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Wim Van Biesen, Raymond Vanholder, Eva Schepers, Griet Glorieux, Annemieke Dhondt, Sunny Eloot
Cardiovascular disease is a major concern in patients with end-stage kidney disease (ESKD). Inflammation induced by retention of uremic toxins, of which a substantial fraction has a molecular weight in the middle molecular range, has been associated with increased cardiovascular risk. In an attempt to reduce inflammation and thus cardiovascular toxicity in patients with ESKD, hemodiafiltration (HDF) has been promoted to enhance the clearance of middle molecular weight substances during dialysis. However, HDF increases the technical complexity and costs, and requires ultrapure dialysis fluid...
2017: Contributions to Nephrology
Anna Lorenzin, Mauro Neri, William R Clark, Francesco Garzotto, Alessandra Brendolan, Federico Nalesso, Nicola Marchionna, Monica Zanella, Marco Sartori, Gianfranco B Fiore, Claudio Ronco
High retention onset (HRO) is the designation for a new class of hemodialysis membranes. A unique characteristic of this class is the highly selective and controlled porosity resulting in sieving properties that provide a clinically desirable balance between middle/large molecular weight solute removal and albumin loss. Another defining feature of this membrane class is the relatively small fiber diameter, which produces high convective volumes in the form of internal filtration. The aim of the present study was to estimate, by semi-empirical methods, convective volumes for 2 new HRO dialyzers: Theranova 400 and Theranova 500 (Baxter International Inc...
2017: Contributions to Nephrology
William R Clark, Dayong Gao, Mauro Neri, Claudio Ronco
Extracorporeal therapy for end-stage renal disease is now provided to more than three million patients globally. Nearly all treatments are performed with filters containing hollow fiber membranes, removing solutes and water by diffusion, convection, and ultrafiltration. In this review, we will provide a detailed quantitative analysis of the transport processes involved in different hemodialysis (HD) therapies. We will also report some technical aspects of hollow fiber membranes and filters composed of them along with the mechanisms of solute and water removal for such devices...
2017: Contributions to Nephrology
Mun Jang, Won Hak Kim, Jung Hee Lee, Mi Soon Kim, Eun Kyoung Lee, So Mi Kim, Jai Won Chang
BACKGROUND: Volume overload results in higher mortality rates in patients on continuous ambulatory peritoneal dialysis (CAPD). The ratio of bioimpedance (RBI) might be a helpful parameter in adjusting dry body weight in CAPD patients. This study examined whether it is possible to distinguish between non-hypervolemic status and hypervolemic status in CAPD patients by using only RBI. METHODS: RBI was calculated as follows: RBI = impedance at 50 kHz/impedance at 500 kHz...
September 2017: Kidney Research and Clinical Practice
Benedito Jorge Pereira, Silvana Barreto, Thais Gentil, Larissa S Assis, Emília Md Soeiro, Isac de Castro, Sandra M Laranja
Introduction: The incidence of chronic kidney disease (CKD) is increasing with the increasing age of the population and the increasing number of elderly survivors of acute kidney injury (AKI). The risk factors for the progression of CKD after AKI are unclear. Objective: To investigate the association between AKI and its progression to CKD and the risk factors involved. Methods: An observational, retrospective study of AKI patients followed from 2009 to 2012 was carried out...
August 28, 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Wanying Cho, Rangadhar Pradhan, Hsin Ying Chen, Yi-Hsuan Weng, Hsueh Yao Chu, Fan-Gang Tseng, Chien-Ping Lin, Jeng-Kai Jiang
The conventional techniques to detect circulating tumour cells (CTCs) are lengthy and the use of centrifugal forces in this technique may cause cell mortality. As the number of CTCs in patients is quite low, the present study aims towards a gentler diagnostic procedure so as not to lose too many CTCs during the sample preparation process. Hence, a Three-Dimensional Microwell dialysis (3D-μDialysis) chip was designed in this study to perform gentle fluorescence-removal process by using dialysis-type flow processes without centrifuging...
September 12, 2017: Scientific Reports
Claudia Hurtado, María Soledad Báez, Anabel Bate, Claudio Opazo, Mauricio Troncoso
Although radioiodine (131-I) can be used as treatment of hyperthyroidism for patients in hemodialysis, its use is limited and the experience is mainly related to differentiated thyroid carcinoma. We report a 58 years old female on hemodialysis with recurrent hyperthyroidism after propylthiouracil treatment. She was successfully treated with 131-I and four months after the intervention her euthyroid state was confirmed. We measured 131-I activity in blood, dialysate liquid and other waste products, as well as patient radiation exposure rates...
May 2017: Revista Médica de Chile
Dmitry Gil, Anastasia Frank-Kamenetskii, John Barry, Vladimir Reukov, Yun Xiang, Arabinda Das, Abhay K Varma, Mark S Kindy, Naren L Banik, Alexey Vertegel
Polymeric nanoparticles have been extensively studied as drug delivery vehicles both in vitro and in vivo for the last two decades. In vitro methods to assess drug release profiles usually utilize degradation of nanoparticles in aqueous medium, followed by the measurement of the concentration of the released drug. This method, however, is difficult to use for drugs that are poorly water soluble. In this study, we describe a protocol for measuring drug release kinetic using albumin solution as the medium. Albumin is a major blood transport protein, which mediates transport of many lipid soluble compounds including fatty acids, hormones, and bilirubin...
September 7, 2017: Biotechnology Journal
Rodrigo Luiz Targino Dutra, Aline Macedo Dantas, Débora de Araújo Marques, Jéssica Dayanne Ferreira Batista, Bruno Raniere Lins de Albuquerque Meireles, Ângela Maria Tribuzy de Magalhães Cordeiro, Marciane Magnani, Graciele da Silva Campelo Borges
This study characterized the phenolic profile in siriguela, umbu-cajá and mangaba, as well in their frozen pulps (FPs). The bioaccessibility of phenolic compounds and the antioxidant activity of the FP dialysates were determined following exposure to simulated gastrointestinal conditions. The profile of phenolic compounds identified in fruit and FPs were relatively similar. After pulp processing, increases of 33.60% and 68.72% in free phenolics were observed for mangaba and umbu-cajá, respectively, whereas in siriguela, the free phenolic was reduced by 56...
October 2017: Food Research International
Vaibhav Maheshwari, Stephan Thijssen, Xia Tao, Doris Fuertinger, Franz Kappel, Peter Kotanko
Protein-bound uremic toxins (PBUTs) are difficult to remove by conventional hemodialysis; a high degree of protein binding reduces the free fraction of toxins and decreases their diffusion across dialyzer membranes. Mechanistic understanding of PBUT kinetics can open new avenues to improve their dialytic removal. We developed a comprehensive model of PBUT kinetics that comprises: (1) a three-compartment patient model, (2) a dialyzer model. The model accounts for dynamic equilibrium between protein, toxin, and the protein-toxin complex...
September 4, 2017: Scientific Reports
Isabel Galán, Santiago Cedeño, A Vega, S Abad, Nicolás Macías, J M López-Gómez, José Luño
INTRODUCTION AND OBJECTIVE: Higher infusion volumes (IV) in online hemodiafiltration (OL-HDF) are associated with better survival. The IV depends mainly on blood flow (Qb). The objectives of our study were to evaluate the influence of the caliber of arteriovenous fistula (AVF) puncture needles on the total convective volume and other characteristics of OL-HDF, and to investigate possible adverse effects. MATERIAL AND METHODS: Prospective intervention study analyzing six sessions of postdilution OL-HDF with 14G needles and six sessions with 15G needles in the same patients, to compare results of efficacy and safety...
August 28, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Asuka Ito, Mostofa Jamal, Kiyoshi Ameno, Naoko Tanaka, Ayaka Takakura, Takanori Miki, Hiroshi Kinoshita
Carbon monoxide (CO) produces several neurological effects, including cognitive, mood, and behavioral disturbance. Glutamate is thought to play a particularly important role in learning and memory. Thus, the present study was aimed at investigating the local effect of CO on the glutamate level in the hippocampus of mice using in vivo reverse microdialysis. Mice were perfused with Ringer's solution (control) or CO (60-125 μM) in Ringer's solution into the hippocampus via microdialysis probe. Dialysate samples were collected every 20 min, and then analyzed with high-performance liquid chromatography coupled to an electrochemical detector...
September 4, 2017: Drug and Chemical Toxicology
Michael Hulko, Rose Speidel, Julia Gauss, Markus Storr, Bernd Krause
PURPOSE: Removal of cytokines is relevant for dialysis patients as they are suspected to promote cardiovascular complications. The objective of this study was to benchmark membranes with different permeability profiles under standardized in vitro test conditions using miniaturized devices with respect to their ability to remove cytokines from human serum and to lower cell activating potential. METHODS: In vitro dialysis was used to dialyze cytokine enriched serum in 3 independent experiments per tested membrane...
August 11, 2017: International Journal of Artificial Organs
Kamal Hassan, Fadi Hassan
OBJECTIVE: Hypertension and hypoalbuminemia are common risk factors for cardiovascular complications in peritoneal dialysis (PD) patients. Data are limited regarding the effects of whey protein consumption on blood pressure in this population. The aim of the present study was to examine if whey protein supplementation for 12 weeks to hypoalbuminemic PD patients affects their blood pressure. PATIENTS AND METHODS: This prospective randomized study included 36 stable PD patients with serum albumin levels <3...
2017: Therapeutics and Clinical Risk Management
Giedrius Kanaporis, Rimantas Treinys, Rodolphe Fischmeister, Jonas Jurevičius
Metabolic stress evoked by myocardial ischemia leads to impairment of cardiac excitation and contractility. We studied the mechanisms by which metabolic inhibition affects the activity of L-type Ca2+ channels (LTCCs) in frog ventricular myocytes. Metabolic inhibition induced by the protonophore FCCP (as well as by 2,4- dinitrophenol, sodium azide or antimycin A) resulted in a dose-dependent reduction of LTCC current (ICa,L) which was more pronounced during β-adrenergic stimulation with isoprenaline. ICa,L was still reduced by metabolic inhibition even in the presence of 3 mM intracellular ATP, or when the cell was dialysed with cAMP or ATP-γ-S to induce irreversible thiophosphorylation of LTCCs, indicating that reduction in ICa,L is not due to ATP depletion and/or reduced phosphorylation of the channels...
2017: PloS One
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
August 28, 2017: Critical Care Medicine
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
Daniel Azpiazu, Emilio González-Parra, Alberto Ortiz, Jesús Egido, Ricardo Villa-Bellosta
OBJECTIVES: Vascular calcification is a frequent complication in chronic haemodialysis patients and is associated with adverse outcomes. Serum calcium and phosphate levels and imbalances in calcification regulators are thought to contribute to the process. In this regard, the dialysate calcium concentration is a modifiable tool for modulating the risk of vascular calcification. We explored pre- and post-dialysis phosphate and calcium concentrations in stable chronic haemodialysis patients treated by dialysis with the KDIGO-suggested 1...
2017: PloS One
Christoph Schmaderer, Matthias C Braunisch, Yana Suttmann, Georg Lorenz, Dang Pham, Bernhard Haller, Susanne Angermann, Julia Matschkal, Lutz Renders, Marcus Baumann, Jürgen R Braun, Uwe Heemann, Claudius Küchle
BACKGROUND: Although low magnesium levels have been associated with an increased mortality in dialysis patients, they are kept low by routinely-used dialysates containing 0.50 mmol/L magnesium. Thus, we investigated the impact of a higher dialysate magnesium concentration on mortality. METHODS: 25 patients on high dialysate magnesium (HDM) of 0.75 mmol/L were 1:2 matched to 50 patients on low dialysate magnesium (LDM) of 0.50 mmol/L and followed up for 3 years with regards to all-cause and cardiovascular mortality...
August 23, 2017: Nutrients
Magdalena König, Anna Thinnes, Jochen Klein
Microdialysis is a technique that allows access to the extracellular space of many tissues. For behavioural studies, microdialysis probes are inserted into the brain under anesthesia, but the experiment can be done in awake and freely moving animals. Microdialysis is a sampling method (not a measuring method), therefore, the analyte(s) under study must be quantified from the dialysate using available analytical methods of high sensitivity. Neurotransmitters and energy metabolites are most commonly measured...
August 18, 2017: Journal of Neuroscience Methods
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