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Bicarbonate dialysis

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https://www.readbyqxmd.com/read/29032379/oral-bicarbonate-slows-decline-of-residual-renal-function-in-peritoneal-dialysis-patients
#1
Xiang-Yang Liu, Xiu-Mei Gao, Ning Zhang, Rui Chen, Feng Wu, Xin-Chao Tao, Chun-Jun Li, Ping Zhang, Pei Yu
BACKGROUND/AIMS: Metabolic acidosis is a common consequence of end-stage renal disease (ESRD) which may result in a substantial adverse outcome. The effect of oral bicarbonate on the preservation of residual renal function (RRF) in peritoneal dialysis (PD) patients has been rarely reported. METHODS: We randomly assigned 40 continuous ambulatory peritoneal dialysis (CAPD) patients to the oral bicarbonate group or placebo group at a 1: 1 ratio. All enrollments were followed for a duration of 104 weeks...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28992851/initiation-of-peritoneal-dialysis-in-the-first-weeks-after-catheter-insertion-a-comparison-of-a-neutral-ph-low-gdp-pd-fluid-and-a-conventional-pd-fluid%C3%A2
#2
Karima Farhat, Frans J van Ittersum, Pieter M Ter Wee, Nanne J Paauw, Robbert H J Beelen, Caroline E Douma
BACKGROUND: Chronic exposure to peritoneal dialysis (PD) fluid is associated with development of functional and structural alterations of the peritoneal membrane. The exact time point at which these changes actually occur is not known. Whether changes to the peritoneum occur immediately after installation of PD fluids and whether there is a difference between neutral-pH, low glucose degradation product (low-GDP) PD fluids and conventional PD fluids is not known either. MATERIALS AND METHODS: We performed an observational study...
October 10, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28957333/association-between-mortality-and-replacement-solution-bicarbonate-concentration-in-continuous-renal-replacement-therapy-a-propensity-matched-cohort-study
#3
Kianoush Kashani, Charat Thongprayoon, Wisit Cheungpasitporn, Gina M Iacovella, Abbasali Akhoundi, Robert C Albright
BACKGROUND: Given the known deleterious effects seen with bicarbonate supplementation for acidemia, we hypothesized that utilizing high bicarbonate concentration replacement solution in continuous venovenous hemofiltration (CVVH) would be independently associated with higher mortality. METHODS: In a propensity score-matched historical cohort study conducted at a single tertiary care center from December 9, 2006, through December 31, 2009, a total of 287consecutive adult critically ill patients with Stage III acute kidney injury (AKI) requiring CVVH were enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28933414/association-between-low-serum-bicarbonate-concentrations-and-cardiovascular-disease-in-patients-in-the-end-stage-of-renal-disease
#4
Vaia D Raikou, Despina Kyriaki
BACKGROUND: Metabolic acidosis, a common condition particularly in the end-stage of renal disease patients, results in malnutrition, inflammation and oxidative stress. In this study, we focused on the association between low serum bicarbonate and cardiovascular disease in patients on intermittent dialysis. METHODS: We studied 52 on-line-pre-dilution hemodiafiltration (on-l HDF) patients, 32 males and 20 females, with a mean age of 58.01 ± 15.4 years old. Metabolic acidosis was determined by serum bicarbonate concentrations less than 22 mmol/L...
November 15, 2016: Diseases (Basel)
https://www.readbyqxmd.com/read/28860170/effects-of-vehicle-microdialysis-solutions-on-cutaneous-vascular-responses-to-local-heating
#5
Caroline J Smith, Daniel H Craighead, Lacy M Alexander
Microdialysis is a minimally invasive technique often paired with laser Doppler flowmetry to examine cutaneous microvascular function, yet presents with several challenges, including incompatibility with perfusion of highly lipophilic compounds. The present study addresses this methodological concern, with an emphasis on the independent effects of commonly used vehicle dialysis solutions to improve solubility of pharmacological agents with otherwise low aqueous solubility. Four microdialysis fibers were placed in the ventral forearm of eight subjects (4 men, 4 women; 25 ± 1 years) with sites randomized to serve as 1) control (lactated Ringer's), 2) Sodium carbonate-bicarbonate buffer administered at physiological pH (SCB-HCL; pH 7...
August 31, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28851317/the-dynamics-of-the-metabolism-of-acetate-and-bicarbonate-associated-with-use-of-hemodialysates-in-the-abchd-trial-a-phase-iv-prospective-single-center-single-blind-randomized-cross-over-two-week-investigation
#6
William B Smith, Sandy Gibson, George E Newman, Kendra S Hendon, Margarita Askelson, James Zhao, Jamil Hantash, Brigid Flanagan, John W Larkin, Len A Usvyat, Ravi I Thadhani, Franklin W Maddux
BACKGROUND: In the United States, hemodialysis (HD) is generally performed via a bicarbonate dialysate. It is not known if small amounts of acid used in dialysate to buffer the bicarbonate can meaningfully contribute to overall buffering administered during HD. We aimed to investigate the metabolism of acetate with use of two different acid buffer concentrates and determine if it effects blood bicarbonate concentrations in HD patients. METHODS: The Acid-Base Composition with use of hemoDialysates (ABChD) trial was a Phase IV, prospective, single blind, randomized, cross-over, 2 week investigation of peridialytic dynamics of acetate and bicarbonate associated with use of acid buffer concentrates...
August 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28707330/the-impact-of-dialysis-modality-and-membrane-characteristics-on-intradialytic-hypotension
#7
Samir Patel, Jochen G Raimann, Peter Kotanko
The risk of intradialytic hypotension (IDH) is determined by various factors, among them dialysis modality and dialyzer membrane. We conducted a literature search in PubMed on November 1, 2016 and selected relevant randomized controlled and cross-over trials, and prospective and retrospective cohort studies published in English that investigated the association between IDH and dialysis modality and membrane, respectively. This literature search revealed 669 publications on dialysis modality, 64 on dialysis membrane, and 24 on acetate/bicarbonate dialysate...
July 13, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28672414/-therapy-of-intradialytic-chronic-metabolic-acidosis-in-germany-is-it-according-to-latest-evidence
#8
Helmut Geiger, Oliver Jung
Background Chronic metabolic acidosis is a frequent comorbidity in chronic kidney disease, especially in patients undergoing dialysis. Recent study data suggest that treatment of acidosis during dialysis with bicarbonate may result in increased levels of serum bicarbonate, which is associated with increased mortality. Methods We aimed to evaluate the current management of chronic metabolic acidosis in Germany: have recent study results been transferred into daily routine and are nephrologists aware of these new study data? Therefore, we did a survey with 17 questions among 2096 German nephrologists...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28655387/hemodialysis-treatment-of-cardiorenal-syndrome
#9
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje
AIMS: We evaluated the impact of hemodialysis on mortality and hospital readmission in patients with cardiorenal syndrome. METHODS: All patients were NYHA IV functional class and underwent laboratory testing, echocardiography, and cardiac functional testing. Hemodialysis was indicated in patients with progressive decline of kidney function and consequent failure to titrate heart failure medication as well as in patients with hypervolemia that was resistant to conservative treatment with more than 4 annual hospitalizations due to heart failure and/or concomitant chronic kidney disease stage III - IV...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28574225/three-stream-bicarbonate-based-hemodialysis-solution-delivery-system-revisited-with-an-emphasis-on-some-aspects-of-acid-base-principles
#10
REVIEW
Susie Q Lew, Orly F Kohn, Yuk-Lun Cheng, Carl M Kjellstrand, Todd S Ing
Hemodialysis patients can acquire buffer base (i.e., bicarbonate and buffer base equivalents of certain organic anions) from the acid and base concentrates of a three-stream, dual-concentrate, bicarbonate-based, dialysis solution delivery machine. The differences between dialysis fluid concentrate systems containing acetic acid versus sodium diacetate in the amount of potential buffering power were reviewed. Any organic anion such as acetate, citrate, or lactate (unless when combined with hydrogen) delivered to the body has the potential of being converted to bicarbonate...
June 2017: Artificial Organs
https://www.readbyqxmd.com/read/28560615/effect-of-continuous-dialysis-on-blood-ph-in-acidemic-hypercapnic-animals-with-severe-acute-kidney-injury-a-randomized-experimental-study-comparing-high-vs-low-bicarbonate-affluent
#11
Thiago Gomes Romano, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Eduardo Leite Vieira Costa, Marcelo Park
BACKGROUND: Controlling blood pH during acute ventilatory failure and hypercapnia in individuals suffering from severe acute kidney injury (AKI) and undergoing continuous renal replacement therapy (CRRT) is of paramount importance in critical care settings. In this situation, the optimal concentration of sodium bicarbonate in the dialysate is still an unsolved question in critical care since high concentrations may worsen carbon dioxide levels and low concentrations may not be as effective in controlling pH...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28535516/citrate-anticoagulation-during-continuous-renal-replacement-therapy
#12
Davide Ricci, Laura Panicali, Maria Grazia Facchini, Elena Mancini
During extracorporeal dialysis, some anticoagulation strategy is necessary to prevent the coagulation of blood. Heparin has historically been used as an anticoagulant because of its efficacy combined with low cost. However, a variable incidence of hemorrhagic complications (5-30%) has been documented in patients undergoing continuous renal replacement therapy (CRRT) with heparin as an anticoagulant. Citrate has anticoagulation properties secondary to its ability to chelate calcium, which is necessary for the coagulation cascade...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28394304/the-diet-and-haemodialysis-dyad-three-eras-four-open-questions-and-four-paradoxes-a-narrative-review-towards-a-personalized-patient-centered-approach
#13
REVIEW
Giorgina Barbara Piccoli, Maria Rita Moio, Antioco Fois, Andreea Sofronie, Lurlinys Gendrot, Gianfranca Cabiddu, Claudia D'Alessandro, Adamasco Cupisti
The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients' lives. In the early years of dialysis, potassium was identified as "the killer", and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the "third era" finds us combating protein-energy wasting...
April 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28385806/urine-ammonium-predicts-clinical-outcomes-in-hypertensive-kidney-disease
#14
Kalani L Raphael, David J Carroll, Jennifer Murray, Tom Greene, Srinivasan Beddhu
Metabolic acidosis is associated with poor outcomes in CKD. Because impaired renal ammonium excretion is important in the pathogenesis of acidosis, urine ammonium excretion might be a better and perhaps earlier acid-base indicator of risk than serum bicarbonate, particularly in patients without acidosis. We evaluated the association between baseline ammonium excretion and clinical outcomes in African American Study of Kidney Disease and Hypertension participants (n=1044). Median daily ammonium excretion was 19...
August 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28353202/a-single-dialysis-session-of-hemodiafiltration-with-sorbent-regenerated-endogenous-ultrafiltrate-reinfusion-hfr-removes-hepcidin-more-efficiently-than-bicarbonate-hemodialysis-a-new-approach-to-containing-hepcidin-burden-in-dialysis-patients
#15
Nicola Tessitore, Albino Poli, Valeria Bedogna, Luca Corazza, Natascia Campostrini, Mauro Atti, Luisa Sereni, Annalisa Castagna, Domenico Girelli, Giuseppina Pessolano, Antonio Lupo
BACKGROUND: Most hemodialysis patients have high Hepcidin-25 levels, which may be involved in the pathogenesis of several uremic complications related to an altered iron biology. The hemodialysis procedure itself can influence Hepcidin-25 levels by removing Hepcidin-25 and maybe stimulating its production due to a pro-inflammatory effect. METHODS: To assess the relationship between dialysis-related inflammation and intradialysis changes in Hepcidin-25, we performed a crossover trial in 28 hemodialysis patients to compare the effects on serum levels of Hepcidin-25 and inflammatory markers activated during dialysis [Tumor Necrosis Factor-α (TNF-α), Interleukin-6, C-reactive protein (CRP), Pentraxin-3] of a single dialysis session using a technique capable of reducing inflammation, HFR (Hemo Filtrate Reinfusion: a hemodiafiltration system combining convection, diffusion and adsorption) or bicarbonate-dialysis using either the same low-flux membrane as in the diffusion stage of HFR (LFBD) or a high-flux membrane (HFBD)...
March 28, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28348100/effects-of-conversion-to-a-bicarbonate-lactate-buffered-neutral-ph-low-gdp-pd-regimen-in-prevalent-pd-a-2-year-randomized-clinical-trial
#16
Karima Farhat, Caroline E Douma, E Ferrantelli, Pieter M Ter Wee, Robert H J Beelen, Frans J van Ittersum
♦ BACKGROUND: The use of pH-neutral peritoneal dialysis (PD) fluids low in glucose degradation products (GDP) may better preserve the peritoneal membrane and have fewer systemic effects. The effects of conversion from conventional to neutral-pH, low-GDP PD fluids in prevalent patients are unclear. Few studies on the role of neutral-pH, low-GDP PD have studied residual renal function, ultrafiltration, peritonitis incidence and technique failure, transport characteristics, and local and systemic markers of inflammation in prevalent PD patients...
May 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28337775/effectiveness-and-safety-assessment-of-citrate-anticoagulation-during-albumin-dialysis-in-comparison-to-other-methods-of-anticoagulation
#17
Agnieszka Dyla, Wojciech Mielnicki, Joanna Bartczak, Tomasz Zawada, Piotr Garba
Liver failure is a serious and often deadly disease often requiring MARS (Molecular Adsorbent Recirculating System) therapy. Choosing the safe and effective method of anticoagulation during artificial liver support systems seems to be very difficult and extremely important. The aim of this study was to assess effectiveness and safety of regional anticoagulation with citrate in liver failure patients during MARS. We used a single center observational study. We analyzed 158 MARS sessions performed in 65 patients: 105 (66...
March 23, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28337716/long-term-variation-of-serum-levels-of-uremic-toxins-in-patients-treated-by-post-dilution-high-volume-on-line-hemodiafiltration-in-comparison-to-standard-low-flux-bicarbonate-dialysis-results-from-the-redert-study
#18
Vincenzo Panichi, Maria Teresa Rocchetti, Alessia Scatena, Alberto Rosati, Massimiliano Migliori, Francesco Pizzarelli, Loreto Gesualdo
PURPOSE OF THE STUDY: Little information have been provided till now regarding the effect of high volume HDF (hv-OL-HDF) in respect to standard bicarbonate dialysis (BHD) in medium-long term protein-bound toxins removal. PROCEDURES: A randomised cross-over multicentre study (REDERT study) was designed to compare the effects of hv-OL-HDF and low-flux BHD on uremic toxins serum levels in 36 chronic dialysis patients followed for 13 months. Group 1 patients were treated with BHD (Treatment A) for 6 months, and afterwards, they were transferred to hv-OL-HDF for a further 6 months (Treatment B)...
August 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28296160/changes-in-serum-bicarbonate-levels-caused-by-acetate-containing-bicarbonate-buffered-hemodialysis-solution-an-observational-prospective-cohort-study
#19
Mandip Panesar, Neal Shah, Sarosh Vaqar, Kaushik Ivaturi, Gregory Gudleski, Mary Muscarella, Judy Lambert, Winnie Su, Brian Murray
Fresenius Medical Care's NaturaLyte dialysate has been associated with increased risk of sudden cardiac death by causing metabolic alkalosis from its acetate content based on retrospective data using pre-dialysis bicarbonate levels only. The study objective was to measure inter/intra-dialytic changes in serum bicarbonate and degree of alkalosis conferred by varying concentrations of NaturaLyte bicarbonate dialysate. Thirty-nine hemodialysis patients were divided into four groups based on prescribed bicarbonate dialysate concentrations; Group 1 (N = 9): 30-32 mEq/L, Group 2 (N = 5): 33-34 mEq/L, Group 3 (N = 10): 35-36 mEq/L, Group 4 (N = 15): 37-40 mEq/L...
April 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28191541/metabolic-acidosis-status-and-mortality-in-patients-on-the-end-stage-of-renal-disease
#20
Vaia D Raikou
BACKGROUND AND OBJECTIVES: Uncorrected metabolic acidosis leads to higher death risk in dialysis patients. We observed the relationship between metabolic acidosis status and mortality rate in patients on renal replacement therapy during a median follow up time of 60 months. METHODS: We studied 76 patients on an on-line hemodiafiltration. The dialysis adequacy was defined by Kt/V for urea. The Framingham risk score (FRS) points were used to determine the 10-year risk for coronary heart disease...
December 1, 2016: Journal of Translational Internal Medicine
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