1,216 results match your criteria effects hemodiafiltration

Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study.

Toxins (Basel) 2021 Mar 29;13(4). Epub 2021 Mar 29.

Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.

The aim of this systematic review is to investigate the effects of the use of a medium cut-off membrane (MCO) and dietary fiber on the concentration of protein-bound uremic toxins (PBUTs) and inflammatory markers in hemodialysis (HD) patients. Of 11,397 papers originally found, eight met the criteria of randomized controlled trial design. No study examined the effects of MCO membranes on PBUTs. Read More

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Effectiveness of fibroblast growth factor 23 lowering modalities in chronic kidney disease: a systematic review and meta-analysis.

Int Urol Nephrol 2021 Apr 2. Epub 2021 Apr 2.

Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873 RAMA IV, Bangkok, 10330, Thailand.

Introduction: The heightened fibroblast growth factor 23 (FGF23) level in patients with chronic kidney disease (CKD) is associated with increased cardiovascular disease and mortality. We performed a systematic review and meta-analysis to synthesize the available strategies to reduce FGF23 in CKD patients.

Methods: We conducted a meta-analysis by searching the databases of MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) and single-arm studies that examined the effects of dietary phosphate restriction, phosphate binders, iron supplements, calcimimetics, parathyroidectomy, dialysis techniques, and the outcome of preservation of residual renal function (RRF) on FGF23 levels in CKD patients. Read More

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Arterial Versus Venous Port Site Administration of Nadroparin for Preventing Thrombosis of Extracorporeal Blood Circuits in Patients Receiving Hemodiafiltration Treatment.

Kidney Int Rep 2021 Feb 31;6(2):351-356. Epub 2020 Dec 31.

Global Medical Office, Fresenius Medical Care Deutschland, Bad Homburg, German.

Introduction: Administration of low-molecular-weight heparins (LMWHs) is necessary for preventing extracorporeal circuit thrombosis during hemodialysis. A substantial amount of LMWH is removed with online hemodiafiltration (OL-HDF) when administered through the inlet site of the extracorporeal circuit. Consequently, administration of LMWH at the outlet site appears to be more efficient. Read More

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February 2021

Recombinant Human Thrombomodulin has Additive Effects in Septic Patients Undergoing Continuous Hemodiafiltration due to Intestinal Perforation.

Shock 2021 Feb 15. Epub 2021 Feb 15.

First Department of Surgery, Faculty of Medicine, University of Yamanashi.

Background: Disseminated intravascular coagulation (DIC) is associated with high mortality in patients with severe sepsis. The purpose of this study was to investigate the effects of recombinant human thrombomodulin (rhTM) in septic patients undergoing continuous hemodiafiltration (CHDF). Furthermore, effects of rhTM in acute lung injury, the first target organ in sepsis, was investigated using a sepsis model in rats. Read More

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February 2021

Updates on hemodialysis techniques with a common denominator: The personalization of the dialytic therapy.

Semin Dial 2021 Feb 16. Epub 2021 Feb 16.

Department of Organ Failures and Transplantations, Policlinico S.Orsola-Malpighi- Bologna, Italy.

Hemodialysis (HD) is a life-saving therapy for patients with end-stage renal disease. In dialyzed patients, the prevalence of multi-morbidity is rising driven by various factors, such as the population aging, the incomplete correction of uremia, and the side effects of the dialysis therapy itself. Each dialyzed patient has their own specific clinical and biochemical problems. Read More

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February 2021

Effects of Polymyxin B Hemoperfusion on Septic Shock Patients Requiring Noradrenaline: Analysis of a Nationwide Administrative Database in Japan.

Blood Purif 2021 Feb 12:1-6. Epub 2021 Feb 12.

Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Tokyo, Japan.

Introduction: Polymyxin B hemoperfusion (PMX) reduces endotoxin in septic shock patients' blood and can improve hemodynamics and organ functions. However, its effects on the reduction of septic shock mortality are controversial.

Methods: Using the Japanese diagnosis procedure combination database from April 2016 to March 2019, we identified adult septic shock patients treated with noradrenaline. Read More

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February 2021

Effective glutamate clearance from the systemic circulation by hemodialysis: Potential relevance for cerebral ischemia management.

Artif Organs 2021 Feb 9. Epub 2021 Feb 9.

Servicio de Nefrología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.

High glutamate levels after head trauma or cerebral ischemia have neurotoxic effects. The objective of the present study was to evaluate the efficacy of hemodialysis to remove glutamate from the blood and to assess the behavior of this small molecule. Ten patients with end-renal disease on hemodialysis were included in the study. Read More

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February 2021

Citrate high volume on-line hemodiafiltration modulates serum Interleukin-6 and Klotho levels: the multicenter randomized controlled study "Hephaestus".

J Nephrol 2021 Feb 9. Epub 2021 Feb 9.

Nephrology and Dialysis Unit, ASL Toscana Centro, Empoli, Italy.

Background: Studies addressing the anti-inflammatory properties of citrate dialysate enrolled patients in both hemodialysis (HD) and hemodiafiltration (HDF), the latter not adjusted for adequate convective exchange. This is a potential source of confounding in that HDF itself has anti-inflammatory effects regardless of the buffer, and optimal clinical outcomes are related to the amount of convection.

Methods: To distinguish the merits of the buffer from those of convection, we performed a 6-month, prospective, randomized, crossover AB-BA study. Read More

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February 2021

Combination of Multiple Hemodialysis Modes: Better Treatment Options for Patients Under Maintenance Hemodialysis.

Ther Clin Risk Manag 2021 29;17:127-133. Epub 2021 Jan 29.

Department of Nephrology, The Sixth Medical Center of PLA General Hospital, Beijing, People's Republic of China.

Purpose: Chronic renal failure has become a major public health concern and treatment strategies are urgently needed. We aimed to investigate whether combination of hemodialysis modes was superior to regular hemodialysis for patients under maintenance hemodialysis.

Patients And Methods: A total of 144 patients with end-stage renal failure (ESRF) were enrolled in this single-center retrospective study. Read More

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January 2021

Suspected cholestatic liver injury induced by favipiravir in a patient with COVID-19.

J Infect Chemother 2021 Feb 28;27(2):390-392. Epub 2020 Dec 28.

Division of Pharmacy, Chiba University Hospital, Japan; Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, Chiba University, Japan.

Favipiravir is an antiviral drug that is expected to have a therapeutic effect on SARS-CoV2 infection. Teratogenicity and hyperuricemia are known as the main side effects of favipiravir, but little is known about other side effects. This report describes a case of cholestatic liver injury induced by favipiravir. Read More

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February 2021

Hemodialysis-related headache: Still a challenge in 2020? Effect of conventional versus online hemodiafiltration from a study in Casablanca, Morocco.

Artif Organs 2020 Dec 16. Epub 2020 Dec 16.

Neurology Department, Faculty of Medicine, Cheikh Khalifa Ibn Zayed Hospital, Mohamed VI University of Health Sciences, Casablanca, Morocco.

Hemodialysis-related headache (HRH) is a well-known clinical event. It is considered as one of the most commonly reported neurological symptoms among hemodialysis patients. Its epidemiological, physiological, clinical, and therapeutic data remain scarce and are poorly studied. Read More

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December 2020

Pharmacological Actions of Indoxyl Sulfate and AST-120 That Should Be Recognized for the Strategic Treatment of Patients with Chronic Kidney Disease.

Int J Nephrol Renovasc Dis 2020 4;13:359-365. Epub 2020 Dec 4.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.

Although there are many uremic substances in the body, the most studied and well-known molecule that predominantly binds to plasma proteins is indoxyl sulfate (IS). Many research groups have reported IS to have toxic effects on the kidney and cardiovascular system. It is difficult to remove IS with regular hemodialysis or hemodiafiltration. Read More

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December 2020

Haemoadsorption by CytoSorb® in patients with acute liver failure: A case series.

Int J Artif Organs 2020 Dec 10:391398820981383. Epub 2020 Dec 10.

Fundeni Clinical Institute, Department of General Surgery and Liver Transplantation, Bucharest, Romania.

Acute liver failure (ALF) is a life-threatening disease associated with multi-organ failure and increased mortality. Severe inflammation is now considered the main pathophysiological mechanism for organ dysfunction, thus rebalancing pro- and anti- inflammatory cytokines may improve liver function and outcome. The aim of this study was to assess the clinical effects of a haemoadsorption column on biochemical parameters in patients with ALF. Read More

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December 2020

Development, implementation and outcomes of a quality assurance system for the provision of continuous renal replacement therapy in the intensive care unit.

Sci Rep 2020 11 26;10(1):20616. Epub 2020 Nov 26.

Division of Nephrology, Bone and Mineral Metabolism, Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.

Critically ill patients with requirement of continuous renal replacement therapy (CRRT) represent a growing intensive care unit (ICU) population. Optimal CRRT delivery demands continuous communication between stakeholders, iterative adjustment of therapy, and quality assurance systems. This Quality Improvement (QI) study reports the development, implementation and outcomes of a quality assurance system to support the provision of CRRT in the ICU. Read More

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November 2020

Myoglobin clearance with continuous veno-venous hemodialysis using high cutoff dialyzer versus continuous veno-venous hemodiafiltration using high-flux dialyzer: a prospective randomized controlled trial.

Crit Care 2020 11 11;24(1):644. Epub 2020 Nov 11.

Medical Intensive Care Unit, University Hospital Leipzig, Leipzig, Saxony, Germany.

Background: Myoglobin clearance in acute kidney injury requiring renal replacement therapy is important because myoglobin has direct renal toxic effects. Clinical data comparing different modalities of renal replacement therapy addressing myoglobin clearance are limited. This study aimed to compare two renal replacement modalities regarding myoglobin clearance. Read More

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November 2020

Effect of hemodiafiltration on measured physical activity: primary results of the HDFIT randomized controlled trial.

Nephrol Dial Transplant 2020 Nov 7. Epub 2020 Nov 7.

Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Background: Dialysis patients are typically inactive and their physical activity (PA) decreases over time. Uremic toxicity has been suggested as a potential causal factor of low PA in dialysis patients. Post-dilution high-volume online hemodiafiltration (HDF) provides greater higher molecular weight removal and studies suggest better clinical/patient-reported outcomes compared with hemodialysis (HD). Read More

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November 2020

Effects of intradialytic cycling exercise on daily physical activity, physical fitness, body composition, and clinical parameters in high-volume online hemodiafiltration patients: a pilot randomized-controlled trial.

Int Urol Nephrol 2021 Feb 31;53(2):359-371. Epub 2020 Oct 31.

Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.

Purpose: The mortality of dialysis patients treated with high-volume online hemodiafiltration (OL-HDF) is better than hemodialysis, but is still higher than healthy population. Low daily physical activity increases cardiovascular mortality. Addition of intradialytic exercise (IDX) program might improve physical activity and health status in OL-HDF patients. Read More

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February 2021

Population Pharmacokinetics of Phenobarbital in Neonates and Infants on Extracorporeal Membrane Oxygenation and the Influence of Concomitant Renal Replacement Therapy.

J Clin Pharmacol 2021 Mar 22;61(3):378-387. Epub 2020 Sep 22.

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

The objective of this study was to describe the pharmacokinetics (PK) of intravenous phenobarbital in neonates and infants on extracorporeal membrane oxygenation (ECMO) and to provide dosing recommendations in this population. We performed a retrospective single-center PK study of phenobarbital in neonates and infants on ECMO between January 1, 2014, and December 31, 2018. We developed a population PK model using nonlinear mixed-effects modeling, performed simulations using the final PK parameters, and determined optimal dosing based on attainment of peak and trough concentrations between 20 and 40 mg/L. Read More

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Public health benefits of water purification using recycled hemodialyzers in developing countries.

Sci Rep 2020 07 6;10(1):11101. Epub 2020 Jul 6.

Easy Water for Everyone, 10 Bank Street, Suite 560, White Plains, NY, 10606, USA.

In rural regions with limited resources, the provision of clean water remains challenging. The resulting high incidence of diarrhea can lead to acute kidney injury and death, particularly in the young and the old. Membrane filtration using recycled hemodialyzers allows water purification. Read More

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Impact of the angle between aortic and mitral annulus on the occurrence of hemolysis during Impella support.

J Artif Organs 2020 Sep 14;23(3):207-213. Epub 2020 May 14.

Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama, 930-0194, Japan.

Despite optimal management, we sometimes experience refractory hemolysis requiring extensive device speed reduction or continuous hemodiafiltration following Impella implantation. However, pre-procedural predictors of such a refractory hemolysis remain unknown. In this study, we investigated the pre-procedural factors, including the echocardiographic narrow angle between aortic and mitral annulus, associating with the occurrence of refractory hemolysis following Impella insertion. Read More

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September 2020

Randomized controlled trial of medium cut-off versus high-flux dialyzers on quality of life outcomes in maintenance hemodialysis patients.

Sci Rep 2020 05 8;10(1):7780. Epub 2020 May 8.

Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.

Medium cut-off (MCO) dialyzers help remove larger middle molecules associated with symptoms related to the accumulation of uremic retention solutes. We investigated the effect of an MCO dialyzer on the improvement of quality of life (QOL) in maintenance hemodialysis (HD) patients. Forty-nine HD patients with high-flux dialysis were randomly assigned to either an MCO (Theranova 400, Baxter) or a high-flux (FX CorDiax 80 or 60, Fresenius Medical Care) dialyzer and completed the study. Read More

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Dialysis patients who smoke are more hypertensive, more fluid overloaded and take more antihypertensive medications than nonsmokers.

Ren Fail 2020 Nov;42(1):413-418

Ralph H. Johnson VA Medical Center, Charleston, SC, USA.

Smoking remains a powerful risk factor for death in end-stage renal disease (ESRD) and so is the presence of fluid overload. The relationship between smoking, blood pressure (BP) control and volume overload is insufficiently explored in patients on maintenance dialysis. This is a retrospective cross-sectional cohort study, utilizing existing patients' data generated during routine ESRD care, including bimonthly protocol bioimpedance fluid assessment of the volume status. Read More

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November 2020

The effect of hemodialysis on N-terminal pro-brain natriuretic peptide: A systematic review and meta-analysis.

Am J Emerg Med 2020 Apr 1. Epub 2020 Apr 1.

Department of Emergency Internal Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China. Electronic address:

Background: N-terminal pro-brain natriuretic peptide (NT-pro BNP) increases in patients with heart failure and renal failure. Hemodialysis is a useful treatment to these patients. The aim of this study was to conduct a systematic and meta-analysis to evaluate the influence of hemodialysis on NT-pro BNP concentration. Read More

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Differences and Effects of Metabolic Fate of Individual Amino Acid Loss in High-Efficiency Hemodialysis and Hemodiafiltration.

J Ren Nutr 2020 09 14;30(5):440-451. Epub 2020 Apr 14.

Treatment Study Group of Chronic Renal Disease of Italian Society of Nephrology, Cagliari, Italy. Electronic address:

Objective: The objective of the study was to quantify the loss and arterial blood concentration of the three main classes of amino acids (AAs)-nonessential amino acids (NEAAs), essential amino acids (EAAs), and branched-chain amino acids-as resulting from high-efficiency hemodialysis (HED) and hemodiafiltration (HDF). We moreover aimed to identify the different fates and metabolic effects manifested in patients undergoing hemodialysis and the consequences on body composition and influence of nutritional decline into protein energy wasting.

Design And Methods: Identical dialysis monitors, membranes, and dialysate/infusate were used to ensure consistency. Read More

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September 2020

Protein-Bound Uremic Toxins in Hemodialysis Patients Relate to Residual Kidney Function, Are Not Influenced by Convective Transport, and Do Not Relate to Outcome.

Toxins (Basel) 2020 04 7;12(4). Epub 2020 Apr 7.

Department of Nephrology and Hypertension, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.

Protein-bound uremic toxins (PBUTs) are predominantly excreted by renal tubular secretion and hardly removed by traditional hemodialysis (HD). Accumulation of PBUTs is proposed to contribute to the increased morbidity and mortality of patients with end-stage kidney disease (ESKD). Preserved PBUT excretion in patients with residual kidney function (RKF) and/or increased PBUT clearance with improved dialysis techniques might improve the prognosis of patients with ESKD. Read More

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Therapeutic effect of high-efficiency online hemodiafiltration for recurrent restless legs syndrome in dialysis patients.

J Artif Organs 2020 Sep 30;23(3):296-301. Epub 2020 Mar 30.

Hashimoto Clinic, 3-21-5 Hashimoto Midori-ku, Sagamihara, Kanagawa, 252-0143, Japan.

Two dialysis patients developed recurrent restless legs syndrome. The clinical courses and the association between the α-microglobulin removal rate and the therapeutic effects of hemodiafiltration were analyzed. Case 1: a middle-aged woman was switched from predilution online hemodiafiltration to hemodialysis, following which the α-microglobulin removal rate decreased from 39. Read More

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September 2020

Effect of Low-Sodium versus Conventional Sodium Dialysate on Left Ventricular Mass in Home and Self-Care Satellite Facility Hemodialysis Patients: A Randomized Clinical Trial.

J Am Soc Nephrol 2020 05 18;31(5):1078-1091. Epub 2020 Mar 18.

Department of Renal Medicine, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.

Background: Fluid overload in patients undergoing hemodialysis contributes to cardiovascular morbidity and mortality. There is a global trend to lower dialysate sodium with the goal of reducing fluid overload.

Methods: To investigate whether lower dialysate sodium during hemodialysis reduces left ventricular mass, we conducted a randomized trial in which patients received either low-sodium dialysate (135 mM) or conventional dialysate (140 mM) for 12 months. Read More

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Comparison of the effects of hemodialysis and hemodiafiltration on left ventricular hypertrophy in end-stage renal disease patients: A systematic review and meta-analysis.

Semin Dial 2020 03 11;33(2):120-126. Epub 2020 Mar 11.

Fondazione Policlinico Agostino Gemelli IRCCS, University Hospital, Università Cattolica del Sacro Cuore, Rome.

Whether hemodiafiltration (HDF) is better than conventional hemodialysis (HD) in improving left ventricular hypertrophy (LVH), defined as reduction of the left ventricular mass index (LVMi) and increasing the ejection fraction (EF), is unclear. A systematic literature search was performed. Primary outcome was the mean difference between pre- and post-procedural LVMi. Read More

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New Intravenous Calcimimetic Agents: New Options, New Problems. An Example on How Clinical, Economical and Ethical Considerations Affect Choice of Treatment.

Int J Environ Res Public Health 2020 02 14;17(4). Epub 2020 Feb 14.

Nephrology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy.

Background: Dialysis treatment is improving, but several long-term problems remain unsolved, including metabolic bone disease linked to chronic kidney disease (CKD-MBD). The availability of new, efficacious but expensive drugs (intravenous calcimimetic agents) poses ethical problems, especially in the setting of budget limitations.

Methods: Reasons of choice, side effects, biochemical trends were discussed in a cohort of 15 patients (13% of the dialysis population) who stared treatment with intravenous calcimimetics in a single center. Read More

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February 2020

Population Pharmacokinetic Analysis of Meropenem in Critically Ill Patients With Acute Kidney Injury Treated With Continuous Hemodiafiltration.

Ther Drug Monit 2020 08;42(4):588-594

Division of Pharmacy, University Hospital.

Background: The aim of this study was to conduct a population pharmacokinetic (PK) analysis of meropenem and to explore the optimal dosing strategy for meropenem in critically ill patients with acute kidney injury receiving treatment with continuous hemodiafiltration (CHDF).

Methods: Blood samples were obtained on days 1, 2, and 5 after the start of meropenem administration, immediately before dosing, and at 1, 2, 6, and 8 hours after dosing. Population PK model analysis was performed and concentration-time profiles were simulated using the Nonlinear Mixed Effects Model software. Read More

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