Dialyzer

BACKGROUND: A kinetic model for beta-2-microglobulin removal and generation was used to explore the impact of adding hemodiafiltration on predialysis and time-averaged serum values. METHODS: The model was tested on data from the HEMO study and on a sample of patients undergoing high-flux hemodialysis. The impact of hemodiafiltration on beta-2-microglobulin levels was evaluated by modeling four randomized studies of hemodiafiltration vs. hemodialysis. The impact of residual kidney function on beta-2-microglobulin was tested by comparing results of previously reported measured data with model predictions...

Between 2013 and 2021, indicators of vascular access protection (IPAV) integrating a census of haematomas and multiple punctures were set up on the active file of chronic kidney failure patients with a vascular access dialyzed in Monaco's private haemodialysis center. They could help reduce the occurrence of complications and improve the quality of care offered to patients. This article reports on the results obtained before and after the introduction of this quality approach.

BACKGROUND: Older patients in hemodialysis have high prevalence of malnutrition that is often associated with rapid weight loss till cachexia. OBJECTIVES: We aimed to investigate whether in older patients undergoing hemodialysis the association between poor nutritional status and mortality may be independent of comorbidities and other risk factors. DESIGN: Retrospective longitudinal study. SETTING: Unit of Nephrology, Dialysis and Kidney Transplantation of the Policlinic Hospital of Milan, Milan, Italy...

INTRODUCTION: In hemodialysis patients, pain associated with needle insertion into an arteriovenous fistula is a physical and psychological problem. The aim of this study was to assess the effectiveness of pre-puncture application of an ice pack, EMLA cream, or lidocaine spray to reduce pain associated with access puncture. METHODS: This was a multicenter study done in nine hemodialysis centers in Iraq. The study utilized a randomized, parallel-group design, in which patients being dialyzed using an arteriovenous access were allocated into one of four groups...

Precipitation was an important obstacle to improving zinc's bioavailability. Therefore, zinc-whey protein hydrolysate-chitosan oligosaccharide (Zn-WPH-COS) complexes (167 nm) were prepared by linking Zn-WPH (zinc: 18.4%) with COS (1:1, 2 h) to enhance zinc's bioaccessibility. Fourier-transform infrared showed Zn-WPH formed with zinc replaced hydrogen (from 3274 to 3279 cm-1 ) and reacted with COO- (C-N: from 1394 to 1402 cm-1 ), a new peak at 1025 cm-1 proved COS can be successful cross-linked (Zn-WPH-COS)...

Ex-vivo lung perfusion (EVLP) has extended the number of transplantable lungs by reconditioning marginal organs. However, EVLP is performed at 37°C without homeostatic regulation leading to metabolic wastes' accumulation in the perfusate and, as a corrective measure, the costly perfusate is repeatedly replaced during the standard of care procedure. As an interesting alternative, a hemodialyzer could be placed on the EVLP circuit, which was previously shown to rebalance the perfusate composition and to maintain lung function and viability without appearing to impact the global gene expression in the lung...

BACKGROUND: Elderly hemodialysis (HD) patients have a high risk of death. The effect of different types of HD membranes on survival is still controversial. The purpose of this study was to determine the relationship between the use of low-flux or high-flux membranes and all-cause and cardiovascular mortality in elderly hemodialysis patients. METHODS: This was a retrospective clinical study involving maintenance hemodialysis patients which were categorized into low-flux and high-flux groups according to the dialyzer they were using...

This prospective study investigated the relationship between inflammation, damage-associated molecular patterns (DAMPs), and thrombus formation on dialyzer membranes in critically ill patients undergoing renal replacement therapy (RRT) from July 2020 to August 2022, identifying mechanisms and interventions to prevent clotting. The patients were divided into two groups: inflammatory (n = 56, serum C-reactive protein >10 mg/dl) and noninflammatory control (n = 45, serum C-reactive protein <5 mg/dl)...

INTRODUCTION: Patients on hemodialysis, especially with diabetes, face elevated cardiovascular events. A major contributor to complications associated with diabetes is advanced glycation end products (AGEs). Removing these compounds is challenging in traditional hemodialysis. Medium-cut-off (MCO) membranes potentially remove toxins without significant albumin loss. This study explored how MCO membranes impact AGEs levels in uncontrolled diabetic patients undergoing hemodialysis. METHODS: Sixteen patients received MCO membrane dialysis, while others used high-flux (HF) membranes...

Worldwide, the number of elderly individuals receiving chronic hemodialysis is rising. The aim of our study was to evaluate several clinical and analytical biomarkers in chronically dialyzed patients and analyze how they change with age. A cross-sectional study was performed by evaluating 289 end-stage renal disease patients undergoing dialysis. We evaluated the hemogram, adipokines, the lipid profile, and several markers related to inflammation, endothelial function/fibrinolysis, nutrition, iron metabolism, and cardiac and renal fibrosis...

INTRODUCTION: Arteriovenous fistula (AVF) creation during an inpatient hospitalization is often performed for patient convenience and to ensure compliance. We sought to evaluate whether this approach has comparable outcomes to outpatient AVF creation. METHODS: We identified patients undergoing index AVF creation from the United States Renal Data System dataset (2012-2017). Patients were grouped into outpatient and inpatient. Outpatient included patients that were operated in either an outpatient setting, ambulatory surgical center or were admitted inpatient on the day of AVF creation...

BACKGROUND: In-center hemodialysis entails repeated interactions between patients and clinic staff, potentially facilitating the spread of COVID-19. We examined if in-center hemodialysis is associated with the spread of SARS-CoV-2 between patients. METHODS: Our retrospective analysis comprised all patients receiving hemodialysis in four New York City clinics between March 12th, 2020, and August 31st, 2022. Treatment-level clinic ID, dialysis shift, dialysis machine station, and date of COVID-19 diagnosis by RT-PCR were documented...

BACKGROUND: Middle uremic toxins (MUTs) can cause anemia and erythropoietin hyporesponsiveness. Theranova dialyzers may improve anemia management by removing MUTs. Hence, the impact of Theranova dialyzers on erythropoietin responsiveness was studied. METHODS: This exploratory single-center prospective observational study, encompassing 50 patients undergoing dialysis with either the Theranova-400 or FX80 membrane for 6 months, involved monthly tracking of hemoglobin levels, weight-adjusted erythropoiesis-stimulating agent (w-ESA) dosing, and erythropoietin resistance index (ERI), with ESA treatment decisions guided by a proprietary algorithm...

BACKGROUND: The knowledge and attitudes of dialyzed patients toward the best method of renal replacement treatment (ie, kidney transplantation [KTx]) may be the main factor motivating them to apply and be put on the national kidney transplant waiting list, resulting in a better prognosis. OBJECTIVE: Assessment of the knowledge and attitudes of dialyzed patients toward KTx. METHODS: A pilot study is considered an introductory step before the nationwide project, which will cover dialysis centers in Poland from 2023 to 2024...

BACKGROUND: Patients with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) or haemodyalisis (PD) appear to be less physically active than healthy persons, a situation that could lead to reductions in quality of life. The aim of the present study was to assess and compare physical activity and health-related quality of life in renal patients on HD and PD programs. METHODS: In May 2020, 130 patients (106 HD and 24 PD) were enrolled in a study of chronic dialysis programs...

BACKGROUND: Metformin is a biguanide hyperglycemic agent used to manage non-insulin-dependent diabetes mellitus. Adverse reactions include mainly mild gastrointestinal adverse effects, but severe complications, such as metformin-associated lactic acidosis (MALA) can occur. Metformin is excreted renally and, therefore, not recommended in patients with renal impairment. The reported incidence of MALA is 3 cases per 100,000 patient-years. CASE REPORT: A 79-year-old woman with a complex medical history, including end-stage renal disease on dialysis and type 2 diabetes, presented to the emergency department (ED) for altered mental status...

BACKGROUND: Data on 25 [OH] vitamin D and intact parathyroid hormone [iPTH] in hemodialysis patients are very limited in sub-Saharan African countries. The present study aimed to assess the magnitude of hypovitaminosis D, and to evaluate the achievement of iPTH KDIGO 2017 targets among chronic hemodialysis patients followed in Kinshasa. METHODS: We conducted a multicenter cross-sectional study in 6 hospitals in Kinshasa. All patients followed on hemodialysis for more than 3 months were included...

BACKGROUND: New versions of the polyester polymer alloy (PEPA) membrane have appeared over the years, with increases in both the pore size and the amount of polyvinylpyrrolidone (PVP) to optimize hydrophilicity performance. This study aimed to assess the efficacy of the most recently developed PEPA dialyzer, the FDY series, in hemodialysis (HD) modality in terms of uremic toxin removal and albumin loss and to compare it with that of several high-flux dialyzers currently used in HD and post-dilution hemodiafiltration (HDF) treatments...

This review provides a detailed analysis of hemodiafiltration (HDF), its progress from an emerging technique to a potential conventional treatment for chronic hemodialysis patients, and its current status. The article covers the advances, methods, and clinical benefits of HDF, specifically focusing on its impact on cardiovascular health, survival rates, and overall well-being. The review also addresses questions about the safety of HDF and provides evidence to dispel concerns related to the elimination of beneficial substances and infection risks...

BACKGROUND: Chronic kidney disease is a prevalent global health issue, particularly in advanced stages requiring dialysis. Vascular access (VA) quality is crucial for the well-being of hemodialysis (HD) patients, ensuring optimal blood transfer through a dialyzer machine. The ultrasound dilution technique (UDT) is used as the gold standard for assessing VA quality; however, its limited availability due to high costs impedes its widespread adoption. We aimed to develop a novel deep learning model specifically designed to predict VA quality from Photoplethysmography (PPG) sensors...