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Dialysis, vascular access, haemodiafiltration

Fabio Paglialonga, Silvia Consolo, Carmine Pecoraro, Enrico Vidal, Bruno Gianoglio, Flora Puteo, Stefano Picca, Maria Teresa Saravo, Alberto Edefonti, Enrico Verrina
BACKGROUND: Chronic haemodialysis (HD) in small children has not been adequately investigated. METHODS: This was a retrospective investigation of the use of chronic HD in 21 children aged  <2 years (n = 12 aged <1 year) who were registered in the Italian Pediatric Dialysis Registry. Data collected over a period of >10 years were analysed. RESULTS: The median age of the 21 children at start of HD was 11.4 [interquartile range (IQR) 6...
May 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ionut Nistor, Suetonia C Palmer, Jonathan C Craig, Valeria Saglimbene, Mariacristina Vecchio, Adrian Covic, Giovanni F M Strippoli
BACKGROUND: Convective dialysis modalities (haemofiltration (HF), haemodiafiltration (HDF), and acetate-free biofiltration (AFB)) removed excess body fluid across the dialysis membrane with positive pressure and accumulated middle- and larger-size accumulated solutes more efficiently than haemodialysis (HD). This increased larger solute removal combined with use of ultra-pure dialysis fluid in convective dialysis is hypothesised to reduce the frequency and severity of symptoms during dialysis as well as improve clinical outcomes...
May 20, 2015: Cochrane Database of Systematic Reviews
José A Herrero-Calvo, Emilio González-Parra, Rafael Pérez-García, Fernando Tornero-Molina
OBJECTIVES: This study’s objectives were to determine which anticoagulation methods are commonly used in patients who are undergoing haemodialysis (HD) in Spain, on what criteria do they depend, and the consequences arising from their use. MATERIAL AND METHOD: Ours was a cross-sectional study based on two types of surveys: a "HD Centre Survey" and a "Patient Survey". The first survey was answered by 87 adult HD units serving a total of 6093 patients, as well as 2 paediatric units...
2012: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Francisco Maduell, Marta Arias, Carlos E Durán, Manel Vera, Néstor Fontseré, Manel Azqueta, Nayra Rico, Nuria Pérez, Alexis Sentis, Montserrat Elena, Néstor Rodriguez, Carola Arcal, Eduardo Bergadá, Aleix Cases, Jose Luis Bedini, Josep M Campistol
BACKGROUND: Longer and more frequent dialysis sessions have demonstrated excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. The aim of this study was to evaluate the beneficial effects of a longer (nocturnal) and more frequent (every-other-day) dialysis schedule with OL-HDF at the same or the highest convective volume. METHODS: This prospective, in-centre crossover study was carried out in 26 patients, 18 males and 8 females, 49...
April 2012: Nephrology, Dialysis, Transplantation
Michel Fischbach, Joelle Terzic, Soraya Menouer, Céline Dheu, Laure Seuge, Ariane Zalosczic
BACKGROUND: In children, growth can be used as a measurable parameter of adequate nutrition and dialysis dose. Despite daily administration of recombinant human growth hormone (rhGH), growth retardation remains a frequent problem in children on chronic dialysis. Therefore, we performed an observational prospective non-randomized study of children on in-centre daily on line haemodiafiltration (D-OL-HDF) dialysis with the aim of promoting growth. PATIENTS AND METHODS: Mean age at the start of the study was 8 years and 3 months, and all children had been receiving rhGH treatment for >12 months before enrolment...
March 2010: Nephrology, Dialysis, Transplantation
J Kanter, M Carretero Puerta, R Pérez García, J M López Gómez, R Jofré, P Benítez Rodríguez
BACKGROUND: on line haemodiafiltration provides the greatest clearance for low and high-molecular weight uremic toxins, which is associated with a lower risk of mortality in our patients. Nowadays, there's increasing evidence about the need of achieving at least 20 litters ultrafiltration in postdilution mode and 70% reduction of beta-2-Microglobulin (B2M), however it requires a vascular access's high blood flow. Unfortunately, we do not succeed in these objectives because of our patients being older, diabetic and with poor vascular access; in this situation high blood flows are more difficult to get at the expense of lower post-dilution exchange volumes...
2008: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
K T Woo
Haemodialysis in Singapore started in 1961 when a patient with kidney failure was dialysed using the twin coil artificial kidney. Over the years, we have seen various new techniques like rapid high efficiency dialysis, haemodiafiltration (HDF) and rapid high flux HDF introduced. Dialysers with newer membranes have improved solute transport, biocompatibility and water removal. Mini heparinisation and heparin-free dialysis have circumvented problems of bleeding in high risk patients. Technological advances in haemodialysis will continue with more new modalities introduced...
May 1993: Annals of the Academy of Medicine, Singapore
M C Falk, J F Knight, L P Roy, B Wilcken, D N Schell, A J O'Connell, J Gillis
The accumulation of toxic metabolites in children with inborn errors of metabolism may cause acute metabolic crises and result in long-term neurological dysfunction or death. Peritoneal dialysis often provides insufficient clearance to protect against these complications, while intermittent haemodialysis cannot prevent reaccumulation of metabolites between dialysis sessions. We describe the use of continuous venovenous haemofiltration (CVVH) or haemodiafiltration (CVVHD) in three infants with maple syrup urine disease (MSUD) and one child with carbamyl phosphate synthetase (CPS) deficiency...
June 1994: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
J A van Geelen, H H Vincent, M A Schalekamp
Continuous arteriovenous haemofiltration (CAVH) was employed in ten patients with acute renal failure using an AN-69 plate filter. Special measures were taken to improve the efficiency of the technique, including the use of short, large-bore catheters for vascular access, predilution infusion of the substitution fluid, and moderate vacuum suction to the ultrafiltrate compartment. In five patients continuous arteriovenous haemodiafiltration was performed by the addition of slow dialysis at a dialysate flow of 1 litre per hour...
1988: Nephrology, Dialysis, Transplantation
R Bellomo, G Parkin, J Love, N Boyce
We have prospectively investigated the effect of a flexible approach to the management of acute renal failure in critically ill patients based on continuous haemodiafiltration (CHD). Fifty critically ill patients (mean APACHE II score 28.1, range 18-37), with a mean age of 59.5 years, were treated with continuous arteriovenous haemodiafiltration (CAVHD) and/or continuous venovenous haemodiafiltration (CVVHD). CHD achieved excellent haemodynamic stability and control of azotaemia in all patients and permitted aggressive parenteral nutrition...
1992: American Journal of Nephrology
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