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Hemodialysis heparin

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https://www.readbyqxmd.com/read/29142987/prospective-study-of-routine-heparin-avoidance-hemodialysis-in-a-tertiary-acute-care-inpatient-practice
#1
Sami Safadi, Robert C Albright, John J Dillon, Amy W Williams, Fares Alahdab, Julie K Brown, Amanda L Severson, Walter K Kremers, Mary Ann Ryan, Marie C Hogan
Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015). Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29106676/safety-and-efficacy-of-taurolidine-urokinase-versus-taurolidine-heparin-as-a-tunneled-catheter-lock-solution-in-hemodialysis-patients-a-prospective-randomized-controlled-study
#2
Fadwa Al-Ali, Ahmad F Hamdy, Abdullah Hamad, Mohamed Elsayed, Zafar Zafar Iqbal, Aisha Elsayed, Rania Ibrahim, Hoda Tolba, Hisham Buanan, Ashraf Fawzy
Background: Taurolidine citrate with heparin (Taurolock/Hep) is a promising central venous catheter lock solution. Despite its universal use among our hemodialysis patients, the prevalence of catheter malfunction was high. We aimed to compare Taurolock/Hep and taurolidine citrate with urokinase (Taurolock/U) as a catheter lock solution in order to identify whether either solution could reduce catheter-related dysfunction. Methods: In this prospective, randomized, controlled trial, patients were randomized to receive either Taurolock/Hep or Taurolock/U and were followed for 6 months...
July 4, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29082854/acute-myocardial-infarction-associated-with-thrombotic-microangiopathy-following-a-hump-nosed-viper-bite-a-case-report
#3
Nipun Lakshitha de Silva, Lalindra Gooneratne, Eranga Wijewickrama
BACKGROUND: Hump-nosed viper bite is the commonest cause of venomous snakebite in Sri Lanka. Despite initially being considered a moderately venomous snake more recent reports have revealed that it could cause significant systemic envenoming leading to coagulopathy and acute kidney injury. However, myocardial infarction was not reported except for a single case, which occurred immediately after the snakebite. CASE PRESENTATION: A 50-year-old previously healthy Sri Lankan woman had a hump-nosed viper bite with no evidence of systemic envenoming during initial hospital stay...
October 30, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29081491/deep-vein-thrombosis-complicated-by-spontaneous-iliopsoas-hematoma-in-patient-with-septic-shock
#4
Muhammad Umer Butt, Lili A Buzsaki, Susan S Smyth, Samy-Claude Elayi
BACKGROUND Spontaneous retroperitoneal hemorrhage (SRH) is a rare and difficult-to-diagnose entity. It is not associated with trauma, pathology, or iatrogenic manipulations. Few cases have been reported, with the only precipitating factor recognized being bleeding diatheses such as anticoagulation states, inherited coagulopathies, and hemodialysis. However, none of these have been described in combination with septic shock, which itself is associated with platelet dysfunction, coagulation dysfunction, and vasculopathy...
October 30, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29026846/intracranial-hemorrhage-in-methanol-toxicity-challenging-the-probable-heparin-effect-during-hemodialysis
#5
Hossein Hassanian-Moghaddam, Hooman Bahrami-Motlagh, Nasim Zamani, Seyed Amirhossein Fazeli, Behdad Behnam
Brain hemorrhages are rare complications of acute methanol poisoning. There is a debate on association of brain hemorrhage in methanol toxicity and application of systemic anticoagulation during hemodialysis (HD). A 70-year-old male presented to us with severe metabolic acidosis and a methanol level of 7.6 mg/dL. Ethanol and folinic acid were administered, and HD was performed. Brain computed tomography (CT) scan which was normal on presentation showed extensive bilateral subcortical supratentorial hypodensities on the 3(rd) day after commencing the treatment...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28890326/taurolidine-based-catheter-lock-regimen-significantly-reduces-overall-costs-infection-and-dysfunction-rates-of-tunneled-hemodialysis-catheters
#6
Wolfgang Winnicki, Harald Herkner, Matthias Lorenz, Ammon Handisurya, Željko Kikić, Bernhard Bielesz, Benjamin Schairer, Thomas Reiter, Farsad Eskandary, Gere Sunder-Plassmann, Guerkan Sengoelge
Catheter-related infections and dysfunction are the main catheter complications causing morbidity and mortality in hemodialysis patients. However, there are no consistent data for the choice of catheter lock solutions for tunneled hemodialysis lines. In this prospective, multicenter, randomized, controlled trial, two lock regimens using three commercial catheter lock solutions were compared in 106 hemodialysis patients with a newly inserted tunneled central catheter. In the taurolidine group, TauroLock™-Hep500 was used twice per week and TauroLock™-U25,000 once a week...
September 7, 2017: Kidney International
https://www.readbyqxmd.com/read/28857854/heparin-free-prolonged-intermittent-hemodialysis-using-calcium-free-citrate-dialysate-in-critically-ill-patients
#7
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28768540/in-vivo-and-in-vitro-performance-of-a-china-made-hemodialysis-machine-a-multi-center-prospective-controlled-study
#8
Yong Wang, Xiang-Mei Chen, Guang-Yan Cai, Wen-Ge Li, Ai-Hua Zhang, Li-Rong Hao, Ming Shi, Rong Wang, Hong-Li Jiang, Hui-Min Luo, Dong Zhang, Xue-Feng Sun
OBJECTIVE: To evaluate the in vivo and in vitro performance of a China-made dialysis machine (SWS-4000). METHODS: This was a multi-center prospective controlled study consisting of both long-term in vitro evaluations and cross-over in vivo tests in 132 patients. The China-made SWS-4000 dialysis machine was compared with a German-made dialysis machine (Fresenius 4008) with regard to Kt/V values, URR values, and dialysis-related adverse reactions in patients on maintenance hemodialysis, as well as the ultrafiltration rate, the concentration of electrolytes in the proportioned dialysate, the rate of heparin injection, the flow rate of the blood pump, and the rate of malfunction...
August 2, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28762633/platelet-activation-and-clotting-cascade-activation-by-dialyzers-designed-for-high-volume-online-hemodiafiltration
#9
Kamonwan Tangvoraphonkchai, Anne Riddell, Andrew Davenport
INTRODUCTION: Hemodialysis patients are pro-thrombotic. Higher volume online postdilutional hemodiafiltration (OL-HDF), with increasing hematocrit increases the risk of clotting in the extracorporeal circuit (ECC). We wished to determine whether OL-HDF increased platelet activation and ECC clotting. METHODS: Coagulation parameters, platelet, white cell, and endothelial activation markers were measured at the start and end of dialysis sessions in 10 patients and also pre- and post-dialyzer after 15 minutes using two different dialyzers designed for high volume OL-HDF; cellulose triacetate (TAGP) and polysulphone (PS), and polyvinylpyrrolidone (PVP)...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28744613/development-of-functionalized-polyetherimide-polyvinylpyrrolidone-membranes-for-application-in-hemodialysis
#10
Alana Melo Dos Santos, Alberto Claudio Habert, Helen Conceição Ferraz
The present study aimed to synthesize membranes for hemodialysis based on polyetherimide (PEI) and polyvinylpyrrolidone (PVP), with chemical immobilization of heparin on its surface to increase blood compatibility. The synthesized PEI/PVP membranes were characterized by morphological analysis and transport properties, as well by infrared spectroscopy (FT-IR), protein adsorption, contact angle, activated partial thromboplastin time (aPTT), and platelet adhesion. Hydraulic permeability of the synthesized PEI membranes were comparable to those of current high flux clinical membranes; values of diffusive permeability and rejection for typical solutes were similar to those reported in literature...
September 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28623638/urokinase-containing-locking-solution-in-the-prevention-of-dialysis-catheter-dysfunction-a-double-blind-randomized-controlled-trial
#11
Florence Bonkain, Freya Van Hulle, Peter Janssens, Concetta Catalano, Mandelina Allamani, Jean-Claude Stolear, Dominique Vandervelde, Mark Libertalis, Serge Treille, Marie M Couttenye, Annemie Dhondt, Wim Van Biesen, Jean François Fils, Christian Tielemans, Karl M Wissing
INTRODUCTION: The prophylactic use of recombinant tissue plasminogen activator once weekly reduces the incidence rate of tunneled cuffed catheter (TCC) malfunction and bacteremia as compared to the exclusive use of heparin as locking solution. Restricting the use of prophylactic thrombolytic agents to patients with a history of thrombotic TCC malfunction could be more cost effective. We conduct a multicenter, double-blind, randomized controlled trial and test the hypothesis that weekly use of urokinase lock will reduce the incidence of thrombotic malfunction by 50% in prevalent hemodialysis patients with a history of thrombotic malfunction...
June 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28592259/safety-of-low-molecular-weight-heparin-compared-to-unfractionated-heparin-in-hemodialysis-a-systematic-review-and-meta-analysis
#12
Hind Harrak Lazrak, Émilie René, Naoual Elftouh, Martine Leblanc, Jean-Philippe Lafrance
BACKGROUND: Low molecular weight heparins (LMWH) have been extensively studied and became the treatment of choice for several indications including pulmonary embolism. While their efficacy in hemodialysis is considered similar to unfractionated heparin (UFH), their safety remains controversial mainly due to a risk of bioaccumulation in patients with renal impairment. The aim of this systematic review was to evaluate the safety of LMWH when compared to UFH for extracorporeal circuit (ECC) anticoagulation...
June 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28569990/prospective-randomized-multicenter-controlled-trial-triathron-1-on-a-new-antithrombogenic-hydrophilic-dialysis-membrane
#13
Claudio Ronco, Alessandra Brendolan, Federico Nalesso, Monica Zanella, Massimo De Cal, Valentina Corradi, Grazia M Virzì, Fiorenza Ferrari, Francesco Garzotto, Anna Lorenzin, Aakash N Karopadi, Marco Sartori, Silvia De Rosa, Sara Samoni, Faeq Husain-Syed, Alessandra Spinelli, Mauro Neri, Gianluca Villa, Alberta Alghisi
INTRODUCTION: Hemodialysis treatment requires anticoagulation to prevent thrombosis of the dialyzer. The Hydrolink® (NV series; Toray) has been designed to reduce thrombotic complications by increasing membrane hydrophilic properties. Previous studies have confirmed reduced platelet activation, improved removal of β2-microglobulin and excellent small-solute removal. METHODS: We designed a prospective, multi-centered, randomized clinical study to compare the antithrombogenic effects (platelet count) of NV dialyzers versus conventional treatment...
May 29, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28554992/dialysis-procedures-alter-metabolic-conditions
#14
REVIEW
Bernd Stegmayr
A progressive chronic kidney disease results in retention of various substances that more or less contribute to dysfunction of various metabolic systems. The accumulated substances are denominated uremic toxins. Although many toxins remain undetected, numerous newly defined toxins participate in the disturbance of food breakdown. In addition, toxic effects may downregulate other pathways, resulting in a reduced ability of free fatty acid breakdown by lipoprotein lipase (LPL) and hepatic lipase (HL). Dialysis may even worsen metabolic functions...
May 27, 2017: Nutrients
https://www.readbyqxmd.com/read/28497450/the-role-of-hemodialysis-in-treatment-of-acute-acetic-acid-poisonings
#15
Andon Chibishev, Lidija Petkovska, Liljana Tozija, Milka Zdravkovska, Emilija Shikole
INTRODUCTION: The aim of this study is to show the importance of hemodialysis as an active method in treatment of acute acetic acid poisonings. Its main role is to support the renal function during the state of the intoxication when patients develop acute renal failure. METHODS: We analyzed data from a 10-year period, a total of 71 patients who ingested acetic acid, either intentionally or accidentally. Patients with a need of hemodialysis (HD) treatment underwent 3- to 4-hour HD sessions every day or every second day, according to clinical assessment, as needed, until recovery of kidney function...
May 10, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28456484/hypersensitivity-reactions-in-patients-receiving-hemodialysis
#16
REVIEW
Lavjay Butani, Gianfranco Calogiuri
OBJECTIVE: To describe hypersensitivity reactions in patients receiving maintenance hemodialysis. DATA SOURCES: PubMed search of articles published during the past 30 years with an emphasis on publications in the past decade. STUDY SELECTIONS: Case reports and review articles describing hypersensitivity reactions in the context of hemodialysis. RESULTS: Pharmacologic agents are the most common identifiable cause of hypersensitivity reactions in patients receiving hemodialysis...
June 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28425077/unexpected-and-striking-effect-of-heparin-free-dialysis-on-cytokine-release
#17
Alicja Rydzewska-Rosolowska, Joanna Gozdzikiewicz-Lapinska, Jacek Borawski, Ewa Koc-Zorawska, Michal Mysliwiec, Beata Naumnik
Heparin (both unfractionated and low molecular weight) is not only a potent anticoagulant but also has many pleiotropic effects, some of which are mediated by cytokine release. We compared the effect of hemodialysis (HD) with enoxaparin as an anticoagulant and without systemic anticoagulation (heparin-grafted membrane-Evodial) on the release of monocyte chemoattractant protein 1 (MCP-1), endostatin (ES) and activin A (Act-A). Nineteen stable HD patients were dialyzed with or without heparin, and plasma levels of MCP-1, ES and Act-A were measured after such a dialysis...
August 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28420841/tranexamic-acid-controlled-chronic-disseminated-intravascular-coagulation-associated-with-aortic-dissection-and-patent-false-lumen-for-three-years
#18
Yodo Gatate, Nobuyuki Masaki, Atsushi Sato, Risako Yasuda, Takayuki Namba, Hirotaka Yada, Akio Kawamura, Takeshi Adachi
The management of chronic disseminated intravascular coagulation (DIC) caused by aortic dissection has not yet been established. Even in cases where surgical correction is performed, therapeutic control of systemic hemorrhaging is still required. We herein report the successful treatment of a case of aortic dissection with a patent false lumen using tranexamic acid for acute exacerbation of chronic DIC. Oral administration of 1,500 mg tranexamic acid per day stabilized the coagulative and fibrinolytic parameters and relieved bleeding tendencies with no side effects...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28418614/efficacy-and-safety-of-low-dose-heparin-in-hemodialysis
#19
Mariana Murea, Gregory B Russell, Pirouz Daeihagh, Anita M Saran, Karan Pandya, Mark Cabrera, John M Burkart, Barry I Freedman
INTRODUCTION: The dose of unfractionated heparin (UFH) administered during hemodialysis (HD) varies widely. This prospective study evaluated the safety and efficacy of UFH dose de-escalation. METHODS: Sixty-six prevalent patients on HD receiving UFH per standard-dose protocol (load dose [LD] 50-75 units/kg, maintenance dose [MD] 500-1000 units/hour) had heparin prescription converted to low-dose protocol (start LD 15 units/kg and MD 500 units/hour; dose adjusted in small increments based on assessments of extracorporeal blood circuit)...
April 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28381917/dosing-of-enoxaparin-in-renal-impairment
#20
Suhail A Shaikh, Randolph E Regal
OBJECTIVE: To review enoxaparin treatment dosing, pharmacokinetics, and clinical outcomes data in patients with renal impairment and to examine the current two-tiered dosing regimen approved by the Food and Drug Administration (FDA). DATA SOURCES: A literature search of PubMed (1990-2016) was performed using the search terms low-molecular-weight heparin, unfractionated heparin, bleeding, enoxaparin, renal impairment, pharmacokinetics, and hemodialysis. STUDY SELECTION AND DATA EXTRACTION: All studies assessing the pharmacokinetic properties of enoxaparin in patients with renal impairment were evaluated...
April 2017: P & T: a Peer-reviewed Journal for Formulary Management
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