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Haemodiafiltration

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https://www.readbyqxmd.com/read/29730670/haemodialysis-membranes
#1
REVIEW
Claudio Ronco, William R Clark
Haemodialysis is an extracorporeal process in which the blood is cleansed via removal of uraemic retention products by a semipermeable membrane. Traditionally, dialysis membranes have been broadly classified on the basis of their composition (cellulosic or noncellulosic) and water permeability (low flux or high flux). However, advances in materials technology and polymer chemistry have led to the development of membranes with specific characteristics and refined properties that mandate a reconsideration of traditional membrane classification systems...
May 5, 2018: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29722110/biochemical-comparison-of-8-hour-haemodialysis-and-4-hour-haemodiafiltration-and-two-dialysis-membranes-in-a-randomised-cross-over-trial
#2
Shi Z Choo, Kevan R Polkinghorne, Peter G Kerr
AIM: Extended-hours haemodialysis has long been regarded as the optimal form of dialysis for solute clearance. With emerging benefits of haemodiafiltration, we wanted to compare these two head-to-head. METHODS: In this randomised cross-over trial, we recruited existing nocturnal haemodialysis patients, who had not been hospitalised in the prior three months. After a baseline 8-hour haemodialysis session, subjects were randomised to either 2 weeks of 8-hour haemodialysis or 4-hour haemodiafiltration with cross-over to the alternative treatment after a 2-week washout period...
May 2, 2018: Nephrology
https://www.readbyqxmd.com/read/29709365/protein-losses-and-urea-nitrogen-underestimate-total-nitrogen-losses-in-peritoneal-dialysis-and-hemodialysis-patients
#3
Clara Salame, Simon Eaton, George Grimble, Andrew Davenport
OBJECTIVE: Muscle wasting is associated with increased mortality and is commonly reported in dialysis patients. Hemodialysis (HD) and peritoneal dialysis (PD) treatments lead to protein losses in effluent dialysate. We wished to determine whether changes in current dialysis practice had increased therapy-associated nitrogen losses. DESIGN: Cross-sectional cohort study. METHODS: Measurement of total protein, urea and total nitrogen in effluent dialysate from 24-hour collections from PD patients, and during haemodiafiltration (HDF) and haemodialysis (HD) sessions...
April 28, 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29700220/intensive-care-management-of-severe-hypernatraemia-in-the-context-of-group-a-streptococcal-septicaemia
#4
Bethan Davies, Robert Jesty, Shahana Uddin, Victoria Metaxa
This case describes a 54-year-old woman with exudative eczema, who was admitted to the intensive care unit with a serum sodium concentration of 191 mmol/L, secondary to profound dehydration in the context of group A streptococcal septicaemia. Successful rehydration and electrolyte normalisation was achieved with continuous venovenous haemodiafiltration (CVVHDF), the replacement fluid of which was infused with hypertonic saline to limit the rate of sodium reduction. This case report comments on three areas of interest...
April 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29688552/haemodialysis-or-haemodiafiltration-that-is-the-question
#5
Francesco Locatelli, Fabio Carfagna, Lucia Del Vecchio, Vincenzo La Milia
Despite the technological and pharmacological advancements in the last 30 years, morbidity and mortality of dialysis patients are still astonishingly high. Today, convective treatments, such as high-flux haemodialysis (hf-HD) and haemodiafiltration (HDF), are established techniques; the online production of fresh pure dialysate has provided clinical and economic advantages. Nevertheless, the actual benefits of HDF, even with high-convective-volume treatments, are still debatable. Three recent, randomized controlled trials compared survival outcomes in prevalent patients receiving conventional HD or post-dilution HDF and reported conflicting results...
April 24, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29649802/is-there-not-sufficient-evidence-to-show-that-haemodiafiltration-is-superior-to-conventional-haemodialysis-in-treating-end-stage-kidney-disease-patients
#6
Bernard Canaud, Ellen Busink, Christian Apel, Sudhir K Bowry
No abstract text is available yet for this article.
2018: Blood Purification
https://www.readbyqxmd.com/read/29534338/-massive-metformin-overdose
#7
Angela L Chiew, Daniel F B Wright, Nicola M Dobos, Kylie McArdle, Ahmed A Mostafa, Annemarie Newth, Michael S Roberts, Geoffrey K Isbister
Massive metformin overdose can cause metabolic acidosis with hyperlactatemia. A 55-year-old woman presented 5 h after multidrug overdose, including 132 g extended-release metformin. Continuous venovenous haemodiafiltration (CVVHDF) and noradrenaline were commenced due to metabolic acidosis (pH 7.0, lactate 17 mmol l-1 ) and shock. Despite 3 h of CVVHDF, her acidosis worsened (pH 6.83, lactate 24 mmol l-1 ). Intermittent haemodialysis (IHD) improved acidosis (pH 7.13, lactate 26 mmol l-1 ) but again worsened (pH 6...
March 13, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29523566/long-term-clinical-parameters-after-switching-to-nocturnal-haemodialysis-a-dutch-propensity-score-matched-cohort-study-comparing-patients-on-nocturnal-haemodialysis-with-patients-on-three-times-a-week-haemodialysis-haemodiafiltration
#8
Thijs Thomas Jansz, Akin Özyilmaz, Muriel P C Grooteman, Tiny Hoekstra, Marieke Romijn, Peter J Blankestijn, Michael L Bots, Brigit C van Jaarsveld
OBJECTIVES: Nocturnal haemodialysis (NHD), characterised by 8-hour sessions ≥3 times a week, is known to improve clinical parameters in the short term compared with conventional-schedule haemodialysis (HD), generally 3×3.5-4 hours a week. We studied long-term effects of NHD and used patients on conventional HD/haemodiafiltration (HDF) as controls. DESIGN: Four-year prospective follow-up of patients who switched to NHD; we compared patients with patients on HD/HDF using propensity score matching...
March 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29519257/-loss-of-kidney-function-caused-by-implanted-gentamicin-sponges
#9
S L Verweij, N H Schut, R E A M Zwartelé, M L Becker
BACKGROUND: Infected joint replacements can be treated with gentamicin-containing materials for implantation. This may lead to side effects, especially in patients with impaired renal function. CASE DESCRIPTION: A 74-year-old woman underwent two surgeries for an acutely infected hip replacement. Gentamicin sponges (Garacol) were implanted during both interventions. The day after the second operation, her serum gentamicin levels had risen to toxic values. This confirmed the suspicion that she had a kidney impairment which was probably caused by the implanted gentamicin-containing sponges...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29506150/pharmacokinetics-of-piperacillin-in-critically-ill-patients-with-acute-kidney-injury-receiving-sustained-low-efficiency-diafiltration
#10
Mahipal G Sinnollareddy, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Background: Piperacillin is a β-lactam penicillin antibiotic commonly used for the empirical therapy of sepsis and other hospital-acquired infections. However, knowledge regarding the effect of sustained low-efficiency diafiltration (SLED-f), a technique increasingly being used in ICUs, on piperacillin pharmacokinetics (PK) and dosing in critically ill patients is lacking. Objectives: To describe the PK of piperacillin during SLED-f and compare the results with those reported for other forms of renal replacement therapies...
March 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29454540/asymmetric-cellulose-triacetate-is-a-safe-and-effective-alternative-for-online-haemodiafiltration
#11
Marta Albalate Ramón, Patricia Martínez Miguel, Lourdes Bohorquez, Patricia de Sequera, Hanane Bouarich, Rafael Pérez-García, Diego Rodríguez Puyol, Guillermina Barril, Jose Antonio Sánchez Tomero, Martin Giorgi, Manuel Rafael Ramirez Chamond
BACKGROUND: In post-dilution haemodiafiltration only synthetic membranes have been used to date. Asymmetric cellulose triacetate (ATA™) is now available, whose characteristics are suitable for this technique. OBJECTIVES: To describe the in vivo performance and behaviour of this membrane, to identify its depurative effectiveness, use in clinical practice and its biocompatibility, both acute and after one month of treatment. METHODS: Observational prospective study of 23 patients who were dialysed for 4 weeks using an ATA™ membrane and who maintained their prior regimen...
May 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29423206/achievement-of-kidney-disease-improving-global-outcomes-mineral-and-bone-targets-between-2010-and-2014-in-incident-dialysis-patients-in-france-the-photo-graphe3-study
#12
Denis Fouque, Hubert Roth, Bernadette Darné, Louis Jean-Bouchet, Eric Daugas, Tilman B Drüeke, Thierry Hannedouche, Guillaume Jean, Gérard M London
Background: Abnormal serum phosphate, calcium and parathyroid hormone (PTH) levels in patients with chronic kidney disease (CKD) undergoing haemodialysis have been associated with poor survival. The French Phosphorus and Calcium Observatory (Photo-Graphe® 3) aimed to estimate the percentage of CKD patients achieving the three Kidney Disease: Improving Global Outcomes (KDIGO) targets about optimal serum phosphate, calcium and PTH over a 3.5-year follow-up period. Methods: This was a prospective, multicentre, epidemiological observational study conducted with nephrologists in France, selected using a clustering approach...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29390242/-severe-lactic-acidosis-requiring-continuos-haemodiafiltration-in-a-young-patient-with-unrecognized-metabolic-abnormality-case-report
#13
Federica N Vigotti, Germana Daidola, Antonio Marciello, Francesco Berruto, Antonietta Rizzuto, Ernesto Reina, Paolo M Perosa, Marco Saltarelli
BACKGROUND: Lactic acidosis (LA) is the most common form of metabolic acidosis, defined by lactate values greater than 5 mmol/L and pH<7.34. The pathogenesis of LA involves hypoxic causes (type A) and non-hypoxic (type B), often coexisting. Identification and removal of the trigger are mandatory in the therapeutic management of LA. The case: A 38 years-old male patient entered the Emergency Ward for dyspnea, fever, vomiting and hyporexia. An important respiratory distress with hyperventilation due to severe LA was found, together with severe hypoglicemia, without renal impairment...
February 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29370428/the-effect-of-high-volume-online-haemodiafiltration-on-nutritional-status-and-body-composition-the-protein-stores-preservation-peset-study
#14
Pablo Molina, Belén Vizcaíno, Mariola D Molina, Sandra Beltrán, Mercedes González-Moya, Antonio Mora, Cristina Castro-Alonso, Julia Kanter, Ana I Ávila, José L Górriz, Nuria Estañ, Luis M Pallardó, Denis Fouque, Juan J Carrero
Background: Compared with conventional haemodialysis (HD), online haemodiafiltration (OL-HDF) achieves a more efficient removal of uraemic toxins and reduces inflammation, which could favourably affect nutritional status. We evaluate the effect of OL-HDF on body composition and nutritional status in prevalent high-flux HD (HF-HD) patients. Methods: In all, 33 adults with chronic kidney disease (CKD) Stage 5 undergoing maintenance HF-HD were assigned to post-dilution OL-HDF (n = 17) or to remain on HF-HD (n = 16, control group) for 12 months...
January 22, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29325671/evaluation-of-the-dialyser-inner-diameter-in-online-haemodiafiltration
#15
Francisco Maduell, Raquel Ojeda, Lara Belmar, Paula Munguía, Cristina Sango, Ana Isabel Martinez-Díaz, Marta Arias-Guillén, Manel Vera, Néstor Fontseré, Miquel Gómez, Lida Rodas, Nayra Rico
INTRODUCTION: Online haemodiafiltration (OL-HDF) has been associated with increased survival. To date, the influence of the inner diameter of the hollow fibres of the dialyser on convective volume has not been well established. The objective of the study was to evaluate the effect of increasing the inner diameter of the dialyser on the convective volume and removal capacity. MATERIAL AND METHODS: We included 16 patients in posdilutional OL-HDF with autosubstitution...
January 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29232669/implication-of-haemodiafiltration-flow-rate-on-amikacin-pharmacokinetic-parameters-in-critically-ill-patients
#16
Jesús Ruiz-Ramos, Esther Villarreal, Mónica Gordon, María Martin-Cerezula, Maria Jesús Broch, María Remedios Marqués, Jose Luis Poveda, Álvaro Castellanos-Ortega, Paula Ramírez
BACKGROUND: To analyse the effect of haemodiafiltration (CVVHDF) flow rate on amikacin pharmacokinetics and blood concentrations. METHODS: Prospective observational study. Patients receiving CVVHDF and amikacin treatment were included. Pharmacokinetic parameters were calculated using Bayesian analysis. Spearman correlation test was used in order to assess the influence of CVVHDF flux on amikacin minimum concentration (Cmin) and plasma clearance. RESULTS: Thirty patients undergoing CVVHDF procedures were included...
December 12, 2017: Blood Purification
https://www.readbyqxmd.com/read/29198593/a-new-generation-of-cellulose-triacetate-suitable-for-online-haemodiafiltration
#17
Francisco Maduell, Raquel Ojeda, Marta Arias-Guillén, Néstor Fontseré, Manel Vera, Lida Rodas, Miquel Gómez, Karen P Huablocho, Fanny Esquivel, Paola D Mori, Valentina Hoffmann, Jessica Ugalde, Nayra Rico
BACKGROUND: Online haemodiafiltration (OL-HDF) is currently the most effective dialysis technique that also improves survival. To date, high permeability membranes with low albumin loss, such as polysulfone, polyamide and polyacrylonitrile membranes have been the most widely used. However, the initially restricted use of cellulose triacetate (CTA) membranes in OL-HDF has expanded. The aim of the study was to ascertain whether the latest generation asymmetric CTA membranes are more effective in obtaining high convective transport...
March 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28988498/2-methyl-4-chlorophenoxyacetic-acid-mcpa-and-bromoxynil-herbicide-ingestion
#18
Angela L Chiew, Colin B Page, David Clancy, Ahmed Mostafa, Michael S Roberts, Geoffrey K Isbister
CONTEXT: Ingestion of bromoxynil and 2-methyl-4-chlorophenoxyacetic acid (MCPA) in combination is associated with high mortality. Toxicity is characterised by hyperthermia and metabolic acidosis. Dialysis is a proposed treatment, but little data exist regarding its effectiveness. CASE DETAILS: Case 1: A 50-year-old female presented 18 h post-ingestion of 200  mL of bromoxynil(200 g/L) and MCPA(200 g/L). She was agitated, tachycardic and tachypnoeic. She was intubated and continuous venovenous haemodiafiltration (CVVHDF) was commenced...
October 9, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28868173/analysis-of-the-alarms-from-a-blood-purification-machine-during-continuous-haemodiafiltration
#19
Takeshi Yano, Hiroyuki Fukumoto, Masahiko Taniguchi, Isao Tsuneyoshi
No abstract text is available yet for this article.
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28689876/impact-of-renal-replacement-modalities-on-the-clearance-of-piperacillin-tazobactam-administered-via-continuous-infusion-in-critically-ill-patients
#20
Claire Roger, Menino O Cotta, Laurent Muller, Steven C Wallis, Jeffrey Lipman, Jean-Yves Lefrant, Jason A Roberts
This prospective pharmacokinetic study aimed to compare the clearance of piperacillin-tazobactam administered as a 24-h continuous infusion between continuous venovenous haemodiafiltration (CVVHDF) and continuous venovenous haemofiltration (CVVH) applied at equal dose in critically ill patients. A loading dose of 4.5 g of piperacillin-tazobactam followed by a continuous infusion (500 mg/h) was administered to patients randomized to receive CVVHDF or CVVH. Serial pre- and postfilter blood samples were drawn during an 8-h sampling interval...
August 2017: International Journal of Antimicrobial Agents
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