Kidney and dialysis最新文献_第10页

Opinion on the (Hemo)dialysate Sodium Prescription: Dialysate Sodium Prescription Should Not Be Considered in Isolation 对(血液)透析液钠处方的意见:透析液钠处方不应单独考虑

Kidney and dialysis Pub Date : 2021-12-02 DOI: 10.3390/kidneydial1020021

K. Ng, I. Dasgupta

引用次数: 0

Sodium in Hemodialysis Fluid 血液透析液中的钠

Kidney and dialysis Pub Date : 2021-12-02 DOI: 10.3390/kidneydial1020020

S. Agarwal

引用次数: 0

Evidence from Studies of Patient-Reported Outcomes Supports a Policy of Using a Dialysate Sodium Concentration of 140 mEq/L for the Majority of Patients 来自患者报告结果研究的证据支持大多数患者使用透析液钠浓度为140 mEq/L的政策

Kidney and dialysis Pub Date : 2021-12-01 DOI: 10.3390/kidneydial1020018

H. Rayner

引用次数: 0

A Personal and Practical Answer from a Clinical Perspective 从临床角度的个人和实用的答案

Kidney and dialysis Pub Date : 2021-12-01 DOI: 10.3390/kidneydial1020019

B. Canaud

引用次数: 3

Dialysate Sodium—One Size Unlikely to Fit All 透析液钠——一种规格不可能适合所有人

Kidney and dialysis Pub Date : 2021-11-30 DOI: 10.3390/kidneydial1020016

Finnian R. Mc Causland

引用次数: 0

Vascular Access Flow during Dialysis: Does Needle Orientation Matter? 透析期间血管通路流动:针的方向有影响吗?

Kidney and dialysis Pub Date : 2021-11-30 DOI: 10.3390/kidneydial1020017

G. Tsangalis, Valérie Loizon

{"title":"Vascular Access Flow during Dialysis: Does Needle Orientation Matter?","authors":"G. Tsangalis, Valérie Loizon","doi":"10.3390/kidneydial1020017","DOIUrl":"https://doi.org/10.3390/kidneydial1020017","url":null,"abstract":"Background: Monitoring of vascular access outflow (VAO) in dialysis is based on the indicator dilution method by ultrasound (UD). The role of arterial needle orientation in VAO measurement is not clear. We compared the impact of the retrograde (RET) versus the antegrade orientation (ANT) in terms of (a) VAO (UD) and (b) dialysis adequacy. Moreover, we compared VAO (UD ANT and RET orientation) with VAO measured by Doppler ultrasound. Methods: 22 patients participated in the study. Inclusion criteria: Dialysis > 6 months with a functioning AVF, no stenosis, no active infection, EF > 45% and informed consent. 4 flow measurements were taken on the same dialysis day (4 consecutive weeks). To account for blood pressure variation, we “corrected” VAO for a mean arterial pressure of 100 mmHg. Doppler VAO was measured just before dialysis. Means were compared by the paired t-test. For correlation and agreement, linear regression and Bland-Altman analysis were performed respectively. Results: Mean VAO (UD) was higher in the (ANT) versus the (RET) orientation: 1286.17 mL/min (SD = 455.78, 95%CI = 1084–1488) versus 1189.96 mL/min (SD = 401.05, 95%CI = 1012–1368) (p = 0.013) with a mean difference of 96.21 mL/min (5.66%). Mean Kt/V (RET orientation) was 1.57 (SD = 0.10, 95%CI = 1.52–1.61) versus 1,55 (SD = 0.10, 95%CI = 1.50–1.60) (ANT) orientation (p = 0.062). Recirculation was always 0%. The mean VAO (Doppler) was 1079.54 mL/min (SD = 356.04, 95%CI = 922–1237), 16% lower than VAO measured by UD with (ANT) orientation (p = 0.009) and 9.3% lower than the VAO in the (RET) orientation (p = 0.113). Linear regression analysis showed that VA flows (ANT versus RET) orientation of the needle correlates well between them (r = 0.93, p < 0.001) but show poor agreement (Bland–Altman analysis). Conclusion: VAO (UD) in the RET orientation was significantly lower than VAO in the ANT orientation and more consistent with VAO assessed by Doppler without influencing dialysis adequacy. Therefore, when using UD for VAO surveillance, the RET orientation should be used.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46364685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combining Diffusion, Convection and Absorption: A Pilot Study of Polymethylmethacrylate versus Polysulfone Membranes in the Removal of P-Cresyl Sulfate by Postdilution On-Line Hemodiafiltration 结合扩散、对流和吸收:聚甲基丙烯酸甲酯膜与聚砜膜在线稀释血液透析滤除对甲酰硫酸盐的中试研究

Kidney and dialysis Pub Date : 2021-11-09 DOI: 10.3390/kidneydial1020015

P. Molina, J. Peiró, M. Martínez-Gómez, Belén Vizcaíno, C. Esteller, Mercedes González-Moya, María García-Valdelvira, Mariola D. Molina, F. Maduell

{"title":"Combining Diffusion, Convection and Absorption: A Pilot Study of Polymethylmethacrylate versus Polysulfone Membranes in the Removal of P-Cresyl Sulfate by Postdilution On-Line Hemodiafiltration","authors":"P. Molina, J. Peiró, M. Martínez-Gómez, Belén Vizcaíno, C. Esteller, Mercedes González-Moya, María García-Valdelvira, Mariola D. Molina, F. Maduell","doi":"10.3390/kidneydial1020015","DOIUrl":"https://doi.org/10.3390/kidneydial1020015","url":null,"abstract":"Dialytic clearance of p-cresyl sulfate (pCS) and other protein-bound toxins is limited by diffusive and convective therapies, and only a few studies have examined how to improve their removal by adsorptive membranes. This study tested the hypothesis that high-flux polymethylmethacrylate (PMMA) dialysis membranes with adsorptive capacity increase pCS removal compared to polysulfone membranes, in a postdilution on-line hemodiafiltration (OL-HDF) session. Thirty-five stable hemodialysis patients randomly completed a single study of 4 h OL-HDF with PMMA (BG2.1U, Toray®, Tokyo, Japan) and polysulfone (TS2.1, Toray®) membranes. The primary endpoint was serum pCS reduction ratios (RRs) obtained with each dialyzer. Secondary outcomes included RRs of other solutes such as β2-microglobulin, the convective volume obtained after each dialysis session, and the dialysis dose estimated by ionic dialysance (Kt) and urea kinetics (Kt/V). The RRs for pCS were higher with the PMMA membrane than those obtained with polysulfone membrane (88.9% vs. 58.9%; p < 0.001), whereas the β2-microglobulin RRs (67.5% vs. 81.0%; p < 0.001), Kt (60.2 ± 8.7 vs. 65.5 ± 9.4 L; p = 0.01), Kt/V (1.9 ± 0.4 vs. 2.0 ± 0.5; p = 0.03), and the convection volume (18.8 ± 2.8 vs. 30.3 ± 7.8 L/session; p < 0.001) were significantly higher with polysulfone membrane. In conclusion, pCS removal by OL-HDF was superior with high-flux PMMA membranes, appearing to be a good dialysis strategy for improving dialytic clearance of pCS, enabling an acceptable clearance of β2-microglobulin and small solutes.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41612183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis 运动、体育活动、饮食或联合干预能改善新肾移植受者的体重吗？叙事系统综述与元分析

Kidney and dialysis Pub Date : 2021-10-02 DOI: 10.3390/kidneydial1020014

E. Castle, E. McBride, J. Greenwood, K. Bramham, J. Chilcot, S. Greenwood

{"title":"Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis","authors":"E. Castle, E. McBride, J. Greenwood, K. Bramham, J. Chilcot, S. Greenwood","doi":"10.3390/kidneydial1020014","DOIUrl":"https://doi.org/10.3390/kidneydial1020014","url":null,"abstract":"Weight gain within the first year of kidney transplantation is associated with adverse outcomes. This narrative systematic review and meta-analysis examines the effect of exercise, physical activity, dietary, and/or combined interventions on body weight and body mass index (BMI) within the first year of kidney transplantation. Seven databases were searched from January 1985 to April 2021 (Prospero ID: CRD42019140865), using a ‘Population, Intervention, Controls, Outcome’ (PICO) framework. The risk-of-bias was assessed by two reviewers. A random-effects meta-analysis was conducted on randomized controlled trials (RCTs) that included post-intervention body weight or BMI values. Of the 1197 articles screened, sixteen met the search criteria. Ten were RCTs, and six were quasi-experimental studies, including a total of 1821 new kidney transplant recipients. The sample sizes ranged from 8 to 452. Interventions (duration and type) were variable. Random-effects meta-analysis revealed no significant difference in post-intervention body weight (−2.5 kg, 95% CI −5.22 to 0.22) or BMI (−0.4 kg/m2, 95% CI −1.33 to 0.54). Despite methodological variance, statistical heterogeneity was not significant. Sensitivity analysis suggests combined interventions warrant further investigation. Five RCTs were classified as ‘high-risk’, one as ‘some-concerns’, and four as ‘low-risk’ for bias. We did not find evidence that dietary, exercise, or combined interventions led to significant changes in body weight or BMI post kidney transplantation. The number and quality of intervention studies are low. Higher quality RCTs are needed to evaluate the immediate and longer-term effects of combined interventions on body weight in new kidney transplant recipients.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43634866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Vascular Access, Complications and Survival in Incident Hemodialysis Patients 血液透析患者的血管通路、并发症和生存率

Kidney and dialysis Pub Date : 2021-09-30 DOI: 10.3390/kidneydial1020013

M. Torreggiani, L. Bernasconi, M. Colucci, Simone Accarino, E. Pasquinucci, V. Esposito, G. Sileno, C. Esposito

{"title":"Vascular Access, Complications and Survival in Incident Hemodialysis Patients","authors":"M. Torreggiani, L. Bernasconi, M. Colucci, Simone Accarino, E. Pasquinucci, V. Esposito, G. Sileno, C. Esposito","doi":"10.3390/kidneydial1020013","DOIUrl":"https://doi.org/10.3390/kidneydial1020013","url":null,"abstract":"The arteriovenous fistula (AVF) has long been considered the optimal vascular access. However, the evolving characteristics of the ageing dialysis population limit the creation of an AVF in all patients. Thus, more patients start hemodialysis (HD) with a central venous catheter (CVC) rather than an AVF, and the supremacy of the AVF has recently been questioned. The aim of this study was to analyze the incidence and rate of access complications in 100 patients between 2010 and 2015. A total of 63 patients started HD with an AVF, while 37 began HD with a CVC. We found no differences in patient survival according to the vascular access in use at the beginning of dialysis, but patients were more likely to die while undergoing dialysis by means of a CVC than an AVF. Patients started on dialysis with a CVC had more cardiovascular disease, while patients who began dialysis with an AVF presented more hypertension. Fistulas presented a longer survival time despite more hospital admissions, but CVCs bore a higher risk of infections. Our results suggest that starting dialysis with a CVC does not confer a greater risk of death.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43280185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Dialysis Access and Preemptive Kidney Transplantation 透析途径与预防性肾移植

Kidney and dialysis Pub Date : 2021-09-24 DOI: 10.3390/kidneydial1020012

Y. Mochizuki, Y. Miyata, T. Matsuda, Y. Mukae, K. Ohba, H. Sakai

{"title":"Dialysis Access and Preemptive Kidney Transplantation","authors":"Y. Mochizuki, Y. Miyata, T. Matsuda, Y. Mukae, K. Ohba, H. Sakai","doi":"10.3390/kidneydial1020012","DOIUrl":"https://doi.org/10.3390/kidneydial1020012","url":null,"abstract":"Sustainable vascular or peritoneal access for dialysis is very important for patients undergoing dialysis therapy, and access trouble is occasionally involved with unexpected occurrence of complications. Once access trouble occurs, dialysis therapy might be discontinued and be followed by a life-threatening state of patients with end-stage kidney disease. Bacterial infection, massive bleeding, and thrombosis in patients undergoing hemodialysis and acute infectious peritonitis and chronic encapsulating peritoneal sclerosis in patients undergoing peritoneal dialysis are important clinical issues. Preemptive kidney transplantation prior to dialysis has several advantages over transplantation after exposure to dialysis therapy. One of the notable advantages is the lack of necessity of dialysis access, which avoids access operations before transplantation. However, some transplant recipients may need short-term dialysis therapy due to the unexpected progression of chronic renal dysfunction. Dialysis access is required in a short preoperative period for preconditioning. The selection of renal replacement therapy without complications in a short-term dialysis before transplant surgery is important for the success of kidney transplantation. Appropriate preparation of short-term dialysis therapy and access is a key to success of preemptive kidney transplantation.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47289403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0