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Bicarbonate dialysis

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https://www.readbyqxmd.com/read/29193165/precise-quantitative-assessment-of-the-clinical-performances-of-two-high-flux-polysulfone-hemodialyzers-in-hemodialysis-validation-of-a-blood-based-simple-kinetic-model-versus-direct-dialysis-quantification
#1
Paik-Seong Lim, Yuyu Lin, Minfeng Chen, Xiaoqi Xu, Yun Shi, Sudhir Bowry, Bernard Canaud
Highly permeable dialysis membranes with better design filters have contributed to improved solute removal and dialysis efficacy. However, solute membrane permeability needs to be well controlled to avoid increased loss of albumin that is considered to be detrimental for dialysis patients. A novel high-flux dialyzer type (FX CorDiax; Fresenius Medical Care) incorporating an advanced polysulfone membrane modified with nano-controlled spinning technology to enhance the elimination of a broader spectrum of uremic toxins has been released...
November 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29171574/methanol-poisoning-27-years-experience-at-a-tertiary-care-hospital
#2
Fareed Ahmed, Nadeem Ullah Khan, Noman Ali, Asher Feroze
Methanol toxicity can result in serious morbidity and mortality without timely diagnosis and treatment. Many cases of methanol poisoning outbreaks have been noted in our population but no study has been performed to estimate methanol exposure and its outcomes and complications. A retrospective study was conducted to review all the cases of methanol poisoning admitted from January 1988 to December 2015 at the Aga Khan University Hospital. A total of 35 methanol poisoning cases were reported. All the patients were male, and the mean age was 36...
November 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29150416/-bicarbonate-from-physiology-to-treatment-for-all-clinicians
#3
Julie Beaume, Antoine Braconnier, Thibault Dolley-Hitze, Jean-Philippe Bertocchio
Acid-base regulation is essential to maintain homeostasis in humans. Carbonic acid/bicarbonate (H2CO3/HCO3(-)) couple is the most predominant extracellular buffer to keep plasma pH within a physiological range. The ability to (re)generate such a buffer is a key milestone that necessitates to understand a precise physiology of both renal tubule and digestive tract. Here, we first reviewed renal and digestive cycles of bicarbonate in physiology. We also reviewed pathological findings where acid-base disequilibrium is involved and nutritional and/or alkali therapy could be necessary...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29130810/outcomes-after-angiography-with-sodium-bicarbonate-and-acetylcysteine
#4
Steven D Weisbord, Martin Gallagher, Hani Jneid, Santiago Garcia, Alan Cass, Soe-Soe Thwin, Todd A Conner, Glenn M Chertow, Deepak L Bhatt, Kendrick Shunk, Chirag R Parikh, Edward O McFalls, Mary Brophy, Ryan Ferguson, Hongsheng Wu, Maria Androsenko, John Myles, James Kaufman, Paul M Palevsky
Background Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury and associated adverse outcomes after angiography without definitive evidence of their efficacy. Methods Using a 2-by-2 factorial design, we randomly assigned 5177 patients at high risk for renal complications who were scheduled for angiography to receive intravenous 1.26% sodium bicarbonate or intravenous 0.9% sodium chloride and 5 days of oral acetylcysteine or oral placebo; of these patients, 4993 were included in the modified intention-to-treat analysis...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29094800/low-protein-diet-for-conservative-management-of-chronic-kidney-disease-a-systematic-review-and-meta-analysis-of-controlled-trials
#5
Connie M Rhee, Seyed-Foad Ahmadi, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
BACKGROUND: Recent data pose the question whether conservative management of chronic kidney disease (CKD) by means of a low-protein diet can be a safe and effective means to avoid or defer transition to dialysis therapy without causing protein-energy wasting or cachexia. We aimed to systematically review and meta-analyse the controlled clinical trials with adequate participants in each trial, providing rigorous contemporary evidence of the impact of a low-protein diet in the management of uraemia and its complications in patients with CKD...
November 2, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/29067650/ckd-complications-in-kidney-transplanted-patients-going-back-to-dialysis-impact-on-patients-outcomes
#6
Julien Aniort, Saleh Kaysi, Cyril Garrouste, Mohamed Hadj Abdelkader, Myriam Isnard, Didier Aguilera, Youssef Ali, Marc Bouiller, Aurelien Mulliez, Anne Elisabeth Heng
AIMS: The management of chronic kidney disease (CKD) complications is not always adequate in patients with a failed kidney transplant. We aimed to evaluate the frequency of CKD complications and assess whether they may lead to worse outcomes in this patient population. METHOD: We analyzed 49 kidney transplant recipients with a failed transplant (T+) and matched non-transplanted patients (T-) starting dialysis between 2000 and 2010 in five dialysis centers in France...
October 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29064178/low-dialysate-potassium-concentration-is-associated-with-prolonged-recovery-time
#7
Antonia Harford, Ambreen Gul, Serena Cumber, Susan Paine, Ronald Schrader, Nicole Trujillo, Philip Zager
INTRODUCTION: Modifiable hemodialysis treatment parameters may impact patient reported outcomes, including recovery time. Answers to the recovery question may predict the impact of treatment parameters on clinical outcomes and health related quality of life. However, the reliability of answers to the recovery question after consecutive and nonconsecutive dialysis treatments in diverse populations has not been established. OBJECTIVE: To assess the reliability of this instrument and to determine if recovery time was associated with modifiable dialysis parameters, we conducted a quality assurance project in which we asked, "How long did it take you to recover from your last dialysis session?" after consecutive and nonconsecutive treatments...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29064128/the-association-between-change-in-serum-bicarbonate-and-change-in-thyroid-hormone-levels-in-patients-receiving-conventional-or-more-frequent-maintenance-hemodialysis
#8
Alessio Molfino, Gerald J Beck, Minwei Li, Joan C Lo, George A Kaysen
AIM: Correction of metabolic acidosis in patients with chronic kidney disease has been associated with improvement in thyroid function. We examined whether changes in bicarbonate were associated with changes in thyroid function in patients with end-stage renal disease receiving conventional or more frequent hemodialysis. METHODS: In the Frequent Hemodialysis Network Trials, the relationship between changes in serum bicarbonate, free triiodothyronine (FT3) and free thyroxine (FT4) was examined among 147 and 48 patients with endogenous thyroid function who received conventional (3x/week) or more frequent (6x/week) hemodialysis (Daily Trial) or who received conventional or more frequent nocturnal hemodialysis (Nocturnal Trial)...
October 24, 2017: Nephrology
https://www.readbyqxmd.com/read/29044339/metabolic-acidosis-in-hemodialysis-patients-a-review
#9
Luiza Raksa Rezende, Pablo Brandão de Souza, Giselly Rosa Modesto Pereira, Jocemir Ronaldo Lugon
Metabolic acidosis is highly prevalent in hemodialysis patients. The disorder is associated with increased mortality and its deleterious effects are already present in the predialysis phase of chronic kidney disease. Metabolic acidosis has been linked to progression of chronic kidney disease, changes in protein and glucose metabolism, bone and muscle disorders and cardiovascular disease. At present, the control of metabolic acidosis in hemodialysis is mainly focused on the supply of bicarbonate during dialysis session, but further studies are needed to set the optimum target serum bicarbonate and the best concentration of the bicarbonate dialysate...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29032379/oral-bicarbonate-slows-decline-of-residual-renal-function-in-peritoneal-dialysis-patients
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
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
#19
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
#20
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
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