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urea dialysate

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 1, 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
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
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