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https://www.readbyqxmd.com/read/30011293/preemptively-and-non-preemptively-transplanted-patients-show-a-comparable-hypercoagulable-state-prior-to-kidney-transplantation-compared-to-living-kidney-donors
#1
Gertrude J Nieuwenhuijs-Moeke, Tamar A J van den Berg, Stephan J L Bakker, Marius C van den Heuvel, Michel M R F Struys, Ton Lisman, Robert A Pol
To prevent renal graft thrombosis in kidney transplantation, centres use different perioperative anticoagulant strategies, based on various risk factors. In our centre, patients transplanted preemptively are considered at increased risk of renal graft thrombosis compared to patients who are dialysis-dependent at time of transplantation. Therefore these patients are given a single dose of 5000 IU unfractionated heparin intraoperatively before clamping of the vessels. We questioned whether there is a difference in haemostatic state between preemptively and non-preemptively transplanted patients and whether the distinction in intraoperative heparin administration used in our center is justified...
2018: PloS One
https://www.readbyqxmd.com/read/29989312/phosphate-binders-derived-from-natural-ores-contain-many-kinds-of-metallic-elements-besides-their-active-ingredient-metals
#2
Nobuo Nagano, Ayako Minegishi, Kyoko Ito, Tetsuo Ando, Takaaki Tsutsui, Tetsuya Ogawa
Most patients undergoing dialysis are required to take many phosphate binder pills to control hyperphosphatemia. Phosphate binders prescribed in Japan are classified into two types: metal-based binders (Ca carbonate, lanthanum carbonate, ferric citrate hydrate, and sucroferric oxyhydroxide) and chemically synthesized polymers (sevelamer hydrochloride and bixalomer). The raw materials of metal-based phosphate binders are natural ores; thus, such binders may contain several other metallic elements. We measured the elemental contents in six metal-based phosphate binders using an inductively coupled plasma mass - spectrometry (ICP-MS) method...
July 10, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29966111/a-prospective-observational-study-of-the-change-in-systemic-ionised-calcium-following-4-citrate-locking-of-venous-haemodialysis-catheters-in-intensive-care-patients
#3
S Shewdin, Y C Bong, S Okano, M D Chatfield, J Walsham
Traditionally heparin has been the anticoagulant of choice for venous dialysis catheter locking. There is systemic leakage of heparin catheter locking solutions at the time of injection. Alternative agents, such as citrate, are increasingly being used. We are not aware of any data in the critical care literature on the effect of citrate locking of venous dialysis catheters on systemic ionised calcium (iCa2+ ). To assess the effect of 4% citrate locking of venous dialysis catheters on systemic iCa2+ in intensive care patients we performed a prospective observational study of 50 paired samples in 26 intensive care patients receiving 4% citrate dialysis catheter locking in an adult tertiary intensive care unit between May 2016 and December 2016...
July 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29961562/usefulness-of-oral-ferric-citrate-in-patients-with-iron-deficiency-anemia-and-chronic-kidney-disease-with-or-without-heart-failure
#4
Peter A McCullough, Katrin Uhlig, John F Neylan, Pablo E Pergola, Steven Fishbane
Patients with chronic inflammatory conditions including chronic kidney disease (CKD) and heart failure (HF) are undertreated with iron-deficiency anemia (IDA). Progressive inflammation and reduced iron transport associated with CKD and HF may reduce the efficacy of oral iron therapy. Oral ferric citrate improves anemia markers in CKD, but its effects in patients with CKD and concomitant HF have not been described. Patients with CKD not on dialysis and IDA from a phase 2 and 3 trial were treated with ferric citrate (n = 190) or placebo (n = 188); patients with HF were identified from medical histories...
May 19, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29956006/clinical-experience-with-the-use-of-ferric-citrate-as-a-phosphate-binder-in-pediatric-dialysis-patients
#5
Mark R Hanudel, Marciana Laster, Georgina Ramos, Barbara Gales, Isidro B Salusky
BACKGROUND: Ferric citrate, an iron-based phosphate binder, has been shown to improve both hyperphosphatemia and iron deficiency in adult chronic kidney disease patients, but its use in the pediatric dialysis population has not been described. METHODS: This is a retrospective analysis of 11 unselected pediatric dialysis patients who received ferric citrate as a phosphate binder between 2015 and 2017. Time-averaged laboratory values were compared pre- and post-ferric citrate initiation using the Wilcoxon signed-rank test...
June 28, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29898003/influence-of-citrate-concentration-on-the-activation-of-blood-cells-in-an-in-vitro-dialysis-setup
#6
Jakob Gubensek, Karin Strobl, Stephan Harm, Rene Weiss, Tanja Eichhorn, Jadranka Buturovic-Ponikvar, Viktoria Weber, Jens Hartmann
BACKGROUND: Regional citrate anticoagulation has been associated with enhanced biocompatibility in hemodialysis, but the optimal dose of citrate remains to be established. Here, we compared parameters related to cellular activation during in vitro dialysis, using two doses of citrate. METHODS: Human whole blood, anticoagulated with either 3 mM or 4 mM of citrate, was recirculated in an in vitro miniaturized dialysis setup. Complement (C3a-desArg), soluble platelet factor 4 (PF4), thromboxane B2 (TXB2), myeloperoxidase (MPO), as well as platelet- and red blood cell-derived extracellular vesicles (EV) were quantified during recirculation...
2018: PloS One
https://www.readbyqxmd.com/read/29871769/haemodialysis-related-heparin-induced-thrombocytopenia-case-series-and-literature-review
#7
Joana Gameiro, Sofia Jorge, José António Lopes
Heparin-induced thrombocytopenia (HIT) is a serious and life-threatening complication that occurs in five per cent of patients exposed to heparin. It should be considered in patients with a platelet count <100×109 cells/l or a >50% decrease from baseline count in association with heparin therapy. Thromboembolic complications develop in 50% of patients. Bleeding is rare as the platelet count nadir typically does not drop below 20×109 cells/l. Up to 12% of dialysis patients develop HIT, named haemodialysis-related-heparin-induced thrombocytopenia (HD-HIT), as they are a risk group with continuous exposure to heparin...
June 2, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29860419/acetate-free-citrate-acidified-bicarbonate-dialysis-improves-serum-calcification-propensity-a-preliminary-study
#8
Georg Lorenz, Christopher C Mayer, Quirin Bachmann, Sarah Stryeck, Matthias C Braunisch, Bernhard Haller, Javier Carbajo-Lozoya, Alina Schmidt, Simon Witthauer, Jasmin Abuzahu, Stephan Kemmner, Susanne Angermann, Naresh Koneru, Siegfried Wassertheurer, Richard Bieber, Uwe Heemann, Tobias Madl, Andreas Pasch, Christoph Schmaderer
Background: A novel in vitro test (T50 test) assesses ex vivo serum calcification propensity and predicts mortality in chronic kidney disease and haemodialysis (HD) patients. For the latter, a time-dependent decline of T50 was shown to relate to mortality. Here we assessed whether a 3-month switch to acetate-free, citrate-acidified, standard bicarbonate HD (CiaHD) sustainably improves calcification propensity. Methods: T50 values were assessed in paired midweek pre-dialysis sera collected before and 3 months after CiaHD in 78 prevalent European HD patients...
May 30, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29850456/good-tolerance-of-citrate-accumulation-due-to-plasma-exchange-among-patients-with-acute-on-chronic-liver-failure-a-prospective-observational-study
#9
Yuanji Ma, Yan Xu, Fang Chen, Ying Wang, Lang Bai, Hong Tang
Aim: To assess the tolerance of citrate accumulation due to plasma exchange (PE) among patients with acute-on-chronic liver failure (ACLF). Methods: A prospective, observational study was conducted among patients with ACLF who received heparin anticoagulation during PE-centered therapy without filtration and dialysis. Citrate accumulation was defined as the value of total calcium (Catot ) to ionized calcium (Caion ) ratio (Catot /Caion ) greater than or equal to 2...
2018: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29737362/-regional-citrate-anticoagulation-in-renal-replacement-therapy-in-the-intensive-care-station-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#10
REVIEW
M Schmitz, M Joannidis, D Czock, S John, A Jörres, S J Klein, M Oppert, V Schwenger, J Kielstein, A Zarbock, D Kindgen-Milles, C Willam
BACKGROUND: Regional citrate anticoagulation (RCA) in continuous renal replacement therapy can effectively anticoagulate dialysis circuits without having adverse effects on systemic heparin application. In particular, in continuous renal replacement therapy RCA is well established and represents a safe procedure with longer filter lifetimes and fewer bleeding complications. OBJECTIVES: To provide guidance on the indications, advantages and disadvantages, and use of RCA, current recommendations from the renal section of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
June 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29615020/purification-and-mic-analysis-of-antimicrobial-proteins-from-cucumis-sativus-l-seeds
#11
Raid Al Akeel, Ayesha Mateen, Khalid K Alharbi, Abdullah A Alyousef, Hazem M Al-Mandeel, Rabbani Syed
BACKGROUND: Cucumis sativus L. (cucumber), from the family Cucurbitaceae, is a therapeutic plant with various pharmacological benefits, broadly utilized as a part of complementary medicine (e.g., Unani, Ayurveda, Siddha, and Traditional Chinese). In light of past research discoveries, this plant had been chosen to consider its potential antibacterial action. METHODS: Extracts were purified by dialysis and ion exchange chromatography strategy and then assayed for antibacterial activity against four standard pathogenic bacterial strains known to cause foodborne infections and spoilage of food and herbal drugs...
April 3, 2018: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29614970/a-novel-citrate-based-protocol-versus-heparin-anticoagulation-for-sustained-low-efficiency-dialysis-in-the-icu-safety-efficacy-and-cost
#12
Ming Wen, Claudius Küchle, Dominik Steubl, Robin Satanovskji, Uwe Heemann, Yana Suttmann, Susanne Angermann, Stephan Kemmner, Lisa Rehbehn, Monika Huber, Christine Hauser, Christoph Schmaderer, Anna-Lena Reichelt, Bernhard Haller, Lutz Renders
BACKGROUND: The high cost, complexity of the available protocols, and metabolic complications are the major barriers that impede the clinical utilization of regional citrate anticoagulation (RCA) for sustained low efficiency dialysis (SLED) in critically ill patients. By comparing a novel protocol for SLED using 30% citrate solution with common protocol using unfractionated heparin, this study aimed to provide new insights for clinical applications of RCA. METHODS: In this retrospective study, a total of 282 critically ill patients who underwent SLED with citrate and/or heparin anticoagulation in six adult ICUs were enrolled...
April 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29611144/treatment-dose-and-the-elimination-rates-of-electrolytes-vitamins-and-trace-elements-during-continuous-veno-venous-hemodialysis-cvvhd
#13
Thomas Datzmann, Karl Träger, Bernd Schröppel, Helmut Reinelt, Philipp von Freyberg
INTRODUCTION: During continuous renal replacement therapy, achievement of recommended treatment dose is important. However, relevant substrate loss may occur and recommended nutrition during critical illness could not be sufficient for higher dialysis doses. We investigated the correlation of dialysis dose and substrate loss for a broad range of dialysis doses. METHODS: Forty critically ill patients with acute kidney injury undergoing citrate CVVHD were included in this prospective study...
June 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29597222/clinical-complications-of-continuous-renal-replacement-therapy
#14
Florent Sigwalt, Axelle Bouteleux, François Dambricourt, Théo Asselborn, Florent Moriceau, Thomas Rimmelé
The various complications of continuous renal replacement therapy (CRRT) are mostly preventable. Hemodynamic disturbances are dominated by hypotension due to the modification of volume status, myocardial dysfunction, cardiac arrhythmia, or modification of systemic vascular resistances, which are correlated with body temperature changes. Metabolic complications remain at the forefront and have profoundly changed with the use of regional citrate anticoagulation (RCA). RCA may lead to two distinct situations: citrate overload and citrate accumulation, respectively, responsible for metabolic alkalosis and metabolic acidosis...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29351783/simple-citrate-anticoagulation-protocol-for-low-flux-haemodialysis
#15
Eng Kuang Lim, Ying-Ying T Seow, Shun E Chen, Gao Yang, Min Er Liaw, Shimi Isaac
BACKGROUND: For patients unable to receive heparin anticoagulation during haemodialysis, saline flushes to reduce circuit clotting are often the norm. Regional citrate anticoagulation (RCA) although effective is not used by many centres including in Singapore. We wanted to demonstrate the superiority and safety of a simple regional citrate anticoagulation regime, compared to saline flushes, for heparin-free low flux haemodialysis. METHODS: This is a prospective, open label, cross over study on 25 sequential haemodialysis sessions for inpatients receiving heparin-free haemodialysis...
January 19, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29291028/safety-and-efficacy-of-ferric-citrate-in-phosphate-reduction-and-iron-supplementation-in-patients-with-chronic-kidney-disease
#16
Mei-Yi Wu, Ying-Chun Chen, Chun-Hung Lin, Yun-Chun Wu, Yu-Kang Tu, Der-Cherng Tarng
Ferric citrate has been reported to have the potential to reduce phosphate and increase iron availability in patients with chronic kidney disease. In the present study, we evaluated its safety and efficacy in phosphate reduction and iron supplementation in chronic kidney disease stage 3-5 requiring dialysis patients. We systematically searched for clinical trials published in PubMed, Medline, and Cochrane databases. Only randomized controlled trials on the effects of ferric citrate in chronic kidney disease stage 3-5 requiring dialysis patients were selected...
December 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/29287320/effect-of-ripening-inhibitor-type-on-formation-stability-and-antimicrobial-activity-of-thyme-oil-nanoemulsion
#17
Victor Ryu, David J McClements, Maria G Corradini, Lynne McLandsborough
The objective of this research was to study the impact of ripening inhibitor level and type on the formation, stability, and activity of antimicrobial thyme oil nanoemulsions formed by spontaneous emulsification. Oil-in-water antimicrobial nanoemulsions (10 wt%) were formed by titrating a mixture of essential oil, ripening inhibitor, and surfactant (Tween 80) into 5 mM sodium citrate buffer (pH 3.5). Stable nanoemulsions containing small droplets (d < 70 nm) were formed. The antimicrobial activity of the nanoemulsions decreased with increasing ripening inhibitor concentration which was attributed to a reduction in the amount of hydrophobic antimicrobial constituents transferred to the separated hydrophobic domain, mimicking bacterial cell membranes, by using dialysis and chromatography...
April 15, 2018: Food Chemistry
https://www.readbyqxmd.com/read/29198062/an-evaluation-of-four-modes-of-low-dose-anticoagulation-during-intermittent-haemodialysis
#18
Malin S E Skagerlind, Bernd G Stegmayr
INTRODUCTION: Intensive care participants that need dialysis frequently suffer from increased risk of bleeding. Standard intermittent haemodialysis (SHD) includes anticoagulation to avoid clotting of the dialysis system. The aim of this study was to clarify which of four different low-dose anticoagulant modes was preferable in reducing the exposure to i.v. unfractionated heparin (heparin) and maintaining patency of the dialysis circuit. METHODS: Twenty-three patients on SHD were included to perform haemodialysis with four modes of low-dose anticoagulation...
March 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29191576/-comparison-of-citrate-4-and-heparin-as-tunneled-catheters-locking-solution-in-chronic-hemodialysis
#19
Guillaume Chazot, Manolie Mehdi, Christie Lorriaux, Patrik Deleaval, Brice Mayor, Guillaume Jean, Charles Chazot, Sylvain Lechevallier, Oriane Moncel, Cyril Vo-Van, Jean-Marc Hurot
INTRODUCTION: Citrate 4% is an alternative to heparin as catheter-locking solution in chronic hemodialysis patients. We compared catheter dysfunction episodes, dialysis adequacy, plasminogen-tissular activators use and costs according to catheter-locking solution in our centre. METHODS: Prospective, monocentric, cohort study (NephroCare Tassin-Charcot) on 49 prevalent patients in chronic hemodialysis. Two main groups were formed according to the prescription of catheter-locking solution at the beginning of the study (03/02/2016) and followed until 05/10/2016: heparin (n=26) and citrate (n=22)...
February 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29187232/long-term-continuous-renal-replacement-therapy-and-anticoagulation-with-citrate-in-critically-ill-patients-with-severe-liver-dysfunction
#20
Matthias Klingele, Theresa Stadler, Danilo Fliser, Timo Speer, Heinrich V Groesdonk, Alexander Raddatz
BACKGROUND: As of 2009, anticoagulation with citrate was standard practice in continuous renal replacement therapy (CRRT) for critically ill patients at the University Medical Centre of Saarland, Germany. Partial hepatic metabolism of citrate means accumulation may occur during CRRT in critically ill patients with impaired liver function. The aim of this study was to evaluate the actual influence of hepatic function on citrate-associated complications during long-term CRRT. METHODS: In a retrospective study conducted between January 2009 and November 2012, all cases of dialysis therapy performed in the interdisciplinary surgical intensive care unit were analysed...
November 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
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