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Hemodialysis heparin

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https://www.readbyqxmd.com/read/28623638/urokinase-containing-locking-solution-in-the-prevention-of-dialysis-catheter-dysfunction-a-double-blind-randomized-controlled-trial
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
April 19, 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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28375903/bleeding-risk-of-antithrombotic-treatment-in-patients-on-hemodialysis
#11
Eduardo Vázquez, Carmen Sánchez-Perales, Sonia Ortega, Teresa Vázquez-Sánchez, Enrique Quesada, Daniel Salas, Juan Carlos Fernández-Guerrero
BACKGROUND: The risk-benefit of antithrombotic treatment (ATT) has not been established in patients on dialysis. Our objective was to determine the influence of ATT on the risk of hemorrhage in patients on hemodialysis. METHODS: We included patients who began dialysis between 2003 and 2007. We determined the rates of fatal bleeding or bleeding leading to hospitalization or transfusion. RESULTS: Two hundred twenty-one patients were included...
April 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28344423/anti-platelet-factor-4-heparin-antibody-plays-a-significant-role-in-progression-of-arterial-stiffness-among-hemodialysis-patients
#12
Chieh Kuo, Chiang-Chin Tsai, Chien-An Chen, Yueh-Feng Tsai, Yen-Hsun Chen
BACKGROUND: Arterial stiffness is a determinant of cardiovascular disease in end stage renal disease. Hemodialysis patients may develop anti-platelet factor 4/heparin antibody (PF4-H Ab) because of heparin treatment in dialysis. We tested whether PF4-H Ab was associated with progression of arterial stiffness in a 3-year follow-up. METHODS: We enrolled 74 hemodialysis patients and studied their clinical, biochemical and arterial stiffness measurement with brachial-ankle pulse wave velocity (baPWV) over 3 years...
March 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28330422/bilateral-rectal-sheath-hematomas-after-low-molecular-weight-heparin-treatment-in-uremia
#13
Lu Xu, Lei Liu, Xinjian Li
Rectus sheath hematomas (RSHs) are uncommon. They are usually unilateral and rarely bilateral. In this paper, we report the first case of spontaneous bilateral RSHs in a uremic patient after the administration of the first dose of low-molecular weight heparin during hemodialysis. The most interesting aspect of this case is that the main symptom of RSH in our patient was urinary bladder irritation. We highlight the importance of the prompt diagnosis and management of this medical emergency.
November 2017: Renal Failure
https://www.readbyqxmd.com/read/28297060/drug-eluting-grafts-for-hemodialysis-access
#14
Marc Glickman
The development of new methods for drug elution of graft material, biofiber films and resurfacing of prosthetic graft surfaces offers new opportunities for improvement of graft function in arteriovenous (AV) access. Three areas of research include developing grafts that reduce the development of neointimal hyperplasia, reducing infection and reducing thrombogenicity. The only drug eluting graft presently being used, is the heparin coated expanded polytetrafluoroethylene (ePTFE) graft, which has been shown to decrease the incidence of early thrombosis...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28276631/antithrombotic-medications-in-dialysis-patients-a-double-edged-sword
#15
Georgios Vlachopanos, Farid Girgis Ghalli
In the clinical context of end-stage renal disease (ESRD), thrombosis and bleeding risks are simultaneously increased and may have devastating consequences. While anticoagulant and antiplatelet drugs are indispensable for the prevention of thromboembolic events, the significantly higher bleeding risk makes their handling extremely complicated. In ESRD, they are frequently administered for a wide array of conditions. For example, atrial fibrillation is quite common in ESRD and warrants the use of anticoagulants like warfarin...
February 2017: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/28261626/influence-of-heparin-molecular-size-on-the-induction-of-c-terminal-unfolding-in-%C3%AE-2-microglobulin
#16
Kanon Fukasawa, Yuichiro Higashimoto, Yoshihiro Motomiya, Yoshinori Uji, Yukio Ando
Dialysis-related amyloidosis (DRA) is characterized by accumulation of amyloid β2- microglobulin (β2m) in the interstitial matrix. Matrix substances such as heparin have reportedly been strongly implicated in the pathogenesis of dialysis-related amyloidosis. In clinical setting of hemodialysis, two types of heparin, i.e., high and low molecular heparin (H.M.H. and L.M.H.) have been routinely used. Still commonly used is H.M.H., followed by L.M.H. preparations with distinct advantages. Here, we studied that the interaction of native and two amyloidogenic β2m variants: ΔN6β2m and D76N β2m with H...
December 2016: Molecular Biology Research Communications
https://www.readbyqxmd.com/read/28078825/ethanol-combined-with-heparin-as-a-locking-solution-for-the-prevention-of-catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-randomized-study
#17
Sofia Sofroniadou, Ioanna Revela, Alexandros Kouloubinis, Ioanna Makriniotou, Sinodi Zerbala, Despina Smirloglou, Petros Kalocheretis, Apostolos Drouzas, George Samonis, Christos Iatrou
Introduction Ethanol lock solution has been mainly administered in paediatric and home parenteral nutrition patients in order to prevent catheter related blood stream infections (CRBSI). Its utility in hemodialysis (HD) patients with non-tunneled-uncuffed catheter (NTC) has been poorly explored. Methods We conducted a prospective randomized study in chronic HD patients requiring a newly inserted NTC-while awaiting for the maturation of an already established arteriovenous fistula (AVF) or arteriovenous graft (AVG) or tunneled-cuffed catheter insertion...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28073902/state-of-harmonization-of-24-serum-albumin-measurement-procedures-and-implications-for-medical-decisions
#18
Lorin M Bachmann, Min Yu, James C Boyd, David E Bruns, W Greg Miller
BACKGROUND: Measurements of serum and plasma albumin are widely used in medicine, including as indicators of quality of patient care in renal dialysis centers. METHODS: Pools were prepared from residual patient serum (n = 50) and heparin plasma (n = 48) from patients without renal disease, and serum from patients with kidney failure before hemodialysis (n = 53). Albumin was measured in all samples and in ERM-DA470k/IFCC reference material (RM) by 3 immunochemical, 9 bromcresol green (BCG), and 12 bromcresol purple (BCP) methods...
March 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28052124/prevalence-of-atrial-fibrillation-and-antithrombotic-therapy-in-hemodialysis-patients-cross-sectional-results-of-the-vienna-investigation-of-atrial-fibrillation-and-thromboembolism-in-patients-on-hemodialysis-vivaldi
#19
Oliver Königsbrügge, Florian Posch, Marlies Antlanger, Josef Kovarik, Renate Klauser-Braun, Josef Kletzmayr, Sabine Schmaldienst, Martin Auinger, Günther Zuntner, Matthias Lorenz, Ella Grilz, Gerald Stampfel, Stefan Steiner, Ingrid Pabinger, Marcus Säemann, Cihan Ay
BACKGROUND: Atrial fibrillation (AF) adds significant risk of stroke and thromboembolism in patients on hemodialysis (HD). The aim of this study was to investigate the prevalence of AF in a population-based cohort of HD patients and practice patterns of antithrombotic therapy for stroke prevention in AF. METHODS: The Vienna InVestigation of AtriaL fibrillation and thromboembolism in patients on hemodialysis (VIVALDI), an ongoing prospective observational cohort study, investigates the prevalence of AF and the risk of thromboembolic events in HD patients in Vienna, Austria...
2017: PloS One
https://www.readbyqxmd.com/read/28044236/vascular-adhesion-protein-1-in-hemodialysis-and-hemodiafiltration-patients-effect-of-single-hemodialysis-session-on-its-level-in-regard-to-type-of-anticoagulant
#20
Jolanta Malyszko, Ewa Koc-Zorawska, Piotr Kozminski, Jacek S Malyszko
PURPOSE: Traditional anticoagulants used in intermittent hemodialysis (HD) are unfractionated heparin (UFH) and increasingly low molecular weight heparins (LMWHs). Repeated and prolonged exposure to UFH and/or LMWHs may further disturb hemostasis in uremic patients. Vascular adhesion protein-1 (VAP-1) is secreted by vascular smooth muscle cells, adipocytes and endothelial cells with functional monoamine oxidase activity and is elevated in atherosclerosis, diabetes mellitus and obesity...
May 2017: International Urology and Nephrology
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