Blood Purification最新文献

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Does the Modified Global Removal Score Accurately Reflect Dialytic Performance? Comments on "Expanded Hemodialysis as an Alternative to Suboptimal Online Hemodiafiltration". 修改后的整体去除评分能准确反映透析性能吗?关于“扩大血液透析作为次优在线血液滤过的替代方法”的评论。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-09-05 DOI: 10.1159/bpu/abpag011
Francisco Maduell, Elena Cuadrado-Payán, Isabel Galcerán, José Jesús Broseta
{"title":"Does the Modified Global Removal Score Accurately Reflect Dialytic Performance? Comments on \"Expanded Hemodialysis as an Alternative to Suboptimal Online Hemodiafiltration\".","authors":"Francisco Maduell, Elena Cuadrado-Payán, Isabel Galcerán, José Jesús Broseta","doi":"10.1159/bpu/abpag011","DOIUrl":"https://doi.org/10.1159/bpu/abpag011","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding myoglobin adsorption kinetics: an ex vivo model. 了解肌红蛋白吸附动力学:一个离体模型。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-09-02 DOI: 10.1159/bpu/abpag009
Matteo Marcello, Gonzalo Ramírez-Guerrero, Anna Lorenzin, Gerd Klinkmann, Natascha Perin, Grazia Maria Virzì, Massimo De Cal, Thiago Reis, Monica Zanella, Claudio Ronco
{"title":"Understanding myoglobin adsorption kinetics: an ex vivo model.","authors":"Matteo Marcello, Gonzalo Ramírez-Guerrero, Anna Lorenzin, Gerd Klinkmann, Natascha Perin, Grazia Maria Virzì, Massimo De Cal, Thiago Reis, Monica Zanella, Claudio Ronco","doi":"10.1159/bpu/abpag009","DOIUrl":"https://doi.org/10.1159/bpu/abpag009","url":null,"abstract":"<p><strong>Background: </strong>Myoglobin is a middle-molecule protein released into the bloodstream during rhabdomyolysis, where it contributes to acute kidney injury (AKI) through hemodynamic, oxidative, and obstructive mechanisms. High cut-off membranes may enhance myoglobin clearance but carry a risk of clinically relevant albumin and other protein losses. Hemoadsorption may overcome these limitations. This study aimed to assess the adsorption capacity of a neutral microporous styrene-divinylbenzene copolymer sorbent for myoglobin.</p><p><strong>Methods: </strong>We performed two ex vivo hemoadsorption experiments using mini modules of the HA380 cartridge. Dialysis effluent from a patient with severe rhabdomyolysis was concentrated to 1 L and circulated in a closed loop at 200 mL/min for 240 minutes. Experiments differed in sorbent mass (32 g vs 10.6 g). Myoglobin concentrations were measured at predefined time points using ELISA. Removal ratio (RR) and adsorbed mass were calculated to estimate adsorption kinetics and resin capacity.</p><p><strong>Results: </strong>In the first experiment (32 g sorbent), myoglobin decreased from 66,356 to 8,553 µg/L (RR 87%), with 57.8 mg adsorbed (1.8 mg/g). In the second experiment (10.6 g sorbent), concentration decreased from 76,455 to 7,043 µg/L (RR 91%), with 69.6 mg adsorbed (6.56 mg/g). In both experiments, >50% of total myoglobin was removed within the first 60 minutes, while adsorption plateaued during the last 3 hours, suggesting near saturation without complete exhaustion of binding sites.</p><p><strong>Conclusions: </strong>This is the first study to evaluate the myoglobin adsorption capacity of a polystyrene-divinylbenzene sorbent, demonstrating a high affinity for myoglobin with near-complete removal in an ex vivo model. Although saturation was not fully reached, the maximal capacity of the resin is likely higher than measured. These findings provide quantitative insight into myoglobin adsorption kinetics and support further in vitro and clinical studies to optimize timing and duration of hemoadsorption in severe rhabdomyolysis.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Blood Purification as an Adjunctive Treatment in Pediatric Septic Shock. 血液净化辅助治疗小儿感染性休克的效果。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-09-02 DOI: 10.1159/bpu/abpag014
Nopparak Chanburanavach, Pasita Puttiteerachot, Nattachai Anantasit
{"title":"Effects of Blood Purification as an Adjunctive Treatment in Pediatric Septic Shock.","authors":"Nopparak Chanburanavach, Pasita Puttiteerachot, Nattachai Anantasit","doi":"10.1159/bpu/abpag014","DOIUrl":"https://doi.org/10.1159/bpu/abpag014","url":null,"abstract":"<p><strong>Introduction: </strong>Septic shock remains a major cause of early mortality in pediatric intensive care units. Blood purification (BP) has been used as an adjunctive therapy to modulate hyperinflammation, but pediatric evidence, particularly regarding optimal timing, remains limited. This study aimed to compare outcomes between standard treatment and adjunctive BP in children with persistent vasoactive-dependent septic shock and to identify factors associated with early survival.</p><p><strong>Methods: </strong>We performed a retrospective-prospective observational cohort study of children aged 1 month to 18 years admitted to the PICU between January 2020 and December 2024 with vasoactive-inotropic score (VIS) ≥20 for >6 hours. The BP group received HA330® hemoadsorption based on intensivist discretion, while the control group received standard care. The primary outcome was 72-hour survival after the diagnosis of persistent vasoactive-dependent septic shock. Secondary outcomes included severity score changes, ventilator-free days, and 30-day mortality.</p><p><strong>Results: </strong>Fifty-seven patients were included (BP n=12; control n=45). The BP group had greater baseline severity. Overall, 72-hour survival did not differ between groups. However, BP initiation at lactate <8 mmol/L was associated with significantly improved 72-hour survival (87.5 vs. 0%; p=0.04). Early initiation within 12 hours and PELOD-2 <12 showed trends toward improved survival (50 vs. 0%; p=0.08, and 75 vs. 0%; p=0.06, respectively). Among survivors, VIS decreased significantly after BP therapy from 72.5 [IQR 48, 138.8] to 50 [IQR 24.8, 85] at 6 hours and 30 [IQR 19.3, 51.3] at 24 hours (p=0.02).</p><p><strong>Conclusion: </strong>Blood purification was frequently used in more severely ill children and was not associated with improved survival overall. However, early initiation, particularly before marked lactate elevation and severe organ dysfunction, may improve early survival. These findings highlight timing as a key determinant of BP effectiveness in children with persistent vasoactive-dependent septic shock.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EVALUATION OF ERYPTOSIS INDUCED BY BACTERIAL CONCENTRATIONS IN SEPSIS: A TRANSLATIONAL APPROACH. 脓毒症中细菌浓度引起的脓毒症的评价:一种翻译方法。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-09-02 DOI: 10.1159/bpu/abpag015
Gonzalo Ramírez-Guerrero, Massimo De Cal, Natascha Perin, Cristian Pedreros-Rosales, Alessia Macca, Monica Zanella, Claudio Ronco
{"title":"EVALUATION OF ERYPTOSIS INDUCED BY BACTERIAL CONCENTRATIONS IN SEPSIS: A TRANSLATIONAL APPROACH.","authors":"Gonzalo Ramírez-Guerrero, Massimo De Cal, Natascha Perin, Cristian Pedreros-Rosales, Alessia Macca, Monica Zanella, Claudio Ronco","doi":"10.1159/bpu/abpag015","DOIUrl":"https://doi.org/10.1159/bpu/abpag015","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a life-threatening condition driven by a dysregulated immune response to infection, often leading to multi-organ failure and high mortality. Beyond oxygen transport, red blood cells (RBCs) may contribute to sepsis pathophysiology through eryptosis, a form of programmed RBC death. Characterized by cell shrinkage, membrane changes, and phosphatidylserine exposure, eryptosis can impair microcirculation and tissue oxygenation. This study explored the association between bacterial exposure, eryptosis, and inflammation, assessing its potential as a biomarker for sepsis progression.</p><p><strong>Results: </strong>Three in vitro experiments were conducted with RBCs from healthy donors. In Experiment I, eryptosis increased over time under control conditions, though activation remained low at 72 hours. Experiment II showed a positive correlation between eryptosis and bacterial concentration, with Staphylococcus aureus (Gram-positive) inducing more eryptosis than Escherichia coli (Gram-negative) at the tested doses. However, Experiment III, which compared bacteria at equal concentrations, found that E. coli induced higher eryptosis levels. These findings suggest S. aureus has a dose-dependent effect, while E. coli may exert a stronger pro-eryptotic influence at similar loads.</p><p><strong>Conclusions: </strong>Eryptosis may serve as a biomarker of sepsis severity, sensitive to bacterial type and concentration. Gram-negative bacteria, particularly E. coli, caused greater RBC injury, possibly contributing to worse clinical outcomes. These results warrant further investigation into eryptosis as a diagnostic tool and therapeutic target. Enhancing our understanding of eryptosis could support earlier intervention and personalized treatment strategies in sepsis care.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Depletion of Uric Acid by Continuous Kidney Replacement Therapy. 持续肾替代疗法对尿酸的影响。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-09-01 DOI: 10.1159/bpu/abpag008
Seolhyun Lee, William Vasquez Espinosa, Tammy Lisa Sirich, Timothy Meyer
{"title":"Depletion of Uric Acid by Continuous Kidney Replacement Therapy.","authors":"Seolhyun Lee, William Vasquez Espinosa, Tammy Lisa Sirich, Timothy Meyer","doi":"10.1159/bpu/abpag008","DOIUrl":"https://doi.org/10.1159/bpu/abpag008","url":null,"abstract":"<p><strong>Introduction: </strong>Uric acid levels are commonly elevated in patients maintained on hemodialysis because hemodialysis provides a lower time-average uric acid clearance than the native kidney. However continuous kidney replacement therapy (CKRT) provides higher time-averaged clearances of small solutes than hemodialysis. We therefore examined whether the high small solute clearance provided by CKRT would reduce plasma uric acid levels below normal.</p><p><strong>Methods: </strong>We measured plasma levels of uric acid and other selected solutes in 10 patients initiating CKRT and in 17 patients maintained on CKRT for 5 - 110 days. We estimated solute generation rates from their removal rates. The removal rates of uric acid and phosphate were estimated from their plasma levels while those of urea and creatinine were calculated directly from their effluent levels. CKRT prescription met current guidelines (24 ± 2 ml/kg/hr in patients initiating CKRT and 26 ± 3 ml/kg/hr in patients maintained longer on CKRT).</p><p><strong>Results: </strong>Plasma uric acid levels declined from 8.7 ± 3.0 mg/dL to 1.8 ± 0.5 mg/dL after 2 to 4 days of initiating CKRT (p < 0.001) and were similarly low at 1.7 ± 0.6 mg/dL during ongoing CKRT. Plasma uric acid levels at both intervals were below the normal range. The average uric acid removal rate was not different at 2-4 days post-initiation (922 ± 367 mg/day) and during ongoing CKRT (855 ± 346 mg/day).</p><p><strong>Conclusion: </strong>CKRT prescribed according to current guidelines reduces uric acid levels below normal. The clinical consequences of low uric acid levels in this setting are unknown.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Benefits and Challenges of Telemedicine Utilization in PD Management in Low-Resource Settings. 低资源环境下PD管理中远程医疗利用的好处和挑战。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-08-25 DOI: 10.1159/bpu/abpag010
Ana E Figueiredo, Viviane Calice-Silva, Daniela Ponce
{"title":"Benefits and Challenges of Telemedicine Utilization in PD Management in Low-Resource Settings.","authors":"Ana E Figueiredo, Viviane Calice-Silva, Daniela Ponce","doi":"10.1159/bpu/abpag010","DOIUrl":"https://doi.org/10.1159/bpu/abpag010","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis (PD) is a cost-effective and home-based kidney replacement therapy, particularly relevant in low- and middle-income countries (LMICs). However, outcomes remain suboptimal due to limited access to specialized care, delayed complication detection, and workforce constraints. Telemedicine has emerged as a potential strategy to address these challenges.</p><p><strong>Summary: </strong>This integrative narrative review aimed to synthesize current evidence on telemedicine interventions in PD management, focusing on clinical effectiveness, implementation strategies, and applicability in resource-limited settings. A structured literature search was conducted in PubMed, Scopus, and Google Scholar for studies published between 2010 and 2025. Eligible studies included observational studies, clinical trials, and implementation reports evaluating telemedicine modalities such as remote patient monitoring (RPM), mobile health (mHealth), teleconsultation, and tele-education in PD populations.The evidence indicates that RPM-enabled automated PD is associated with significant reductions in all-cause mortality, cardiovascular events, hospitalization rates, and technique failure. Additional benefits include improved treatment adherence, enhanced fluid management, and earlier detection of complications. Cost-related data suggest reductions in healthcare utilization (direct costs) and patient-related burden such as travel and productivity loss (indirect costs), although formal economic evaluations remain limited. Implementation in LMICs is feasible but requires adaptation to local infrastructure, digital literacy, and health system capacity.</p><p><strong>Key messages: </strong>Telemedicine-supported PD, particularly RPM, is associated with consistent clinical benefits and improved care delivery. Successful implementation in low-resource settings depends on user-centered design, workforce training, sustainable financing models, and supportive regulatory frameworks.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differences in pediatric continuous renal replacement therapy initiation and prescription practices between the jpCRRT registry and the WE-ROCK cohort. jpCRRT登记组和WE-ROCK队列在儿科持续肾替代治疗开始和处方实践方面的差异。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-08-24 DOI: 10.1159/bpu/abpag007
Taiki Haga, Ryuta Itakura, Yuji Yamagami, Kenji Sonota, Takuya Miyazawa, Shunsuke Noda, Sho Wada, Hiroshi Sakihama, Takuya Hayashi, Naoki Fujiwara, Yuki Ichisaka, Hiroshi Okada, Kohei Tsukahara, Mai Miyaji, Kazufumi Yaginuma, Akito Horikawa, Taku Koizumi, Shinya Takarada, Norio Omori, Keiichiro Toma, Wataru Sakai, Takafumi Obara, Takahiro Matsudo
{"title":"Differences in pediatric continuous renal replacement therapy initiation and prescription practices between the jpCRRT registry and the WE-ROCK cohort.","authors":"Taiki Haga, Ryuta Itakura, Yuji Yamagami, Kenji Sonota, Takuya Miyazawa, Shunsuke Noda, Sho Wada, Hiroshi Sakihama, Takuya Hayashi, Naoki Fujiwara, Yuki Ichisaka, Hiroshi Okada, Kohei Tsukahara, Mai Miyaji, Kazufumi Yaginuma, Akito Horikawa, Taku Koizumi, Shinya Takarada, Norio Omori, Keiichiro Toma, Wataru Sakai, Takafumi Obara, Takahiro Matsudo","doi":"10.1159/bpu/abpag007","DOIUrl":"https://doi.org/10.1159/bpu/abpag007","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric continuous renal replacement therapy (CRRT) practice varies across regions, but contemporary registry-based comparisons are limited. We aimed to compare the patient characteristics, pre-CRRT status, and initial CRRT prescription patterns between the published Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) cohort and a WE-ROCK-aligned cohort from the Japanese Pediatric Continuous Renal Replacement Therapy (jpCRRT) Registry.</p><p><strong>Methods: </strong>This descriptive comparison used jpCRRT data collected from January 2023 to March 2026 from 13 participating PICUs in Japan and published aggregate data from WE-ROCK. To improve comparability, we excluded patients receiving maintenance dialysis before CRRT initiation, those treated with concomitant extracorporeal membrane oxygenation, and those receiving CRRT for metabolic or drug/toxin indications. The resulting WE-ROCK-aligned jpCRRT cohort comprised 70 patients.</p><p><strong>Results: </strong>Compared with the WE-ROCK cohort, the jpCRRT cohort was younger and had lower body weight, with a shorter interval from intensive care unit admission to CRRT initiation. The pre-CRRT urine output and serum creatinine level were broadly similar between the cohorts. The initial CRRT practices differed substantially; continuous venovenous hemodialysis predominated in jpCRRT, whereas continuous venovenous hemodiafiltration predominated in WE-ROCK. Non-polysulfone membranes and nafamostat-based anticoagulants were common in jpCRRT, whereas polysulfone membranes and citrate anticoagulants were more frequently used in WE-ROCK. In contrast, vascular access distribution, blood flow rate, and prescribed CRRT dose were similar. Death before intensive care unit discharge occurred in 18.6% of the jpCRRT cohort and 35.8% of the WE-ROCK cohort.</p><p><strong>Conclusion: </strong>Contemporary pediatric CRRT practice differed between the published WE-ROCK cohort and the restricted jpCRRT cohort, particularly in terms of modality, filter type, and anticoagulation strategies. These findings suggest that pediatric CRRT practice is shaped by both regional implementation and patient case mix. Future international studies should use harmonized definitions and comparable outcome frameworks to better evaluate cross-regional differences in pediatric CRRT practice.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in Central Venous Oxygen Saturation during Inpatient Hemodialysis. 住院患者血液透析期间中心静脉血氧饱和度的变化。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-08-17 DOI: 10.1159/bpu/abpag006
Christina Hao Wang Brotman, Molly Kennelly, Charles Hull, Clara Walling, Michael Shashaty, Jesse Yenchih Hsu, Dan Negoianu, Laura M Dember
{"title":"Changes in Central Venous Oxygen Saturation during Inpatient Hemodialysis.","authors":"Christina Hao Wang Brotman, Molly Kennelly, Charles Hull, Clara Walling, Michael Shashaty, Jesse Yenchih Hsu, Dan Negoianu, Laura M Dember","doi":"10.1159/bpu/abpag006","DOIUrl":"10.1159/bpu/abpag006","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrafiltration during hemodialysis can precipitate intradialytic hypotension (IDH), particularly in hospitalized patients with limited cardiovascular reserves. Central venous oxygen saturation (ScvO2) is a surrogate marker of cardiac output and may provide real-time insights into hemodynamic stress during dialysis.</p><p><strong>Methods: </strong>We analyzed data from a prospective observational study of hospitalized adults receiving intermittent hemodialysis with central venous catheters for either acute kidney injury (AKI) or end-stage kidney disease. Continuous ScvO2 was measured throughout the dialysis sessions using Crit-Line-IV. Mixed-effects models were used to characterize intradialytic ScvO2 trends, with restricted cubic splines to evaluate the associations between ScvO2 slopes, ultrafiltration rate (UFR), and IDH.</p><p><strong>Results: </strong>During 204 hemodialysis sessions among 135 individual participants, ScvO2 declined during 58% of the sessions, with substantial inter-patient variability in ScvO2 slopes. Steeper negative ScvO2 slopes were associated with a higher risk of IDH across all IDH definitions, particularly among patients with AKI. Hemodialysis sessions with the steepest ScvO2 declines (defined as the bottom 25th) were associated with increased risk of requiring an intervention for hemodynamic instability, independent of UFR and pre-dialysis blood pressure (adjusted OR: 2.42, 95% CI: 1.12, 5.20). This association was enhanced in patients with AKI (adjusted OR: 5.80, 95% CI: 2.05, 16.46).</p><p><strong>Conclusions: </strong>Continuous intradialytic ScvO2 monitoring is feasible in hospitalized patients and may identify patients at higher risk of hemodynamic instability, especially among those with AKI. ScvO2 may be a useful adjunct for guiding ultrafiltration during inpatient hemodialysis.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Considerations of implementation science in resource-limited settings. 资源有限环境下实施科学的思考。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-08-12 DOI: 10.1159/000553141
Rolando Claure-Del Granado, Thiago Reis, Aarthi Vijaykumar, Etienne Macedo, Nattachai Srisawat, Oleksa Gregory Rewa, Javier A Neyra, Jeremiah Brown, Marlies Ostermann, Ravi Mehta, Claudio Ronco
{"title":"Considerations of implementation science in resource-limited settings.","authors":"Rolando Claure-Del Granado, Thiago Reis, Aarthi Vijaykumar, Etienne Macedo, Nattachai Srisawat, Oleksa Gregory Rewa, Javier A Neyra, Jeremiah Brown, Marlies Ostermann, Ravi Mehta, Claudio Ronco","doi":"10.1159/000553141","DOIUrl":"10.1159/000553141","url":null,"abstract":"<p><p>Closing the know-do gap in critical care nephrology requires delivery models that fit context, foreground equity, and sustain results in resource-limited settings (RLS). This narrative review proposes a pragmatic, equity-first roadmap to implement blood purification and kidney-saving practices in RLS by integrating CFIR for context diagnosis, RE-AIM for planning and evaluation, and ERIC for strategy selection, aligned with implementation outcomes (acceptability, feasibility, fidelity, cost, penetration, sustainability). We reconceptualize \"resources\" as a design variable, introducing a Resource Readiness domain spanning workforce, power/connectivity, supply chains, maintenance, and data systems. We outline learning-while-doing methods: hybrid effectiveness-implementation designs, PDSA cycles, audit-and-feedback, and community co-design to enable adaptive delivery without eroding core functions. Illustrative applications map RE-AIM actions for adoption (e.g., ultrasound-guided dialysis catheter placement, AKI recognition bundles) and de-implementation (e.g., low-value prophylaxis), emphasizing task-sharing, simplified workflows, offline-tolerant tools, and equity guardrails (pre-specified subgroups, access supports, equity-stratified reporting). The adapted CFIR figure depicts how system, site, workforce, and community layers shape mechanisms and outcomes across implementation, clinical, and equity domains. We propose practical recommendations for implementers, funders, and journals to require transparent reporting of context, adaptations, costs, and governance, and to invest in durable local capacity and shared stewardship. An equity-first, resource-aware pathway can accelerate uptake, fidelity, and sustainability of evidence-based kidney care in RLS.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-22"},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perspective: The Future of Peritoneal Dialysis in the Era of Telemedicine and Artificial Intelligence. 透视:腹膜透析在远程医疗和人工智能时代的未来。
IF 2.2 3区 医学
Blood Purification Pub Date : 2026-08-11 DOI: 10.1159/bpu/abpag005
Paolo Lentini, Kianoush Kashani, Claudio Ronco
{"title":"Perspective: The Future of Peritoneal Dialysis in the Era of Telemedicine and Artificial Intelligence.","authors":"Paolo Lentini, Kianoush Kashani, Claudio Ronco","doi":"10.1159/bpu/abpag005","DOIUrl":"10.1159/bpu/abpag005","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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