PTH assays in dialysis patients: Practical considerations
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - August 31, 2018 Category: Hematology Authors: Mohanad Soliman , Waleed Hassan , Maria Yaseen , Madhumathi Rao , B. Peter Sawaya , Amr El ‐Husseini Source Type: research

PTH assays in dialysis patients: Practical considerations.
Abstract Parathyroid hormone (PTH) 1-84 is the main biologically active hormone produced by the parathyroid cells. Circulating PTH molecules include the whole PTH 1-84 along with amino (N) and carboxyl (C) terminal fragments. While PTH is the best available noninvasive biomarker to assess bone turnover in dialysis patients, the biological roles of individual circulating PTH fragments are still not completely known. The understanding that there is an enormous variation in the target specificity of currently available PTH assays for different circulating forms of PTH has led to the evolution of assays from first to ...
Source: Seminars in Dialysis - August 30, 2018 Category: Urology & Nephrology Authors: Soliman M, Hassan W, Yaseen M, Rao M, Sawaya BP, El-Husseini A Tags: Semin Dial Source Type: research

Boundaries of frequency and treatment time in conventional hemodialysis: Balancing convenience, economics, and health outcomes
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - August 10, 2018 Category: Hematology Authors: Clare B. Jones , Christopher T. Chan Source Type: research

Boundaries of frequency and treatment time in conventional hemodialysis: Balancing convenience, economics, and health outcomes.
Abstract Since the inception of hemodialysis (HD) for patients with chronic kidney disease, the "perfect" dialysis prescription has remained elusive. Part of this may relate to the heterogeneity among populations, individual patients, and differences in access to health provision. The optimal balance between dialysis frequency and duration to achieve reductions in patient morbidity and mortality continues to be debated. The concept of dialysis adequacy originated from a post hoc mathematical analysis of the National Cooperative Study and has evolved to become a way of calculating dialysis dose and standa...
Source: Seminars in Dialysis - August 9, 2018 Category: Urology & Nephrology Authors: Jones CB, Chan CT Tags: Semin Dial Source Type: research

Blood pressure control in conventional hemodialysis
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - August 7, 2018 Category: Hematology Authors: Panagiotis I. Georgianos , Rajiv Agarwal Source Type: research

Blood pressure control in conventional hemodialysis.
Abstract Hypertension among patients on hemodialysis is common, difficult to diagnose and often inadequately controlled. Although specific blood pressure (BP) targets in this particular population are not yet established, meta-analyses of randomized trials showed that deliberate BP-lowering with antihypertensive drugs improves clinical outcomes in hemodialysis patients. BP-lowering in these individuals should initially utilize nonpharmacological strategies aiming to control sodium and volume overload. Accordingly, restricting dietary sodium intake, eliminating intradialytic sodium gain via individualized dialysate...
Source: Seminars in Dialysis - August 6, 2018 Category: Urology & Nephrology Authors: Georgianos PI, Agarwal R Tags: Semin Dial Source Type: research

When the color of peritoneal dialysis effluent can be used as a diagnostic tool
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 22, 2018 Category: Hematology Authors: Thomas Dossin , Eric Goffin Source Type: research

When the source of inflammation is hiding in plain sight: Failed kidney transplants, clotted arteriovenous grafts, and central venous catheters
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 22, 2018 Category: Hematology Authors: Steven G. Achinger , Juan Carlos Ayus Source Type: research

When the source of inflammation is hiding in plain sight: Failed kidney transplants, clotted arteriovenous grafts, and central venous catheters.
Abstract Cardiovascular mortality accounts for most deaths among hemodialysis patients and far exceeds the cardiovascular mortality rate of the general population. One important aspect of cardiovascular risk among dialysis patients is chronic inflammation. Iatrogenic sources of chronic inflammation in the form of failed renal allografts, old clotted arteriovenous grafts, and hemodialysis catheters play important, sometimes, unrecognized roles in this inflammatory state. There is ample observational evidence that these sources of inflammation are associated with hypoalbuminemia, erythropoetin-resistant anemia, and ...
Source: Seminars in Dialysis - July 22, 2018 Category: Urology & Nephrology Authors: Achinger SG, Ayus JC Tags: Semin Dial Source Type: research

When the color of peritoneal dialysis effluent can be used as a diagnostic tool.
Abstract Peritoneal dialysis (PD) effluent is normally transparent. A change in its appearance may be the first indication of an intra- or extraperitoneal abnormality which may or may not be related to the peritoneal dialysis technique itself. What diagnosis should be considered when PD effluent turns on red, orange, cloudy, milky white, green, yellow, purple or black in color? After review of the literature, we propose a differential diagnosis, as well as some management recommendations, for specific abnormal color presentations of the PD effluent. PMID: 30032485 [PubMed - as supplied by publisher] (Source: ...
Source: Seminars in Dialysis - July 22, 2018 Category: Urology & Nephrology Authors: Dossin T, Goffin E Tags: Semin Dial Source Type: research

Dialysate potassium concentration: Should mass balance trump electrophysiology?
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 20, 2018 Category: Hematology Authors: Patrick H. Pun Source Type: research

Dialysate potassium concentration: Should mass balance trump electrophysiology?
Abstract Nephrologists are faced with a difficult dilemma in choosing the ideal dialysis prescription to maintain neutral potassium mass balance. Should potassium mass balance goals prioritize the normalization of serum potassium levels using low potassium dialysate at the expense of provoking intradialytic arrhythmias, or should mass balance goals favor permissive hyperkalemia using higher dialysate potassium to avoid rapid intradialytic fluxes at the risk of more interdialytic arrhythmias? This review examines the factors that determine potassium mass balance among HD patients, the relationships between serum an...
Source: Seminars in Dialysis - July 19, 2018 Category: Urology & Nephrology Authors: Pun PH Tags: Semin Dial Source Type: research

Managing protein ‐energy wasting in hemodialysis patients: A comparison of animal‐ and plant‐based protein foods
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 16, 2018 Category: Hematology Authors: David E. St ‐Jules , David S. Goldfarb , Collin J. Popp , Mary Lou Pompeii , Scott E. Liebman Source Type: research

Treatment of secondary hyperparathyroidism: How do cinacalcet and etelcalcetide differ?
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 16, 2018 Category: Hematology Authors: Keith E. Eidman , James B. Wetmore Source Type: research

Treatment of secondary hyperparathyroidism: How do cinacalcet and etelcalcetide differ?
Abstract Secondary hyperparathyroidism (SHPT), commonly encountered in patients receiving maintenance dialysis, is associated with numerous adverse outcomes, including mortality. Calcimimetics, agents that act on the calcium sensing receptor (CaSR), were designed to overcome limitations in the use of vitamin D sterols to treat SHPT, and have demonstrated efficacy in reducing levels of PTH in randomized trials. Currently available calcimimetics include oral cinacalcet and the recently approved intravenously administered agent, etelcalcetide. While cinacalcet is an allosteric modulator of the CaSR, etelcalcetide act...
Source: Seminars in Dialysis - July 15, 2018 Category: Urology & Nephrology Authors: Eidman KE, Wetmore JB Tags: Semin Dial Source Type: research

Managing protein-energy wasting in hemodialysis patients: A comparison of animal- and plant-based protein foods.
Abstract Protein-energy wasting (PEW) is a major diet-related complication in hemodialysis (HD) patients. Nutrient-based dietary guidelines emphasize animal-based protein foods for preventing and managing PEW in HD patients. Although dietary protein intake is important for protein anabolism, other dietary factors contribute to PEW. In this article, we examine the diet-related etiologies of PEW in HD patients, and discuss how they may be affected differently by animal- and plant-based protein foods. In general, animal foods are superior sources of protein, but may contribute more to metabolic derangements that caus...
Source: Seminars in Dialysis - July 15, 2018 Category: Urology & Nephrology Authors: St-Jules DE, Goldfarb DS, Popp CJ, Pompeii ML, Liebman SE Tags: Semin Dial Source Type: research

The physiology of uric acid and the impact of end-stage kidney disease and dialysis.
Abstract Uric acid-mediated biological effects are milieu dependent. In a physiological milieu, serum uric acid serves as an antioxidant; when homeostasis is perturbed, divergent effects are observed depending on the clinical context. Several epidemiologic studies indicated the presence of a direct relationship between higher concentrations of serum uric acid and cardiovascular mortality; yet not all studies support this conclusion. Although high serum levels of uric acid are associated with higher mortality in patients with nondialysis-dependent chronic kidney disease and perhaps in those with end-stage kidney di...
Source: Seminars in Dialysis - July 10, 2018 Category: Urology & Nephrology Authors: Murea M, Tucker BM Tags: Semin Dial Source Type: research

The physiology of uric acid and the impact of end ‐stage kidney disease and dialysis
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 10, 2018 Category: Hematology Authors: Mariana Murea , Bryan M. Tucker Source Type: research

Briefly Noted
Seminars in Dialysis,Volume 31, Issue 4, Page 430-431, July/August 2018. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 6, 2018 Category: Hematology Authors: Richard A. Sherman Source Type: research

Issue Information
Seminars in Dialysis,Volume 31, Issue 4, Page 311-312, July/August 2018. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 6, 2018 Category: Hematology Source Type: research

Introduction to unresolved issues in the care of dialysis patients
Seminars in Dialysis,Volume 31, Issue 4, Page 313-314, July/August 2018. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - July 6, 2018 Category: Hematology Authors: Anna T. Mathew , Steven Fishbane Source Type: research

Introduction to unresolved issues in the care of dialysis patients.
PMID: 29978602 [PubMed - in process] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - July 1, 2018 Category: Urology & Nephrology Authors: Mathew AT, Fishbane S Tags: Semin Dial Source Type: research

When should iron supplementation in dialysis patients be avoided, minimized or withdrawn?
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 29, 2018 Category: Hematology Authors: Guy Rostoker Source Type: research

When should iron supplementation in dialysis patients be avoided, minimized or withdrawn?
Abstract Parenteral iron is used to restore the body's iron pool before and during erythropoiesis-stimulating agent (ESA) therapy; together these agents form the backbone of anemia management in end-stage renal disease (ESRD) patients undergoing hemodialysis. ESRD patients receiving chronic intravenous iron products, which exceed their blood loss are exposed to an increased risk of positive iron balance. Measurement of the liver iron concentration (LIC) reflects total body iron stores in patients with secondary hemosiderosis and genetic hemochromatosis. Recent studies of LIC in hemodialysis patients, measured by q...
Source: Seminars in Dialysis - June 28, 2018 Category: Urology & Nephrology Authors: Rostoker G Tags: Semin Dial Source Type: research

Serum albumin, inflammation, and nutrition in end-stage renal disease: C-reactive protein is needed for optimal assessment.
We reported that a low S-Alb concentration was an independent risk factor for poor outcome in ESRD only in the presence of systemic inflammation. Moreover, the relationships between inflammatory biomarkers and outcome are confounded also by alterations in body composition (such as obese sarcopenia) and oxidative stress. Taken together, S-Alb alone should not be used as a proxy of the nutritional status in a dialysis patient. Its association with dietary intake is poor and low S-Alb values are most often non-nutritional in origin. When analyzing S-Alb to predict mortality risk in ESRD, it should always be combined with meas...
Source: Seminars in Dialysis - June 21, 2018 Category: Urology & Nephrology Authors: Mukai H, Villafuerte H, Qureshi AR, Lindholm B, Stenvinkel P Tags: Semin Dial Source Type: research

Serum albumin, inflammation, and nutrition in end ‐stage renal disease: C‐reactive protein is needed for optimal assessment
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 21, 2018 Category: Hematology Authors: Hideyuki Mukai , Hilda Villafuerte , Abdul Rashid Qureshi , Bengt Lindholm , Peter Stenvinkel Source Type: research

Dietary protein and nutritional supplements in conventional hemodialysis
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 17, 2018 Category: Hematology Authors: Alice Sabatino , Giovanni Piotti , Carmela Cosola , Ilaria Gandolfini , Jeroen  P. Kooman , Enrico Fiaccadori Source Type: research

Anemia in conventional hemodialysis: Finding the optimal treatment balance
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 17, 2018 Category: Hematology Authors: Takeshi Hasegawa , Fumihiko Koiwa , Tadao Akizawa Source Type: research

Anemia in conventional hemodialysis: Finding the optimal treatment balance.
Abstract Renal anemia is a serious and common complication in hemodialysis (HD) patients. The introduction of erythropoiesis-stimulating agents (ESAs) has dramatically improved hemoglobin levels and outcomes. Several interventional studies reported that excessive correction of anemia and the massive use of ESA can trigger cardiovascular disease (CVD), and consequently may worsen the prognosis of patients undergoing HD. Therefore, it has been widely recognized that large doses of ESA should be used with caution. An effective use of iron preparations is required to yield the optimal effect of ESA. It is well-known t...
Source: Seminars in Dialysis - June 17, 2018 Category: Urology & Nephrology Authors: Hasegawa T, Koiwa F, Akizawa T Tags: Semin Dial Source Type: research

Dietary protein and nutritional supplements in conventional hemodialysis.
Abstract Protein energy wasting (PEW) is a condition commonly occurring among patients with ESRD on hemodialysis. PEW is characterized by depletion of protein and energy stores and is caused by multiple factors related to chronic kidney disease, acute and chronic comorbidities and by renal replacement therapy itself. Anorexia is central in the pathogenesis of PEW; it is frequently observed in these patients whose protein and energy intakes are typically lower than guidelines recommendations. If untreated, PEW invariably leads to major complications, and may activate a vicious circle with further worsening of nutri...
Source: Seminars in Dialysis - June 17, 2018 Category: Urology & Nephrology Authors: Sabatino A, Piotti G, Cosola C, Gandolfini I, Kooman JP, Fiaccadori E Tags: Semin Dial Source Type: research

Mineral and bone disorders in conventional hemodialysis: Challenges and solutions
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 14, 2018 Category: Hematology Authors: Takayuki Hamano Source Type: research

Hepatitis E virus infection in hemodialysis patients: A prospective analysis
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 13, 2018 Category: Hematology Authors: Mar ía Belén Pisano , James Leathers , Domingo C. Balderramo , Fernando Diehl , Andrea Bolomo , Pehuen Fernández , Maribel Martínez‐Wassaf , Carla Cristani , Guadalupe Di Cola , Jorge De la Fuente , José D. Debes , Viviana E. Source Type: research

Hemodialysis ‐related amyloidosis: Is it still relevant?
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 13, 2018 Category: Hematology Authors: Shuzo Kaneko , Kunihiro Yamagata Source Type: research

Mineral and bone disorders in conventional hemodialysis: Challenges and solutions.
Abstract Despite the advent of cinacalcet and noncalcium-containing phosphate binders, controlling the progression of vascular calcification (VC) is still challenging. Recent reports demonstrate that carbamylation driven by high urea concentration aggravates VC, suggesting the importance of adequate dialysis in retarding its progression. Theoretically, other promising measures include the use of iron-based phosphate binders, vitamin K, and magnesium supplements, which should be investigated in future randomized controlled trials (RCTs), ideally with hard outcomes. While incidence of hip fracture in patients on dia...
Source: Seminars in Dialysis - June 13, 2018 Category: Urology & Nephrology Authors: Hamano T Tags: Semin Dial Source Type: research

Hepatitis E virus infection in hemodialysis patients: A prospective analysis.
JD, E Ré V PMID: 29896768 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - June 12, 2018 Category: Urology & Nephrology Authors: Pisano MB, Leathers J, Balderramo DC, Diehl F, Bolomo A, Fernández P, Martínez-Wassaf M, Cristani C, Di Cola G, De la Fuente J, Debes JD, E Ré V Tags: Semin Dial Source Type: research

Hemodialysis-related amyloidosis: Is it still relevant?
Abstract Accumulation of amyloid fibrils from β2-microglobulin (β2M) was first recognized as a characteristic osteoarticular complication in long-term hemodialysis (HD) patients and called "HD-related amyloidosis" (HRA). However, this syndrome can also be observed in end-stage renal diseases (ESRD) patients undergoing peritoneal dialysis, and even in patients with chronic renal failure before the initiation of dialytic therapy, suggesting that HD is not a direct cause but that accumulation of β2M or some β2M-associated molecules in the body is a common pathogenesis. Currently the term...
Source: Seminars in Dialysis - June 12, 2018 Category: Urology & Nephrology Authors: Kaneko S, Yamagata K Tags: Semin Dial Source Type: research

Ultrafiltration rate in conventional hemodialysis: Where are the limits and what are the consequences?
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 9, 2018 Category: Hematology Authors: Yelena Slinin , Megha Babu , Areef Ishani Source Type: research

Dialysate bicarbonate concentration: Too much of a good thing?
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 9, 2018 Category: Hematology Authors: Carlo Basile , Luigi Rossi , Carlo Lomonte Source Type: research

Dialysate bicarbonate concentration: Too much of a good thing?
Abstract Acid-base equilibrium is a complex and vital system whose regulation is impaired in chronic kidney disease (CKD). Metabolic acidosis is a common complication of CKD. It is typically due to the accumulation of sulfate, phosphorus, and organic anions. Metabolic acidosis is correlated with several adverse outcomes, such as morbidity, hospitalization and mortality. In patients undergoing hemodialysis, acid-base homeostasis depends on many factors: net acid production, amount of alkali given by the dialysate bath, duration of interdialytic period, as well as residual diuresis, if any. Recent literature data su...
Source: Seminars in Dialysis - June 8, 2018 Category: Urology & Nephrology Authors: Basile C, Rossi L, Lomonte C Tags: Semin Dial Source Type: research

Ultrafiltration rate in conventional hemodialysis: Where are the limits and what are the consequences?
CONCLUSION: Evidence supporting UFR limits is weak and confounded. Randomized controlled trials are needed before UFR can be used as a quality of care indicator. PMID: 29885084 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - June 8, 2018 Category: Urology & Nephrology Authors: Slinin Y, Babu M, Ishani A Tags: Semin Dial Source Type: research

Dry weight targeting: The art and science of conventional hemodialysis
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 7, 2018 Category: Hematology Authors: Yasushi Ohashi , Ken Sakai , Hiroki Hase , Nobuhiko Joki Source Type: research

Dry weight targeting: The art and science of conventional hemodialysis.
Abstract Fluid volume overload is common and is associated with adverse outcomes in hemodialysis patients. Practicing physicians individually manage fluid volume balance in their dialysis patients according to blood pressure, interdialytic weight gain, cardiac function, nutritional status, and other comorbidities. However, accurate assessment of fluid volume status remains a concern. Indicators of dry weight target have been explored further with newer concepts and technologies. In general, total body water comprises approximately 50%-60% of adult body weight (range, 45%-75%), and water comprises 73.3% of lean bod...
Source: Seminars in Dialysis - June 6, 2018 Category: Urology & Nephrology Authors: Ohashi Y, Sakai K, Hase H, Joki N Tags: Semin Dial Source Type: research

How arteriovenous grafts could help to optimize vascular access management
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - June 1, 2018 Category: Hematology Authors: Anatole Besarab , Lalathaksha Kumbar Source Type: research

How arteriovenous grafts could help to optimize vascular access management.
Abstract A one-size-fits-all approach to vascular access for dialysis may be prejudicial. Arteriovenous fistulae (AVF) have high primary failure, failure to mature rate, and late-stage complications making them unsuitable choice for many patients. Aging of population with chronic kidney disease (CKD) coupled with venous injury during CKD stages depletes suitable superficial veins for AVF creation. The National Institutes of Health consortium demonstrated the difficulty in attaining a functional AVF in hemodialysis patients. Recognition of flaws in AVF and the quest to reduce catheter use bring to the fore the bene...
Source: Seminars in Dialysis - June 1, 2018 Category: Urology & Nephrology Authors: Besarab A, Kumbar L Tags: Semin Dial Source Type: research

Assessment and misassessment of potassium, phosphorus, and protein in the hemodialysis diet
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - May 29, 2018 Category: Hematology Authors: David E. St ‐Jules , David S. Goldfarb , Mary Lou Pompeii , Scott E. Liebman , Richard A. Sherman Source Type: research

Acid ‐base homeostasis during hemodialysis: New insights into the mystery of bicarbonate disappearance during treatment
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - May 29, 2018 Category: Hematology Authors: John A. Sargent , Marco Marano , Stefano Marano , F. John Gennari Source Type: research

Hemodiafiltration versus conventional hemodialysis: Should “conventional” be redefined?
Seminars in Dialysis, EarlyView. (Source: Seminars In Dialysis)
Source: Seminars In Dialysis - May 29, 2018 Category: Hematology Authors: Francisco Maduell Source Type: research

Assessment and misassessment of potassium, phosphorus, and protein in the hemodialysis diet.
In this report, we examine the potassium, phosphorus, and protein content of foods, and identify critical challenges, and potential pitfalls when translating nutrient prescriptions into dietary guidelines. Our findings highlight the importance of individualized counseling based on a comprehensive dietary assessment by trained diet professionals, namely renal dietitians, for managing diet-related complications in HD patients. PMID: 29813179 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)
Source: Seminars in Dialysis - May 29, 2018 Category: Urology & Nephrology Authors: St-Jules DE, Goldfarb DS, Pompeii ML, Liebman SE, Sherman RA Tags: Semin Dial Source Type: research

Hemodiafiltration versus conventional hemodialysis: Should "conventional" be redefined?
Hemodiafiltration versus conventional hemodialysis: Should "conventional" be redefined? Semin Dial. 2018 May 29;: Authors: Maduell F Abstract In the 1980s, conventional hemodialysis was considered as dialysis with acetate dialysate, dialysis machines without volumetric control, low blood flow and low-flux dialyzers; in the 1990s, the concept of conventional hemodialysis changed due to technological advances in dialysis machines, control of ultrafiltration and the widespread use of bicarbonate dialysate, which allowed an increase in blood flow and the use of synthetic high-flux dialyzers. To ...
Source: Seminars in Dialysis - May 29, 2018 Category: Urology & Nephrology Authors: Maduell F Tags: Semin Dial Source Type: research

Acid-base homeostasis during hemodialysis: New insights into the mystery of bicarbonate disappearance during treatment.
Abstract In patients receiving hemodialysis, it has long been recognized that much more bicarbonate is delivered during treatment than ultimately appears in the blood. To gain insight into this mystery, we developed a model that allows a quantitative analysis of the patient's response to rapid alkalinization during hemodialysis. Our model is unique in that it is based on the distribution of bicarbonate in the extracellular fluid and assesses its removal from this compartment by mobilization of protons (H+ ) from buffers and other sources. The model was used to analyze the pattern of rise in blood bicarbonate conce...
Source: Seminars in Dialysis - May 29, 2018 Category: Urology & Nephrology Authors: Sargent JA, Marano M, Marano S, Gennari FJ Tags: Semin Dial Source Type: research