Charcoal for the management of pruritus and uremic toxins in patients with chronic kidney disease

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 analogs offer interesting alternatives. Oral preparations are associated with symptom improvement and a better metabolic pattern, probably via a combination of absorption and modification of the intestinal microbiota. Large studies, in well phenotyped populations, are needed. Hemoperfusion, commonly used in poisoning and intoxication, could be an interesting alternative in hemodialysis patients. The treatment has proved promising in some preliminary and small studies; more research is now needed to test its validity. Summary Oral activated charcoal and hemoperfusion can be proposed to patients with severe refractory pruritus based on positive, albeit scattered evidence. They also contribute to reducing uremic toxins. Research on their implementation associated with well established treatments is needed to understand whether they can be used as ‘urem...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Kamyar Kalantar-Zadeh and Ekamol Tantisattamo Source Type: research

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ConclusionP. karwinskii leaf extract inhibited reactive oxygen species and exerted an anti-inflammatory effect. Moreover, this extract did not induce gastric damage in the animals. The bioactivity of the species was found to support its traditional use in traditional medicine. This orchid could be used to treat inflammatory diseases without causing the side effects associated with Nonsteroidal anti-inflammatory drugs. It can also be employed to treat other pathological conditions associated with oxidative stress. The findings herein form the basis for the future discovery of natural products that may serve as safe alternat...
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: Dialysis was not an inhibitory factor affecting outcomes during subacute rehabilitation in patients with stroke. Rehabilitation should be considered for patients with subacute stroke requiring haemodialysis, in order to provide every opportunity to achieve adequate functional outcomes. PMID: 31974589 [PubMed - as supplied by publisher]
Source: Journal of Rehabilitation Medicine - Category: Rehabilitation Tags: J Rehabil Med Source Type: research
This study identified ANRIL as a critical regulator in HPASMCs induced by hypoxia and demonstrated the potential of gene therapy and drug development for treating PAH. PMID: 31974617 [PubMed - in process]
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
CONCLUSION: Riociguat improves functional NYHA class, distance in the 6MWD test and quality of life in a real-world patient population. PMID: 31974533 [PubMed - as supplied by publisher]
Source: Biomedical Papers of the Medical Faculty of the Univ Palacky Olomouc Czech Repub - Category: Biomedical Science Tags: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Source Type: research
Publication date: Available online 25 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Zhi-Huang Qiu, Liang-Wan Chen, Lian-Ming Liao, Jun Xiao, Xiao-Fu Dai, Guan-Hua Fang, Liang-Liang Yan, Qing-Song Wu, Quan-Fang LuoAbstractBackgroundThe efficacy of hemiarch replacement combined with a modified triple-branched stent graft in Debakey type I aortic dissection remains to be confirmed.MethodsFrom January 2016 to December 2017, 167 patients with acute Debakey type I aortic dissection underwent hemiarch replacement combined with a modified triple-branched stent graft. The clinical and imaging data were retrospectivel...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: Available online 25 January 2020Source: Radiation Physics and ChemistryAuthor(s): S.S. Mustafa, E.A. AminAbstractEarly commercial PWR first cores started up without using burnable absorbers. This results in short first core cycle lengths, positive moderator temperature coefficients and high relative power peaking. Burnable absorbers are introduced to address these first core limitations. In the present work, the first part studies the effect of boron (as burnable poisons) concentration on a number of the small modular reactor assembly neutronic parameters. Among these parameters are the infinite multiplic...
Source: Radiation Physics and Chemistry - Category: Physics Source Type: research
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusions: Our study suggested that incident CHD was positively associated with plasma levels of titanium and arsenic, and inversely associated with selenium. Additional research is needed to confirm these findings in other populations. https://doi.org/10.1289/EHP1521 Received: 22 December 2016 Revised: 17 September 2017 Accepted: 19 September 2017 Published: 19 October 2017 Address correspondence to T. Wu, or A. Pan, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd., Wuhan 430030, Hubei, China. Telephone: +86-27-83692347. Email: wut@mails.tjmu.edu.cn or p...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
We examined the association between environmental exposures to lead, mercury, and cadmium and the risk of hearing loss in adults and adolescents while controlling for potential confounding factors, including noise exposures and clinical factors. Methods: We analyzed cross-sectional data from 5,187 adults and 853 adolescents in the Korean National Health and Nutrition Examination Survey 2010–2012. Pure-tone average (PTA) of hearing thresholds at high frequency (3, 4, and 6 kHz) were computed, and hearing loss was defined as a PTA>25 dB in adults and PTA>15 dB in adolescents. Results: In adults, the...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
The recent news about lead exposure from city water in Flint, Michigan, has renewed many people's concerns about an environmental cause of kidney disease. For years, extraordinary efforts have been made to eradicate environmental lead exposure by eliminating lead based gasoline, stopping the sale of lead based paints, removing lead based paint from older homes, and monitoring of blood lead levels in children and the public by local health departments. All of these activities have resulted in consistently fewer reports of lead-associated kidney disease. Environmental exposure from lead in water has only recently been recogn...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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