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urea dialysate

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...
August 15, 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...
July 26, 2018: Blood Purification
Maarten Wester, Maaike K van Gelder, Jaap A Joles, Frank Simonis, Diënty H M Hazenbrink, Theo W M van Berkel, Koen R D Vaessen, Walther H Boer, Marianne C Verhaar, Karin G F Gerritsen
BACKGROUND: The key to success in developing a wearable dialysis device is a technique to safely and efficiently regenerate and re-use a small volume of dialysate in a closed-loop system. In a hemodialysis model in goats, we explored whether urea removal by electro-oxidation (EO) could be effectively and safely applied in vivo. METHODS: A miniature dialysis device was built, containing 1 or 2 'EO unit(s)', each with 10 graphite electrodes, with a cumulative electrode surface of 585 cm2/unit...
July 11, 2018: American Journal of Physiology. Renal Physiology
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Maria Rita Moio, Antioco Fois, Riccardo Cao, Ida Molfino, Ana Kaniassi, Francoise Lippi, Ludivine Froger, Antonello Pani, Marilisa Biolcati
BACKGROUND: Choice of dialysis is context sensitive, explored for PD and extracorporeal dialysis, but less studied for haemodialysis (HD) and hemodiafiltration (HDF), both widely employed in Italy and France; reasons of choice and differences in prescriptions may impact on dialysis-related variables, particularly relevant in elderly, high-comorbidity patients. METHODS: The study involved two high-comorbidity in-hospital cohorts, treated in Centers with similar characteristics, in Italy (Cagliari) and France (Le Mans)...
July 9, 2018: BMC Nephrology
Marina Asano, Takako Ishii, Akiyoshi Hirayama, Masashi Mizuno, Yasuhiro Suzuki, Fumiko Sakata, Shin-Ichi Akiyama, Shoichi Maruyama, Tomoyoshi Soga, Hiroshi Kinashi, Takayuki Katsuno, Yasuhiko Ito
BACKGROUND: Ultrafiltration failure associated with peritoneal membrane dysfunction is one of the main complications for patients on long-term peritoneal dialysis (PD). The dialysate-to-plasma concentration ratio (D/P) of creatinine is widely used to assess peritoneal membrane function. However, other small-sized solutes have not been studied in detail as potential indicators of peritoneal permeability. METHODS: We studied the D/Ps of small, middle-sized and large molecules in peritoneal equilibration tests in 50 PD patients...
July 2, 2018: Clinical and Experimental Nephrology
Miquel Gomez, Francisco Maduell
Kinetic modelling in haemodialysis is usually based upon the resolution of volume-defined compartment models. The interaction among these compartments is described by purely diffusive processes. In this paper we present an alternative kinetic model for uremic toxins in post-dilutional haemodiafiltration treatments by means of a unidimensional diffusion equation. A wide range of solutes such as urea, creatinine, $\beta _{2}$-microglobulin, myoglobin and prolactin were studied by imposing appropriate boundary and initial conditions in a virtual [0,1] domain...
June 15, 2018: Mathematical Medicine and Biology: a Journal of the IMA
Sharmela Sahathevan, Chee-Hee Se, SeeHoe Ng, Ban-Hock Khor, Karuthan Chinna, Bak Leong Goh, Halim A Gafor, Sunita Bavanandan, Ghazali Ahmad, Tilakavati Karupaiah
BACKGROUND AND AIMS: Poor dietary intake is commonly associated with malnutrition in the dialysis population and oral nutritional supplementation is strategized to redress dietary inadequacy. Knowledge on clinical efficacy of whey protein supplementation (WPS) as an option to treat malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients is limited. METHODS: This multicenter, parallel, open-label, randomized controlled trial investigated the clinical efficacy of WPS in 126 malnourished CAPD patients with serum albumin <40 g/L and body mass index (BMI) <24 kg/m2 ...
June 2018: Clinical Nutrition ESPEN
Ryo Tamura, Shigehiro Doi, Ayumu Nakashima, Kensuke Sasaki, Kazuya Maeda, Toshinori Ueno, Takao Masaki
Transforming growth factor-β1 (TGF-β1) is a major mediator of peritoneal fibrosis and reportedly affects expression of the H3K4 methyltransferase, SET7/9. SET7/9-induced H3K4 mono-methylation (H3K4me1) critically activates transcription of fibrosis-related genes. In this study, we examined the effect of SET7/9 inhibition on peritoneal fibrosis in mice and in human peritoneal mesothelial cells (HPMCs). We also examined SET7/9 expression in nonadherent cells isolated from the effluent of peritoneal dialysis (PD) patients...
2018: PloS One
Shi Z Choo, Kevan R Polkinghorne, Peter G Kerr
AIM: Extended-hours haemodialysis has long been regarded as the optimal form of dialysis for solute clearance. With emerging benefits of haemodiafiltration, we wanted to compare these two head-to-head. METHODS: In this randomised cross-over trial, we recruited existing nocturnal haemodialysis patients, who had not been hospitalised in the prior three months. After a baseline 8-hour haemodialysis session, subjects were randomised to either 2 weeks of 8-hour haemodialysis or 4-hour haemodiafiltration with cross-over to the alternative treatment after a 2-week washout period...
May 2, 2018: Nephrology
Clara Salame, Simon Eaton, George Grimble, Andrew Davenport
OBJECTIVE: Muscle wasting is associated with increased mortality and is commonly reported in dialysis patients. Hemodialysis (HD) and peritoneal dialysis (PD) treatments lead to protein losses in effluent dialysate. We wished to determine whether changes in current dialysis practice had increased therapy-associated nitrogen losses. DESIGN: Cross-sectional cohort study. METHODS: Measurement of total protein, urea and total nitrogen in effluent dialysate from 24-hour collections from PD patients, and during haemodiafiltration (HDF) and haemodialysis (HD) sessions...
April 28, 2018: Journal of Renal Nutrition
Ahmed Mohamed, Andrew Davenport
INTRODUCTION: Dialysis adequacy is traditionally measured by monthly blood urea sampling and calculating sessional Kt/Vurea. Modern dialysis machines can estimate clearances each session, so we wished to compare online measurements with standard Kt/Vurea. METHODS: Urea clearance was estimated by intermittent changes in effective ionic dialysance and by continuous ultraviolet light absorption spent during the mid-week dialysis session. Total body water was calculated by the Watson equation and measured by multifrequency bioimpedance...
July 2018: International Journal of Artificial Organs
Raphael Henn, Christian G Kirchler, Zora L Schirmeister, Andreas Roth, Werner Mäntele, Christian W Huck
Blood constituents such as urea, glucose, lactate, phosphate and creatinine are of high relevance in monitoring the process of detoxification in ambulant dialysis treatment. In the present work, 2 different vibrational spectroscopic techniques are used to determine those molecules quantitatively in artificial dialysate solutions. The goal of the study is to compare the performance of near-infrared (NIR) and mid-infrared (MIR) spectroscopy in hyphenation with partial least squares regression (PLSR) directly by using the same sample set...
July 2018: Journal of Biophotonics
Marta Albalate Ramón, Patricia Martínez Miguel, Lourdes Bohorquez, Patricia de Sequera, Hanane Bouarich, Rafael Pérez-García, Diego Rodríguez Puyol, Guillermina Barril, Jose Antonio Sánchez Tomero, Martin Giorgi, Manuel Rafael Ramirez Chamond
BACKGROUND: In post-dilution haemodiafiltration only synthetic membranes have been used to date. Asymmetric cellulose triacetate (ATA™) is now available, whose characteristics are suitable for this technique. OBJECTIVES: To describe the in vivo performance and behaviour of this membrane, to identify its depurative effectiveness, use in clinical practice and its biocompatibility, both acute and after one month of treatment. METHODS: Observational prospective study of 23 patients who were dialysed for 4 weeks using an ATA™ membrane and who maintained their prior regimen...
May 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Aarne Vartia
BACKGROUND: Kt/Vurea reflects the efficacy of haemodialysis scaled to patient size (urea distribution volume). The guidelines recommend monthly Kt/V measurements based on blood samples. Modern haemodialysis machines are equipped with accessories monitoring the dose online at every session without extra costs, blood samples and computers. OBJECTIVE: To describe the principles, devices, benefits and shortcomings of online monitoring of haemodialysis dose. DESIGN: A critical literature overview and discussion...
January 25, 2018: Journal of Renal Care
Francisco Maduell, Raquel Ojeda, Lara Belmar, Paula Munguía, Cristina Sango, Ana Isabel Martinez-Díaz, Marta Arias-Guillén, Manel Vera, Néstor Fontseré, Miquel Gómez, Lida Rodas, Nayra Rico
INTRODUCTION: Online haemodiafiltration (OL-HDF) has been associated with increased survival. To date, the influence of the inner diameter of the hollow fibres of the dialyser on convective volume has not been well established. The objective of the study was to evaluate the effect of increasing the inner diameter of the dialyser on the convective volume and removal capacity. MATERIAL AND METHODS: We included 16 patients in posdilutional OL-HDF with autosubstitution...
January 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Norbert Cibicek, Jiri Ehrmann, Jitka Proskova, Rostislav Vecera
Sensors able to record large bowel physiology and biochemistry in situ in awake rodents are lacking. Microdialysis is a mini-invasive technique that may be utilized to continuously deliver or recover low-molecular substances from various tissues. In this experiment we evaluated the feasibility of in vivo microdialysis to monitor extracellular fluid chemistry in the descending colon submucosa of conscious, freely moving rodents. Following surgical implantation of a microdialysis probe, male Wistar rats were housed in metabolic cages where they were analgized and clinically followed for four days with free access to standard diet and water...
2018: PloS One
Rosaria Del Giorno, Hilary Riva, Gaetano Donato, Luca Gabutti
BACKGROUND: Ionized Magnesium (ion-Mg) represents the active biological fraction of the serum magnesium content. The assessment of total serum Mg (tot-Mg) might not accurately identify patients with hypo-or hyper-magnesaemie. In hemodialysis, serum tot-Mg levels in the upper part of the distribution, have been associated with reduced mortality and fewer vascular calcifications; thus, resulting in the tendency to increase the Mg concentration in the dialysate, traditionally set at 0.5 mmol/L...
June 2018: Clinical and Experimental Nephrology
Shakil Aslam, Subodh J Saggi, Moro Salifu, Robert J Kossmann
Dialysis dose is an important determinant of clinical outcomes in patients with end stage renal disease on maintenance dialysis. In clinical practice dialysis dose is monitored at least monthly by urea clearance based on Urea Kinetic Modeling. Online clearance monitoring using effective ionic dialysance (EID) of sodium (Na+ ) is available on some hemodialysis machines. This paper reviews the background, methodology, additional applications, and potential risks associated with EID. Effective ionic dialysance provides a reliable, real-time, noninvasive, and inexpensive measurement of dialysis dose during an ongoing hemodialysis (HD) session to allow interventions and assess the impact of these changes on clearance...
December 6, 2017: Hemodialysis International
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