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K in dialysis fluid

Abdullah K Al-Hwiesh, Ibrahiem S Abdul-Rahman, Abdul-Salam Noor, Mohammed A Nasr-El-Deen, Abdalla Abdelrahman, Tamer S El-Salamony, Fahd A Al-Muhanna, Khalid M Al-Otaibi, Nehad Al-Audah
♦ Objective: Metformin continues to be the safest and most widely used antidiabetic drug. In spite of its well-known benefits; metformin use in end-stage renal disease (ESRD) patients is still restricted. Little has been reported about the effect of peritoneal dialysis (PD) on metformin clearance and the phantom of lactic acidosis deprives ESRD patients from metformin therapeutic advantages. Peritoneal dialysis is probably a safeguard against lactic acidosis, and it is likely that using this drug would be feasible in this group of patients...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Matthew B Rivara, Scott V Adams, Sooraj Kuttykrishnan, Kamyar Kalantar-Zadeh, Onyebuchi A Arah, Alfred K Cheung, Ronit Katz, Miklos Z Molnar, Vanessa Ravel, Melissa Soohoo, Elani Streja, Jonathan Himmelfarb, Rajnish Mehrotra
Extended-hours hemodialysis offers substantially longer treatment time compared to conventional hemodialysis schedules and is associated with improved fluid and electrolyte control and favorable cardiac remodeling. However, whether extended-hours hemodialysis improves survival remains unclear. Therefore, we determined the association between extended-hours compared to conventional hemodialysis and the risk of all-cause mortality in a nationally representative cohort of patients initiating maintenance dialysis in the United States from 2007 to 2011...
August 20, 2016: Kidney International
G K Rangan, M C Tchan, A Tong, A T Y Wong, B J Nankivell
Autosomal-dominant polycystic kidney disease (ADPKD) is the most common genetic renal disease in adults, affecting one in every 1000 Australians. It is caused by loss-of-function heterozygous mutations in either PKD1 or PKD2 , which encode the proteins, polycystin-1 and polycystin-2 respectively. The disease hallmark is the development of hundreds of microscopic fluid-filled cysts in the kidney during early childhood, which grow exponentially and continuously through life at varying rates (between 2% and 10% per year), causing loss of normal renal tissue and up to a 50% lifetime risk of dialysis-dependent kidney failure...
August 2016: Internal Medicine Journal
Aleksandra Leligdowicz, William A Fischer, Timothy M Uyeki, Thomas E Fletcher, Neill K J Adhikari, Gina Portella, Francois Lamontagne, Christophe Clement, Shevin T Jacob, Lewis Rubinson, Abel Vanderschuren, Jan Hajek, Srinivas Murthy, Mauricio Ferri, Ian Crozier, Elhadj Ibrahima, Marie-Claire Lamah, John S Schieffelin, David Brett-Major, Daniel G Bausch, Nikki Shindo, Adrienne K Chan, Tim O'Dempsey, Sharmistha Mishra, Michael Jacobs, Stuart Dickson, G Marshall Lyon, Robert A Fowler
As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury...
2016: Critical Care: the Official Journal of the Critical Care Forum
Giustina Casagrande, Camilla Bianchi, Domenico Vito, Fabio Carfagna, Claudio Minoretti, Giuseppe Pontoriero, Giuseppe Rombolà, Carlo Schoenholzer, Maria Laura Costantino
BACKGROUND: Dialysis is associated with a non-negligible rate of morbidity, requiring treatment customization. Many mathematical models have been developed describing solute kinetics during hemodialysis (HD) for an average uremic patient. The clinical need can be more adequately addressed by developing a patient-specific, multicompartmental model. MATERIALS AND METHODS: The data from 148 sessions (20 patients), recorded at the Regional Hospital of Lugano, Switzerland, were used to develop and validate the mathematical model...
July 4, 2016: International Journal of Artificial Organs
Tabo Sikaneta, George Wu, Mohamed Abdolell, Anita Ng, Sara Mahdavi, Anton Svendrovski, Tony Tu, Trish Mercer, Matthew Tong, Dimitrios Oreopoulos, Paul Tam
UNLABELLED:BACKGROUND AND OBJECTIVE: Residual renal function (RRF) correlates with mortality and morbidity rates in patients receiving peritoneal dialysis (PD). We examined the effect of a biocompatible PD solution (Gambrosol Trio; Gambro Lundia AB, Lund, Sweden) with lower concentrations of glucose degradation products on rates of decline in RRF. ♦ DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Incident patients at 2 centers in Canada and 1 in Hong Kong were randomized (by minimization) in an open-label parallel group trial to receive Gambrosol Trio or standard PD solution (Dianeal; Baxter Healthcare, Mississauga, Canada) for 2 years...
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
M J E Dekker, D Marcelli, B Canaud, C J A M Konings, K M Leunissen, N W Levin, P Carioni, V Maheshwari, J G Raimann, F M van der Sande, L A Usvyat, P Kotanko, J P Kooman
BACKGROUND/OBJECTIVES: Hyponatremia is a risk factor for mortality in hemodialysis (HD) patients. It is not well known to which extent the comorbidities, malnutrition, fluid status imbalance and inflammation are related to hyponatremia and affect outcomes. SUBJECTS/METHODS: We studied 8883 patients from the European subset of the international MONitoring Dialysis Outcomes initiative. Nutritional and fluid statuses were assessed by bioimpedance spectroscopy. Fluid depletion was defined as overhydration⩽-1...
July 2016: European Journal of Clinical Nutrition
Florin Iordache, Andrei Constantinescu, Eugen Andrei, Bogdan Amuzescu, Ferdinand Halitzchi, Lorand Savu, Horia Maniu
We characterized human amniotic fluid stem cells (AFSC) in senescent cultures (6 weeks) versus cryopreserved cells using whole-cell patch-clamp, immunophenotyping, and differential gene expression profiling for senescence genes. We evidenced five ion current components (outward rectifier, A-type, inward rectifier, and big conductance Ca(2+)-dependent K(+) currents, fast voltage-dependent Na(+) currents). Senescent AFSC showed reduced expression of CD90, CD44, CD133, over 500-fold increase of interferon gamma and telomerase reverse transcriptase genes, increased cycle-dependent kinase 4 inhibitors, p53-binding protein 1, and decreased calreticulin and CD44...
April 6, 2016: Journal of Physiological Sciences: JPS
David S Cooper, Rajit K Basu, Jack F Price, Stuart L Goldstein, Catherine D Krawczeski
The field of cardiac intensive care continues to advance in tandem with congenital heart surgery. The focus of intensive care unit care has now shifted to that of morbidity reduction and eventual elimination. Acute kidney injury (AKI) after cardiac surgery is associated with adverse outcomes, including prolonged intensive care and hospital stays, diminished quality of life, and increased long-term mortality. Acute kidney injury occurs frequently, complicating the care of both postoperative patients and those with heart failure...
March 2016: World Journal for Pediatric & Congenital Heart Surgery
Markus Kofler, Margit Lenninger, Gert Mayer, Hannes Neuwirt, Michael Grimm, Thomas Bechtold
Renal replacement therapy options are limited to hemodialysis and peritoneal dialysis (70% of US patients) or renal transplantation. Diffusion processes are the main physico-chemical principle behind hemodialysis. An alternative way to achieve liquid flow through membranes bases on the electroosmotic flow which is observed as electrokinetic phenomenon in porous membranes which bear surface charges. Agar consists of the non-ionic agarose and the negatively charged agaropectine thus an electroosmotic flux is observed in analytical electrophoresis...
January 20, 2016: Carbohydrate Polymers
Shiva Verma, V A Indumathi, K C Gurudev, Shalini Ashok Naik
INTRODUCTION: Haemodialysis is one of the treatment modalities for patients suffering from end stage renal disease (ESRD). Dialysis patients are exposed to large volumes of water for production of dialysis fluids. Treated water and dialysate come in direct contact with the patient's bloodstream. Such patients suffer from abnormalities of the immune system, making them more susceptible to infections. Microbial contamination of the treated water and dialysate can lead to biofilm formation and release of endotoxins in Haemodialysis system...
October 2015: Journal of Clinical and Diagnostic Research: JCDR
Cheuk-Chun Szeto, Bonnie C H Kwan, Kai-Ming Chow, Phyllis M S Cheng, Vickie W K Kwong, Agnes S M Choy, Man-Ching Law, Chi-Bon Leung, Philip K T Li
BACKGROUND: Previous studies report conflicting results on the benefit of peritoneal dialysis (PD) patients treated with low glucose degradation product (GDP) solution. The effects of low GDP solution on body fluid status and arterial pulse wave velocity (PWV) have not been studied. METHODS: We randomly assigned 68 incident PD patients to low GDP (Intervention Group) or conventional solutions (Control Group); 4 dropped off before they received the assigned treatment...
2015: PloS One
Saeko Nishimi, Ken Ishikawa, Makoto Sasaki, Hiromi Furukawa, Akira Takada, Shoichi Chida
BACKGROUND: We automated our manual, syringe-driven extracorporeal renal replacement therapy (eRRT) system with an ultra-small volume circuit (3.2 ml) that is suitable for neonates without blood priming. Our objective was to determine the solute clearance and water balance of the automated and manual systems in vitro. METHODS: Stored whole blood samples containing exogenous urea, creatinine (Cr), potassium (K), and ammonia (NH3) to imitate acute kidney injury (AKI) and hyperammonemia were dialyzed for 3 h (blood flow, 4...
March 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Boon K Tan, Zanzhe Yu, Wei Fang, Aiwu Lin, Zhaohui Ni, Jiaqi Qian, Graham Woodrow, Sarah B Jenkins, Martin E Wilkie, Simon J Davies
Bioimpedance (BI) has the potential to enable better management of fluid balance, which can worsen over time on peritoneal dialysis (PD) due to loss of residual kidney function and progressive muscle wasting. We undertook a prospective, randomized, open-label, blinded end-point controlled trial to determine whether availability of longitudinal BI measures as vector plots helped clinicians maintain stable fluid status over 12 months in 308 peritoneal dialysis patients from the United Kingdom and Shanghai, China...
February 2016: Kidney International
Anita Saxena, R K Sharma, Amit Gupta, Manns Manohar John
Intradialytic hypotension (IDH) is a life-threatening condition. We evaluated the feasibility of blood volume monitoring (BVM) and blood temperature monitoring (BTM) in preventing IDH in patients prone to the same. Fourteen hemodynamically unstable end-stage renal disease patients who were prone to IDH and unable to achieve dry weight were given BVM treatment twice weekly for two weeks. Forty patients who were not on BVM treatment served as controls. Patients were anemic, had low serum albumin (3.4 ± 0.43 g/dL) and fluid overload and were edematous...
September 2015: Saudi Journal of Kidney Diseases and Transplantation
K Hassan, F Hassan, D Hassan, R Edgem, S Hassan
AIM: The study aimed to evaluate the impact of glucose-based peritoneal dialysis solutions (GBPDS) on diabetic patients on maintenance peritoneal dialysis. METHODS: In this cross-sectional study we compared the influence of long term use of GBPDS on sixteen parameters related to the peritoneal glucose load, hydration status, inflammation, blood pressure, lipid profile and left ventricular mass in 45 stable PD patients (20 diabetic and 25 non-diabetic) receiving GBPDS...
December 2015: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Ezio Movilli, Corrado Camerini, Paola Gaggia, Roberto Zubani, Paolo Feller, Chiara Salviani, Annalisa Facchini, Giovanni Cancarini
BACKGROUND: Inflammation and increased erythropoiesis stimulating agents (ESA) requirement are frequently associated in patients on dialysis. On-line hemodiafiltration (ol-HDF), putting together high levels of diffusion, and convection could improve both conditions. However, it is still not known which depurative component plays a major role in determining this result. The aim of the study was to evaluate the role of convection and diffusion on long-term variations of serum β2 microglobulin (Δβ2M), high-sensitive C-reactive protein (ΔhsCRP) concentrations, and ESA requirement (ΔESA) in ol-HDF...
2015: American Journal of Nephrology
Robert M Cronin, Jacob P VanHouten, Edward D Siew, Svetlana K Eden, Stephan D Fihn, Christopher D Nielson, Josh F Peterson, Clifton R Baker, T Alp Ikizler, Theodore Speroff, Michael E Matheny
OBJECTIVE: Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset of kidney injury is a key step towards AKI prevention. MATERIALS AND METHODS: A national retrospective cohort of 1,620,898 patient hospitalizations from 116 Veterans Affairs hospitals was assembled from electronic health record (EHR) data collected from 2003 to 2012. HA-AKI was defined at stage 1+, stage 2+, and dialysis...
September 2015: Journal of the American Medical Informatics Association: JAMIA
K Panorchan, A Nongnuch, S El-Kateb, C Goodlad, A Davenport
BACKGROUND/OBJECTIVES: Multi-frequency bioelectrical impedance analysis (MFBIA) is becoming more widely used to assess hydration status and body composition in haemodialysis patients. Most centres only measure MFBIA pre dialysis when patients are overhydrated. We wished to determine whether body composition assessments change post dialysis following fluid removal. SUBJECTS/METHODS: Lean body and fat mass were measured by MFBIA pre and post haemodialysis in 676 stable outpatients...
October 2015: European Journal of Clinical Nutrition
Maria-Eleni Roumelioti, Lee K Brown, Mark L Unruh
Obstructive sleep apnea (OSA) is common, underdiagnosed, and undertreated among patients with end-stage renal disease (ESRD). As in all cases, pathogenesis of OSA is related to repeated upper airway (UA) occlusion or narrowing, but in ESRD, additional contributory factors likely include uremic destabilization of central respiratory control and anatomic changes in the UA related to fluid status. Pulmonary congestion is common in acute and chronic kidney failure and is a consequence of cardiomyopathy and fluid overload, two potentially reversible risk factors...
September 2015: Seminars in Dialysis
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