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Ines Rama, Ines Llaudó, Pere Fontova, Gema Cerezo, Carlos Soto, Casimiro Javierre, Miguel Hueso, Nuria Montero, Alberto Martínez-Castelao, Juan Torras, Josep M Grinyó, Josep M Cruzado, Nuria Lloberas
BACKGROUND: Patients undergoing conventional hemodialysis (C-HD) present a greater immuno-inflammatory state probably related to uremia, sympathetic nervous system (SNS) activation and /or membrane bioincompatibility, which could improve with a technique-switching to online hemodiafiltration (OL-HD). The antigen-independent pathway activation of this modified immunologic state turns dendritic cells (DC) into an accurate cell model to study these patients. The aim of this study is to further evaluate the immune-inflammatory state of patients in C-HD assessed by DC maturation...
2016: PloS One
Gergely Becs, Renáta Hudák, Zsolt Fejes, Ildikó Beke Debreceni, Harjit Pal Bhattoa, József Balla, János Kappelmayer
BACKGROUND: Mortality in patients with end-stage renal disorders is often a consequence of cardiovascular complications. Renal replacement therapies may contribute to this morbidity by promoting cellular activation. In renal failure patients peripheral blood samples were investigated for platelet and endothelial cell activation markers to compare the effects of haemodiafiltration (HDF) and haemodialysis (HD). METHODS: Overall 28 patients were included in the study...
October 13, 2016: BMC Nephrology
Xiaoying Xu, Dmytro Khadzhynov, Harm Peters, Ricardo L Chaves, Kamal Hamed, Micha Levi, Natascia Corti
AIM: The objective of this population pharmacokinetic (PK) analysis was to provide guidance for the dosing interval of daptomycin in patients undergoing continuous renal replacement therapy (CRRT). METHODS: A previously published population PK model for daptomycin was updated with data from patients undergoing continuous veno-venous haemodialysis (CVVHD; n = 9) and continuous veno-venous haemodiafiltration (CVVHDF; n = 8). Model-based simulations were performed to compare the 24 h AUC, Cmax and Cmin of daptomycin following various dosing regimens (4, 6, 8, 10, and 12 mg kg(-1) every [Q] 24 h and Q48 h), with the safety and efficacy exposure references for Staphylococcus aureus bacteraemia/right-sided infective endocarditis...
September 15, 2016: British Journal of Clinical Pharmacology
Soraya Abad, Almudena Vega, Borja Quiroga, David Arroyo, Nayara Panizo, Javier Eduardo Reque, Juan Manuel López-Gómez
: Chronic kidney disease is associated with an increased risk of cardiovascular events. In recent years, protein-bound toxins have become more important due to their association with increased morbidity and mortality, characterised by inadequate clearance during dialysis. The purpose of this study is to assess the influence of high convective volumes on postdilution online haemodiafiltration (OL-HDF) on the removal of medium-sized molecules, small molecules and protein-bound molecules...
November 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Andrew Taylor, Adam Sutherland
INTRODUCTION: Clinical supervision is defined by Barber and Norman as having four main functions: educational, supportive, managerial and development of self-awareness.1 It is common practice within initial pharmacy education for clinical supervision to take place at undergraduate, pre-registration and foundation level pharmacist stages. But what about the specialist trainees? It is probably a fair observation that the amount of clinical supervision provided for pharmacists undergoing their advanced level practice drops vividly...
September 2016: Archives of Disease in Childhood
Ilias Karaiskos, Lena E Friberg, Lambrini Galani, Konstantinos Ioannidis, Emmanouela Katsouda, Zoe Athanassa, Harris Paskalis, Helen Giamarellou
Traditionally, reduced daily doses of colistin methanesulphonate (CMS) in critically ill patients receiving continuous venovenous haemodiafiltration (CVVHDF) have resulted in suboptimal colistin concentrations. The necessity of a loading dose (LD) at treatment initiation has been proposed. A LD of 9 million IU (MU) [ca. 270 mg of colistin base activity (CBA)] was administrated with a maintenance dose of 4.5 MU (ca. 140 mg CBA) every 12 h (q12h) to eight critically ill patients receiving renal replacement therapy...
September 2016: International Journal of Antimicrobial Agents
L Xing
Background: The study of the effect of different dialysis methods on cellular immune function of maintenance haemodialysis (MHD) patients should provide theoretical support for deciding on the best method of blood purification that effectively improves cellular immune function of haemodialysis patients. Subjects and Method: Sixty MHD patients were randomly divided into three groups that respectively received treatment of haemodialysis (HD), high flux haemodialysis (HFHD) and haemodiafiltration (HDF)...
April 18, 2016: West Indian Medical Journal
Lotte Lips, Camiel L M de Roij van Zuijdewijn, Piet M Ter Wee, Michiel L Bots, Peter J Blankestijn, Marinus A van den Dorpel, Denis Fouque, Renate de Jongh, Solenne Pelletier, Marc G Vervloet, Menso J Nubé, Muriel P C Grooteman
BACKGROUND: The glycoprotein sclerostin (Scl; 22 kDa), which is involved in bone metabolism, may play a role in vascular calcification in haemodialysis (HD) patients. In the present study, we investigated the relation between serum Scl (sScl) and mortality. The effects of dialysis modality and the magnitude of the convection volume in haemodiafiltration (HDF) on sScl were also investigated. METHODS: In a subset of patients from the CONTRAST study, a randomized controlled trial comparing HDF with HD, sScl was measured at baseline and at intervals of 6, 12, 24 and 36 months...
June 23, 2016: Nephrology, Dialysis, Transplantation
Hugh Davies, Gavin D Leslie, David Morgan
INTRODUCTION: An effect of severe acute kidney injury (AKI) is the development of oliguria and subsequent retention of fluid. Recent studies have reported an association between fluid overload and increased mortality in critically ill patients. Achieving fluid balance control through haemofiltration is an important part of dialysis dose delivery in continuous renal replacement therapy (CRRT). AIMS: (1) Compare the prescribed dose with the delivered dose of dialysis and haemofiltration for CRRT...
June 20, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Albert Power, Evangelia Charitaki, Andrew Davenport
BACKGROUND: Haemodiafiltration (HDF) has been reported to cause less hypotension than haemodialysis (HD). We hypothesized that HDF causes less change in vascular tone, thereby reducing hypotension. METHODS: Aortic pulse wave velocity (PWVao) was measured in 284 patients, during a single dialysis session using cooled dialysate (117 HD, 177 HDF). Patient groups were matched for age, sex and cardiovascular comorbidity. RESULTS: Systolic blood pressure (SBP) declined from 144 ± 26 to 133 ± 26 after 20 minutes, and to 131 ± 26 mmHg post HD, and for HDF from 152 ± 26 to 143 ± 27 after 20 minutes, then to 138 ± 27 mmHg post HDF...
July 4, 2016: International Journal of Artificial Organs
C Roger, B Louart, L Muller, J A Roberts, J Y Lefrant
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Marjorie Houllé-Veyssière, Audrey Courtin, Norddine Zeroual, Philippe Gaudard, Pascal H Colson
OBJECTIVES: To evaluate the nursing workload related to two techniques of continuous renal replacement therapy. RESEARCH METHODOLOGY: We analysed retrospectively the nursing work load caused directly by continuous renal replacement therapy in a cohort of patients admitted consecutively over 10 months. Two types of continuous renal replacement therapy have been compared: dialysis with regional citrate anticoagulation and haemodiafiltration with systemic heparin coagulation...
October 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Gulay Asci, Daniele Marcelli, Aygul Celtik, Aileen Grassmann, Kutay Gunestepe, Mustafa Yaprak, Abdulkerim Furkan Tamer, Mehmet Nuri Turan, Mehmet Sukru Sever, Ercan Ok
BACKGROUND: There are significant differences between countries in the mortality rates of haemodialysis (HD) patients. The extent of these differences and possible contributing factors are worthy of investigation. METHODS: As of March 2009, all patients undergoing HD or haemodiafiltration for >3 months (n = 4041) in the Turkish clinics of the NephroCare network were enrolled. Data were prospectively collected for 2 years through the European Clinical Dialysis Database...
June 2016: Clinical Kidney Journal
Francisco Maduell, Raquel Ojeda, Marta Arias-Guillen, Florencia Rossi, Néstor Fontseré, Manel Vera, Nayra Rico, Leonardo Nicolás Gonzalez, Gastón Piñeiro, Mario Jiménez-Hernández, Lida Rodas, José Luis Bedini
BACKGROUND: New haemodialysis therapeutic regimens are required to improve patient survival. Longer and more frequent dialysis sessions have produced excellent survival and clinical advantages, while online haemodiafiltration (OL-HDF) provides the most efficient form of dialysis treatment. METHODS: In this single-centre observational study, 57 patients on 4-5-hour thrice-weekly OL-HDF were switched to nocturnal every-other-day OL-HDF. Inclusion criteria consisted of stable patients with good prospects for improved occupational, psychological and social rehabilitation...
2016: Nephron
Detlef H Krieter, Eric Devine, Thomas Körner, Marieke Rüth, Christoph Wanner, Manuelle Raine, Joachim Jankowski, Horst-Dieter Lemke
AIM: Protein-bound uraemic toxin accumulation causes uraemia associated cardiovascular morbidity. Enhancing the plasma ionic strength releases toxins from protein binding and makes them available for removal during dialysis. This concept was implemented through high sodium concentrations ([Na(+) ]) in the substituate of predilution haemodiafiltration at increased plasma ionic strength (HDF-IPIS). METHODS: Ex vivo HDF-IPIS with blood tested increasing [Na(+) ] to demonstrate efficacy and haemocompatibility...
June 4, 2016: Acta Physiologica
Kathleen E Hill, Susan Kim, Susan Crail, Tiffany Whittington, Tony J Elias
AIMS: Haemodiafiltration has been widely studied for evidence of superior outcomes in comparison to conventional haemodialysis and there is increasing interest in determining if haemodiafiltration confers any benefit in relation to quality of life. Studies have been conducted with randomized incident patients however little is known regarding haemodiafiltration and quality of life for prevalent patients. This study examined and compared self-reported quality of life at two time points twelve months apart in a cohort of satellite haemodialysis and haemodiafiltration patients using a disease specific questionnaire to determine if HDF conferred an advantage...
June 2, 2016: Nephrology
Chao Liu, Zhi Mao, Hongjun Kang, Jie Hu, Feihu Zhou
BACKGROUND: Regional citrate or heparin is often prescribed as an anticoagulant for continuous renal replacement therapy (CRRT). However, their efficacy and safety remain controversial. Therefore, we performed this meta-analysis to compare these two agents and to determine whether the currently available evidence is sufficient and conclusive by using trial sequential analysis (TSA). METHODS: We searched for relevant studies in PubMed, Embase, the Cochrane Library databases and the China National Knowledge Infrastructure (CNKI) Database from database inception until September 2015...
May 13, 2016: Critical Care: the Official Journal of the Critical Care Forum
M Piastra, A Tempera, E Luca, E Buffone, C Cafforio, V Briganti, O Genovese, M Marano, D Rigante
Streptococcus pneumoniae sepsis has high morbidity, particularly if complicated by renal injury. Four patients with S. pneumonia invasive infections complicated by renal disorders are presented. The first case was an 18-month-old girl with pneumococcal empyema complicated by haemolytic uraemic (HUS) syndrome. She made a full recovery after mechanical ventilation, inotropic support and haemodiafiltration. The second was a 4-year-old boy who presented with acute post-infectious glomerulonephritis associated with bilateral pneumococcal pneumonia...
January 29, 2016: Paediatrics and International Child Health
Sakina Kandouz, Ali Shendi Mohamed, Yishan Zheng, Susan Sandeman, Andrew Davenport
Introduction Indoxyl sulfate (IS) and p cresyl sulfate (PCS) are protein bound toxins which accumulate with chronic kidney disease. Haemodiafiltration (HDF) increases middle molecule clearances and has been suggested to increase IS and PCS clearance. We therefore wished to establish whether higher convective clearances with HDF would reduce IS and PCS concentrations. Methods We measured total plasma IS and PCS in a cohort of 138 CKD5d patients treated by On-line HDF (Ol-HDF), by high pressure liquid chromatography...
April 4, 2016: Hemodialysis International
Claire Roger, Steven C Wallis, Benjamin Louart, Jean-Yves Lefrant, Jeffrey Lipman, Laurent Muller, Jason A Roberts
OBJECTIVES: Whilst commonly performed in ICUs, renal replacement therapies (RRTs) differ in their solute clearances. There is a paucity of data on ciprofloxacin clearances in different RRT techniques. The aim of this study was to compare the population pharmacokinetics of ciprofloxacin during equal doses of continuous venovenous haemofiltration (CVVHF) and continuous venovenous haemodiafiltration (CVVHDF) in septic patients. METHODS: Patients receiving 400 mg of ciprofloxacin intravenously 8 or 12 hourly and undergoing either CVVHF or CVVHDF were eligible...
June 2016: Journal of Antimicrobial Chemotherapy
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