404 results match your criteria session hemodiafiltration

Continuous Renal Replacement Therapy (CRRT) for Nonrenal Indications among Critically Ill Children with Malignancy.

Case Rep Pediatr 2021 13;2021:6660466. Epub 2021 Mar 13.

Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong.

The role of continuous renal replacement therapy (CRRT) has been expanding beyond support for acute kidney injury (AKI) in recent years. Children with malignancy are particularly at risk of developing conditions that may require CRRT. We reported three children with malignancy who received CRRT for non-AKI indications. Read More

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Changes in extracellular water with hemodialysis and fall in systolic blood pressure.

Int J Artif Organs 2021 Feb 20:391398821995503. Epub 2021 Feb 20.

UCL Department of Nephrology, Royal Free Hospital, University College London, London, UK.

Introduction: Intra-dialytic hypotension (IDH) remains the most common complication with outpatient hemodialysis (HD) sessions. As fluid is removed during HD, there is contraction of the extracellular volume (ECW). We wished to determine whether the fall in ECW was associated with a fall in systolic blood pressure (SBP). 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

Quantitative assessment of sodium mass removal using ionic dialysance and sodium gradient as a proxy tool: Comparison of high-flux hemodialysis versus online hemodiafiltration.

Artif Organs 2021 Jan 28. Epub 2021 Jan 28.

Nephrology, University of Montpellier, Montpellier, France.

Restoration and maintenance of sodium are still a matter of concern and remains of critical importance to improve the outcomes in homeostasis of stage 5 chronic kidney disease patients on dialysis. Sodium mass balance and fluid volume control rely on the "dry weight" probing approach consisting mainly of adjusting the ultrafiltration volume and diet restrictions to patient needs. An additional component of sodium and fluid management relies on adjusting the dialysate-plasma sodium concentration gradient. Read More

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January 2021

Low-Intensity Intradialytic Exercise Attenuates the Relative Blood Volume Drop Due to Intravascular Volume Loss during Hemodiafiltration.

Blood Purif 2021 15;50(2):180-187. Epub 2021 Jan 15.

Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.

Introduction: Patients in hemodiafiltration (HDF) eliminate volume overload by ultrafiltration. Vascular volume loss is among the main mechanisms contributing to adverse events such as intradialytic hypotension. Here, we hypothesize that the intradialytic exercise (IDEX) is an intervention that could improve the acute response of physiological mechanisms involved during vascular volume loss. Read More

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January 2021

Water-Soluble Vitamin Levels and Supplementation in Chronic Online Hemodiafiltration Patients.

Kidney Int Rep 2020 Dec 12;5(12):2160-2167. Epub 2020 Sep 12.

Service of Nephrology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Introduction: Supplementation of water-soluble vitamins is a common practice in hemodialysis patients, but dosages are largely based on conventional hemodialysis techniques. The aim of this study was to assess the status of water-soluble vitamins in patients on hemodiafiltration (HDF), and attempt to determine optimal dose of vitamin supplements.

Methods: This monocentric study included 40 patients on thrice-weekly chronic HDF. Read More

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December 2020

Molecular adsorbent recirculating system (MARS) and continuous veno-venous hemodiafiltration (CVVHDF) for diltiazem removal: An in vitro study.

Int J Artif Organs 2020 Dec 1:391398820975041. Epub 2020 Dec 1.

MassSpecLab, Plateforme de Spectrométrie de Masse, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin, Montigny le Bretonneux, France.

The objective of the present study was to evaluate the efficacy of the molecular adsorbent recirculating system (MARS) vs continuous veno-venous hemodiafiltration (CVVHDF). Diltiazem poisoning was simulated in a central compartment consisting in a 5L dialysis solute spiked with diltiazem at two different toxic concentrations: 750 and 5000 µg/L. For CVVHDF, mean extraction coefficients (EC = (in concentration - out concentration)/in concentration) were concentration-dependent with a decrease all along the dialysis. Read More

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December 2020

High volume on line hemodiafiltration in dialysis pregnant patients: predilutional or postdilutional?

J Artif Organs 2020 Nov 19. Epub 2020 Nov 19.

Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany.

Although the frequency of pregnancy in women on chronic dialysis is extremely low, it is associated with severe maternal and perinatal morbidity and mortality. This situation represents a challenge for the therapeutic team, which requires multidisciplinary management, as well as measures to adequate dialysis treatment. Such efforts include increasing the time and frequency of dialysis session, maintaining low uremia levels and ensuring hemodynamic stability by avoiding intra-treatment arterial hypotension and hydro electrolytic fluctuations. Read More

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November 2020

Effect of Kidney Function and Dialysis on the Pharmacokinetics and Pharmacodynamics of Roxadustat, an Oral Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitor.

Eur J Drug Metab Pharmacokinet 2021 Jan;46(1):141-153

Astellas Pharma Europe B.V., Sylviusweg 62, 2333 BE, Leiden, The Netherlands.

Background And Objectives: Roxadustat is an orally active hypoxia-inducible factor prolyl hydroxylase inhibitor for anemia in chronic kidney disease. The pharmacokinetics, metabolic profile, and pharmacodynamics of roxadustat were investigated in subjects with different degrees of kidney function.

Methods: This phase 1 open-label study enrolled subjects with normal and severely impaired kidney function, and end-stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD) or hemodialysis/hemodiafiltration (HD/HDF). Read More

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January 2021

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

Achieving dialysis adequacy: A global perspective.

Semin Dial 2020 11 8;33(6):490-498. Epub 2020 Oct 8.

George Institute for Global Health, UNSW, New Delhi, India.

Dialysis adequacy is conventionally quantified as net urea clearance. Single pool (sp) Kt/V remains the best studied measure of dialysis adequacy globally. Other measures such as fluid status control, anemia correction, and mineral metabolism are monitored variably. Read More

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November 2020

Practice Patterns and Outcomes of Online Hemodiafiltration: A Real-World Evidence Study in a Russian Dialysis Network.

Blood Purif 2020 Sep 23:1-10. Epub 2020 Sep 23.

Fresenius Medical Care, Bad Homburg, Germany,

Background: Evidence suggests that online hemodiafiltration (OL-HDF) is associated with improved survival. Whether the dose-response relationship between convective volume and mortality may be confounded by selection bias or descends from practice patterns is not clear. We sought to evaluate the role of patients' characteristics and practice patterns on OL-HDF dose and mortality in a large private dialysis network in the Republic of Russia. Read More

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September 2020

Multicenter study on the consciousness-regaining effect of a newly developed artificial liver support system in acute liver failure: An on-line continuous hemodiafiltration system.

Hepatol Res 2021 Feb 17;51(2):216-226. Epub 2020 Nov 17.

Department of Gastroenterology, South Miyagi Medical Center, Ohgawara, Japan.

Aim: Acute liver failure (ALF) patients with coma need to be revived not only for spontaneous recovery but also as a bridge to liver transplantation. We developed a new high-volume plasma purification system using an on-line continuous hemodiafiltration (CHDF) system, and evaluated its safety and efficacy in a multicenter study.

Methods: A single arm interventional study using the new apparatus was undertaken in the six major liver centers in Japan. Read More

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February 2021

Renal Data from the Arab World Dialysis in Kuwait: 2013-2019.

Saudi J Kidney Dis Transpl 2020 Jul-Aug;31(4):826-830

Department of Medical Laboratories Faculty of Allied Health Sciences Kuwait University, Jabriya; Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Kuwait.

The total number of end-stage kidney disease patients treated with dialysis in 2019 in Kuwait was 2230, with a 6% increase from the year before. Dialysis prevalence was 465 per million population (PMP) and dialysis incidence was100 PMP. Kuwaiti nationals represented 70% of the dialysis population and males represented 52%. Read More

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Intensive Hemodiafiltration Successfully Removes Ganciclovir Overdose and Largely Exceeds Reported Elimination During Hemodialysis-A Case Report and Review of the Literature.

Front Pharmacol 2020 12;11:882. Epub 2020 Jun 12.

Department of Internal Medicine, Hirslanden Klinik St. Anna, Lucerne, Switzerland.

We present the case of a kidney transplant patient (Cockroft-Gault estimated creatinine clearance 14 ml/min) who was inadvertently eight-fold overdosed with a single dose of 500 mg intravenous ganciclovir. To prevent the immunosuppressed patient from being exposed to severe risks of prolonged ganciclovir overdosing, including potentially fatal bone marrow suppression and severe neurotoxicity, the patient was treated with hemodiafiltration (HDF) to enhance drug elimination. Since the product label reports a 50% decrease of ganciclovir plasma concentrations after intermittent hemodialysis (HD), two HDF sessions were considered necessary to achieve a ≥75% elimination of the drug by precaution, despite targeted intense HDF prescription. Read More

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Hemodiafiltration with ultrafiltrate regeneration reduces free light chains without albumin loss in multiple myeloma patients.

BMC Nephrol 2020 06 15;21(1):227. Epub 2020 Jun 15.

Nephrology Service, Reina Sofia University Hospital, Avenida Menéndez Pidal S/N, 14004, Córdoba, Spain.

Background: Acute kidney injury (AKI) occurs in 12-20% of multiple myeloma (MM) patients. Several studies have shown a reduction of free light chains (FLC) using hemodialysis with High-Cut-Off membranes. However, this technique entails albumin loss. Read More

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A simple method for the calculation of dialysis Kt factor as a quantitative measure of removal efficiency of uremic retention solutes: Applicability to high-dialysate vs low-dialysate volume technologies.

PLoS One 2020 29;15(5):e0233331. Epub 2020 May 29.

Division of Nephrology, Dialysis and Renal Transplantation, ASST GOM Niguarda, Milan, Italy.

Dialysis urea removal metrics may not translate into proportional removal efficiency of non-urea solutes. We show that the Kt factor (plasma volume totally cleared of any solutes) differentiates removal efficiency of non-urea solutes in different technologies, and can easily be calculated by instant blood-dialysate collections. We performed mass balances of urea, creatinine, phosphorus and beta2-microglobulin by whole dialysate collection in 4 low-flux and 3 high-flux hemodialysis, 2 high-volume post-hemodiafiltration and 7 short-daily dialysis with the NxStage-One system. Read More

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Questionnaire survey on the prescription of renal replacement therapy for acute phase patients on maintenance dialysis who developed cerebrovascular disease.

Clin Exp Nephrol 2020 Sep 25;24(9):821-828. Epub 2020 May 25.

Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Background: There is limited information about acute phase renal replacement therapy (RRT) for maintenance hemodialysis patients after the onset of cerebrovascular disease. This study aimed to investigate which modality of renal replacement therapy is currently selected in practice.

Methods: We conducted a mail-based survey in 317 dialysis facilities that were certified by three academic societies that focus on dialysis, neurology, and neurosurgery in Japan. Read More

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September 2020

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

Determining factors for hemodiafiltration to equal or exceed the performance of expanded hemodialysis.

Artif Organs 2020 Oct 5;44(10):E448-E458. Epub 2020 May 5.

Department of Biochemistry, Hospital Clínic Barcelona, Barcelona, Spain.

The aim of the study was to compare expanded hemodialysis (HDx) with hemodiafiltration (HDF) at different infusion flows to identify the main determinants, namely blood flow (Qb), replacement volume, infusion flow (Qi), ultrafiltration flow (Q ), filtration fraction (FF), and the point at which the effectiveness of HDF equals or exceeds that of HDx. We conducted a prospective, single-center study in 12 patients. Each patient underwent 12 dialysis sessions: six sessions with Qb 350 and six with Qb 400 mL/min; with each Qb, one session was with HDx and five sessions were with FX80 (one in HD, and four with Qi 50, 75, 90/100 mL/min or autosubstitution in postdilution HDF). Read More

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October 2020

Evaluation of low-volume post-dilution online hemodiafiltration with Japanese high-performance hemodiafilters.

J Artif Organs 2020 Sep 7;23(3):234-239. Epub 2020 Apr 7.

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

Purpose: To assess the removal performance of low-volume post-hemodiafiltration (HDF) with Japanese hemodiafilters and the removal performance with 20 % reduction in the total dialysate flow rate (Qtotal).

Methods: Subjects were 8 patients undergoing pre-HDF. Study 1: Post-HDF was performed at a blood flow rate (Q) of 250 mL/min and a total volume of substitution fluid (Vs) of 12 L/session(s) for 4 hrs using Fineflux-210Seco (FIX), ABH-21PA (ABH), and NVF-21H (NVF). Read More

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September 2020

Variations in Circulating Active MMP-9 Levels During Renal Replacement Therapy.

Biomolecules 2020 03 26;10(4). Epub 2020 Mar 26.

Cardiorenal Translational Laboratory, Institute of Research i+12 (imas12), Hospital Universitario 12 de Octubre, 28041, Madrid, Spain.

Renal replacement therapy (RRT) is complicated by a chronic state of inflammation and a high mortality risk. However, different RRT modalities can have a selective impact on markers of inflammation and oxidative stress. We evaluated the levels of active matrix metalloproteinase (MMP)-9 in patients undergoing two types of dialysis (high-flux dialysis (HFD) and on-line hemodiafiltration (OL-HDF)) and in kidney transplantation (KT) recipients. Read More

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Enhancement of solute clearance using pulsatile push-pull dialysate flow for the Quanta SC+: A novel clinic-to-home haemodialysis system.

PLoS One 2020 2;15(3):e0229233. Epub 2020 Mar 2.

Quanta Dialysis Technologies Ltd, Alcester, Warwickshire, United Kingdom.

Background And Objective: The SC+ haemodialysis system developed by Quanta Dialysis Technologies is a small, easy-to-use dialysis system designed to improve patient access to self-care and home haemodialysis. A prototype variant of the standard SC+ device with a modified fluidic management system generating a pulsatile push-pull dialysate flow through the dialyser during use has been developed for evaluation. It was hypothesized that, as a consequence of the pulsatile push-pull flow through the dialyser, the boundary layers at the membrane surface would be disrupted, thereby enhancing solute transport across the membrane, modifying protein fouling and maintaining the surface area available for mass and fluid transport throughout the whole treatment, leading to solute transport (clearance) enhancement compared to normal haemodialysis (HD) operation. Read More

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Serum Levels and Removal by Haemodialysis and Haemodiafiltration of Tryptophan-Derived Uremic Toxins in ESKD Patients.

Int J Mol Sci 2020 Feb 23;21(4). Epub 2020 Feb 23.

Fundación Jiménez Díaz University Hospital Health Research Institute, 28040 Madrid, Spain.

Tryptophan is an essential dietary amino acid that originates uremic toxins that contribute to end-stage kidney disease (ESKD) patient outcomes. We evaluated serum levels and removal during haemodialysis and haemodiafiltration of tryptophan and tryptophan-derived uremic toxins, indoxyl sulfate (IS) and indole acetic acid (IAA), in ESKD patients in different dialysis treatment settings. This prospective multicentre study in four European dialysis centres enrolled 78 patients with ESKD. Read More

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February 2020

Evaluation of intradialytic sodium shifts during sodium controlled hemodialysis.

Int J Artif Organs 2020 Sep 4;43(9):620-624. Epub 2020 Feb 4.

EMEA Medical Office, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany.

Plasma sodium shifts during hemodialysis treatments can be minimized by application of a sodium control algorithm. The present randomized cross-over trial was designed to apply this option on a large patient cohort and to observe the time course of plasma sodium over the treatment. In one study phase, patients received post-dilution online hemodiafiltration treatments with sodium control over the entire treatment. Read More

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September 2020

Estimation of residual renal function using beta-trace protein: Impact of dialysis procedures.

Artif Organs 2020 Jun 5;44(6):647-654. Epub 2020 Mar 5.

Département de Biochimie et Hormonologie, PhyMedExp, INSERM, CNRS, Université de Montpellier, CHU de Montpellier, Montpellier Cedex 5, France.

Beta-trace protein (BTP), a low molecular weight protein of 23-29 kDa, has been proposed as a promising biomarker to estimate residual renal function (RRF) in patients on maintenance hemodialysis (HD). Indeed, BTP is cleared by native kidney but not during conventional HD session. By contrast, the removal rate of BTP using convective processes (mainly hemodiafiltration [HDF]) and peritoneal dialysis (PD) has been little or not investigated. Read More

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Acute effect of one session of hemodiafiltration with endogenous reinfusion on uremic toxins and inflammatory mediators.

Int J Artif Organs 2020 Jul 16;43(7):437-443. Epub 2020 Jan 16.

Shanghai Institute of Kidney and Dialysis, Shanghai, China.

Aims: To investigate the acute effects of hemodiafiltration with endogenous infusion on the elimination of uremic toxins and inflammatory mediators in patients with end-stage renal disease.

Materials And Methods: A total of 37 end-stage renal disease patients undergoing chronic hemodialysis received a single hemodiafiltration with endogenous infusion dialysis treatment. The acute effects of one hemodiafiltration with endogenous infusion session on uremic toxins and inflammatory mediators were assessed by comparing the pre- and post-hemodiafiltration with endogenous infusion concentrations. Read More

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Nonadherence to dialysis among saudi patients - Its prevalence, causes, and consequences.

Saudi J Kidney Dis Transpl 2019 Nov-Dec;30(6):1215-1221

Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Dialysis nonadherence among Saudi hemodialysis (HD) patients has not been studied previously. We study its prevalence, causes, and consequences. All chronic HD patients at our center were enrolled. Read More

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A randomized cross-over study with objective quantification of the performance of an asymmetric triacetate and a polysulfone dialysis membrane using different anticoagulation strategies.

Clin Kidney J 2021 Jan 22;14(1):398-407. Epub 2019 Dec 22.

Nephrology Department, Ghent University Hospital, Ghent, Belgium.

Background: Different strategies can be used to counteract coagulation of extracorporeal systems. Systemic anticoagulation is most widely used in routine clinical practice, but can be contraindicated in specific settings. The Solacea dialyser, containing the asymmetric triacetate membrane, claims improved biocompatibility, which should result in decreased tendency for coagulation. Read More

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January 2021