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Bicarbonate dialysis

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https://www.readbyqxmd.com/read/29470534/the-effect-of-isohydric-hemodialysis-on-the-binding-and-removal-of-uremic-retention-solutes
#1
Aleksey Etinger, Kumar, William Ackley, Leland Soiefer, Jonathan Chun, Prabjhot Singh, Eric Grossman, Albert Matalon, Robert S Holzman, Bjorn Meijers, Jerome Lowenstein
BACKGROUND: There is growing evidence that the accumulation of protein- bound uremic retention solutes, such as indoxyl sulfate, p-cresyl sulfate and kynurenic acid, play a role in the accelerated cardiovascular disease seen in patients undergoing chronic hemodialysis. Protein-binding, presumably to albumin, renders these solutes poor-dialyzable. We previously observed that the free fraction of indoxyl sulfate was markedly reduced at the end of hemodialysis. We hypothesized that solute binding might be pH-dependent and attributed the changes in free solute concentration to the higher serum pH observed at the end of standard hemodialysis with dialysis buffer bicarbonate concentration greater than 35 mmol/L...
2018: PloS One
https://www.readbyqxmd.com/read/29461290/volume-resuscitation-in-patients-with-high-voltage-electrical-injuries
#2
Derek M Culnan, Kelley Farner, Genevieve H Bitz, Karel D Capek, Yiji Tu, Carlos Jimenez, William C Lineaweaver
Volume resuscitation of patients with high-voltage electrical injuries (>1000 V) is a more complex challenge than standard burn resuscitation. High voltages penetrate deep tissues. These deep injuries are not accounted for in resuscitation formulae dependent on percentage of cutaneous burn. Myonecrosis occurring from direct electrical injury and secondary compartment syndromes can result in rhabdomyolysis, compromising renal function and urine output. Urine output is the primary end point, with a goal of 1 mL/kg/h for adult patients with high-voltage electrical injuries...
February 15, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29455202/phosphate-and-calcium-control-in-short-frequent-hemodialysis-with-the-nxstage-system-one-cycler-mass-balance-studies-and-comparison-with-standard-thrice-weekly-bicarbonate-dialysis
#3
Chiara Carla Maria Brunati, Francesca Gervasi, Costanza Casati, Maria Luisa Querques, Alberto Montoli, Giacomo Colussi
BACKGROUND: Short frequent dialysis with NxStage System One cycler (NSO) has become increasingly popular as home hemodialysis prescription. Short dialysis sessions with NSO might not allow adequate phosphate (P) removal. METHODS: Single-session and weekly balances of P and calcium (Ca) were compared in 14 patients treated with NSO (6 sessions/week) and in 14 patients on standard bicarbonate dialysis (BHD). RESULTS: NSO and BHD showed similar plasma P fall, with end-dialysis plasma P slightly lower in BHD (2...
February 16, 2018: Blood Purification
https://www.readbyqxmd.com/read/29429793/soluble-toll-like-receptor-4-a-new-player-in%C3%A2-subclinical-inflammation-and-malnutrition-in-hemodialysis-patients
#4
Pasquale Esposito, Edoardo La Porta, Maria Antonietta Grignano, Daniela Verzola, Samantha Milanesi, Francesca Ansaldo, Marilena Gregorini, Carmelo Libetta, Giacomo Garibotto, Teresa Rampino
OBJECTIVE: Toll-like receptor 4 (TLR4) promotes inflammation in hemodialysis patients (HD). A soluble form of extracellular TLR4 (sTLR4) has been recently characterized, which showed the ability to attenuate TLR4 signalling. In this study, we describe the sTLR4 profile in regular HD patients. SUBJECTS: In a cross-sectional study we enrolled forty prevalent HD patients (68.2 ± 16.3 years, twenty-five males) with a median dialysis vintage of 41 months. Nineteen patients were undergoing standard bicarbonate HD (BHD) and 21 patients on-line hemodiafiltration (HDF)...
February 8, 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29420536/randomized-trial-of-one-hour-sodium-bicarbonate-vs-standard-periprocedural-saline-hydration-in-chronic-kidney-disease-patients-undergoing-cardiovascular-contrast-procedures
#5
Judith Kooiman, Jean-Paul P M de Vries, Jan Van der Heyden, Yvo W J Sijpkens, Paul R M van Dijkman, Jan J Wever, Hans van Overhagen, Antonie C Vahl, Nico Aarts, Iris J A M Verberk-Jonkers, Harald F H Brulez, Jaap F Hamming, Aart J van der Molen, Suzanne C Cannegieter, Hein Putter, Wilbert B van den Hout, Inci Kilicsoy, Ton J Rabelink, Menno V Huisman
BACKGROUND: Guidelines advise periprocedural saline hydration for prevention of contrast induced-acute kidney injury (CI-AKI). We analysed whether 1-hour sodium bicarbonate hydration administered solely prior to intra-arterial contrast exposure is non-inferior to standard periprocedural saline hydration in chronic kidney disease (CKD) patients undergoing elective cardiovascular diagnostic or interventional contrast procedures. METHODS: We performed an open-label multicentre non-inferiority trial between 2011-2014...
2018: PloS One
https://www.readbyqxmd.com/read/29417249/post-contrast-acute-kidney-injury-part-2-risk-stratification-role-of-hydration-and-other-prophylactic-measures-patients-taking-metformin-and-chronic-dialysis-patients-recommendations-for-updated-esur-contrast-medium-safety-committee-guidelines
#6
Aart J van der Molen, Peter Reimer, Ilona A Dekkers, Georg Bongartz, Marie-France Bellin, Michele Bertolotto, Olivier Clement, Gertraud Heinz-Peer, Fulvio Stacul, Judith A W Webb, Henrik S Thomsen
OBJECTIVES: The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers. AREAS COVERED IN PART 2: Topics reviewed include stratification of PC-AKI risk, the need to withdraw nephrotoxic medication, PC-AKI prophylaxis with hydration or drugs, the use of metformin in diabetic patients receiving contrast medium and the need to alter dialysis schedules in patients receiving contrast medium...
February 7, 2018: European Radiology
https://www.readbyqxmd.com/read/29404930/comparative-efficacy-of-pharmacological-interventions-for-contrast-induced-nephropathy-prevention-after-coronary-angiography-a-network-meta-analysis-from-randomized-trials
#7
REVIEW
Wen-Qi Ma, Yu Zhao, Ying Wang, Xi-Qiong Han, Yi Zhu, Nai-Feng Liu
BACKGROUND: Contrast-induced nephropathy (CIN) is the major complication related to contrast media administration in patients after coronary angiography (CAG). However, inconsistent results have been published in the literature regarding the effects of pharmacological drugs on CIN prevention. We conducted a network meta-analysis to evaluate the relative efficacy of pharmacological interventions for the prevention of CIN. METHODS: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials...
February 5, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29326306/weekly-standard-kt-vurea-and-clinical-outcomes-in-home-and-in-center-hemodialysis
#8
Matthew B Rivara, Vanessa Ravel, Elani Streja, Yoshitsugu Obi, Melissa Soohoo, Alfred K Cheung, Jonathan Himmelfarb, Kamyar Kalantar-Zadeh, Rajnish Mehrotra
BACKGROUND AND OBJECTIVES: Patients undergoing hemodialysis with a frequency other than thrice weekly are not included in current clinical performance metrics for dialysis adequacy. The weekly standard Kt/Vurea incorporates treatment frequency, but there are limited data on its association with clinical outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used multivariable regression to examine the association of dialysis standard Kt/Vurea with BP and metabolic control (serum potassium, calcium, bicarbonate, and phosphorus) in patients incidental to dialysis treated with home (n=2373) or in-center hemodialysis (n=109,273)...
January 11, 2018: Clinical Journal of the American Society of Nephrology: CJASN
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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