the BFR was altered (300,350 and 450 mL/min). Kt/V urea increased from 0.54 ± 0.10 to 0.58 ± 0.08 and 0.61 ± 0.09 for BFR of 300, 400 and 450 mL/min. For the same BFR variations, the reduction ratio (RR) of β2microglobulin increased from 0.40 ± 0.07 to 0.45 ± 0.06 and 0.48 ± 0.06 and the RR phosphorus increased from 0...
2018: Blood Purification
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