Removal capacity of different high ‐flux dialyzers during postdilution online hemodiafiltration
Hemodialysis International, EarlyView.
Purpose of review Pruritus is an important, prevalent but often neglected symptom in patients with advanced chronic kidney disease (CKD) or on dialysis. This review addresses the use of activated charcoal and its analogs in the treatment of uremic pruritus, which can be a sign of uremic toxicity. Recent findings When common causes are corrected and dialysis efficiency is optimized, pruritus is mainly ascribed to the retention of middle and protein-bound molecules, of which indoxyl sulfate and p-cresyl sulfate are the best studied. While hemodialysis and hemodiafiltration are of limited use, activated charcoal and its ...
Publication date: Available online 28 November 2019Source: Journal of Membrane ScienceAuthor(s): Danilo Donato, Markus Storr, Bernd KrauseAbstractThe recent development of dialyzers equipped with medium cut-off membranes has made it possible to perform a new technique, termed expanded hemodialysis, in which the removal of middle molecular weight solutes from patients suffering from end-stage kidney disease is increased by enhanced internal filtration, without requiring complex setup and fluid reinfusion, as in hemodiafiltration. A systematic analysis of the effect of all dialyzer design parameters on the rate of internal f...
Conclusion: Continuous hemodiafiltration is probably the best available modality of CRRT to treat hemodynamically unstable and critically ill patients of hepatic failure and/ or hepatorenal syndrome and it should be advocated more frequently. PMID: 31562715 [PubMed - in process]
The population undergoing haemodialysis continues to expand, with an increasing prevalence of elderly dependent patients including those aged>80 years. Despite major advances in technology, long-term clinical outcomes are disappointing, even in low-risk patients. Current definitions of adequacy of dialysis, based on urea clearance, need to be broadened to encompass parameters including middle molecule clearance, salt and water balance, and patient symptoms and well-being. Haemodiafiltration provides improved middle molecule clearance over haemodialysis, with some evidence of improved survival.
Authors: Tapolyai M, Faludi M, Berta K, Forró M, Zsom L, Pethő ÁG, Rosivall L, Fülöp T Abstract Objectives: Diffuse enlargements of arteriovenous dialysis fistulas customarily attributed to either excessive arterial inflow or central outflow stenosis. The relationship between volume status and clinically enlarged (arteriovenous) fistula (CEF) formation in end-stage renal disease (ESRD) patients is not well understood. Methods: We assessed the pre-dialysis bioimpedance spectroscopy-measured percentage of overhydration (OH%) in 13 prevalent dialysis patients with CEF development and negative ...
CONCLUSION: The increase of the surface area from 1.7 to 2.0 m2 in the MCO dialyzer has not meant a greater depurative effectiveness. In these dialyzers the increase of Qb does not seem to be as determinant as in hemodiafiltration except for the clearance of small molecules. PMID: 31104861 [PubMed - as supplied by publisher]
Conclusions: CRRT achieves timely control of hypeammonemic states. Hemodynamic instability necessitating intervention with vasoactive medications is a common finding in patients with hyperammonemia.Blood Purif
Condition: Chronic Kidney Disease Requiring Chronic Dialysis Intervention: Device: on-line hemodiafiltration Sponsors: Maimónides Biomedical Research Institute of Córdoba; Instituto de Salud Carlos III Recruiting