Blood Purification最新文献

{"title":"Rinaldo Bellomo, MD (1956-2025).","authors":"John A Kellum, Ravindra Mehta, Claudio Ronco","doi":"10.1159/000547078","DOIUrl":"https://doi.org/10.1159/000547078","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-5"},"PeriodicalIF":2.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504813","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}

{"title":"A Comparison of Clinical Outcomes in Urgent-Start Hemodialysis vs. Urgent-Start Peritoneal Dialysis in ESRD patients: A Systematic Review and Meta-Analysis.","authors":"Jia Wu, Yifu Cao, Tianzhi Wang","doi":"10.1159/000547049","DOIUrl":"https://doi.org/10.1159/000547049","url":null,"abstract":"<p><strong>Background: </strong>USPD is related to fewer complications and lower mortality rates compared to USHD in patients who need renal replacement therapy. However, there is a lack of literature specifically addressing its application and results in individuals with ESRD.</p><p><strong>Objective: </strong>A comprehensive examination and synthesis of existing research were conducted to compare fellow up outcomes of USPD versus USHD in ESRD patients .</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Web of Science, and the Cochrane Library, and SpringerLink databases for that compare urgent-start PD to urgent-start HD before November 1th, 2024. Mortality, all complications, noninfectious complications, infectious complications, bacteraemia and peritonitis were used as outcomes to compare USPD and USHD.</p><p><strong>Results: </strong>This meta-analysis incorporated seven studies involving a total of 1,338 patients. Our findings showed no notable distinctions in peritonitis between USPD and USHD. urgent-start PD was linked to a reduced mortality rate \"(OR: 0.48, 95% CI: 0.24 to 0.95, p < 0.05), lower all complications (OR: 0.27, 95% CI: 0.20 to 0.37, p < 0.05), lower noninfectious complications(OR: 0.32, 95% CI: 0.23 to 0.45, p < 0.05), lower infectious complications (OR: 0.29, 95% CI: 0.17 to 0.51, p < 0.05), lower bacteraemia (OR: 0.18, 95% CI: 0.07 to 0.42, p < 0.05)\" compared to urgent-start HD.</p><p><strong>Conclusions: </strong>Our findings indicate that among patients with ESRD, those undergoing urgent-start PD have lower risks during the follow-up period compared to those receiving urgent-start HD. USPD is associated with significantly reduced all-cause mortality, overall complications, infectious complications, non-infectious complications, and bacteremia incidence. The results indicate that USPD could potentially function as an appropriate replacement for USHD. However, further high-quality clinical studies still are necessary to substantiate this conclusion.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483098","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}

{"title":"The Immunomodulatory Potential of Hemoadsorption in Burn Care.","authors":"Nicolas Chardon, Frank Bidar, Paul Samuel Abraham, Céline Monard, Kevin K Chung, Thomas Rimmelé","doi":"10.1159/000547001","DOIUrl":"https://doi.org/10.1159/000547001","url":null,"abstract":"<p><p>Burns are a common injury affecting thousands of people worldwide each year. Clinical severity varies according to the total body surface area burned, which is in turn associated with morbidity and mortality. The management of a severe burn patient requires admission to a referral center. Patients with severe burns exhibit a complex and dysregulated immuno-inflammatory response. This leads to the loss of immune homeostasis, which is a source of infectious complications and organ dysfunctions. This loss of control of immune mechanisms plays a key role in the morbidity and mortality of severe burn patients. Currently, several strategies, such as hemoadsorption, have been developed to modulate this host response. Modern hemoadsorption is based on new highly biocompatible sorbent cartridges of neutral macroporous resin beads. We propose herein a review of the immune pathways in burn injury and the rationale and potential applications of extracorporeal blood purification techniques, such as hemoadsorption, in the management of burn patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483099","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}

{"title":"J-shaped relationship of the triglyceride-glucose index with all-cause mortality in initial-hemodialysis patients in China：a multicentre, retrospective cohort study.","authors":"Shi-Mei Hou, Zhong-Tang Li, Tian-Ke Yu, Min Li, Yao Wang, Min Yang, Jing-Ting Jiang, Li-Rong Hao, Jian-Bing Hao, Feng-Ming Dong, Min Yang, Jing Zheng, Jing-Jie Xiao, Xiao-Liang Zhang, Bi-Cheng Liu, Jing-Yuan Cao, Bin Wang","doi":"10.1159/000546704","DOIUrl":"https://doi.org/10.1159/000546704","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between the triglyceride-glucose (TyG) index and mortality in hemodialysis patients remains uncertain. This study aimed to investigate the correlation between TyG index and all-cause mortality in initial-hemodialysis patients in China.</p><p><strong>Methods: </strong>783 patients participated in the study and were grouped into quintiles according to the TyG index. Multivariate Cox models and subgroup analyses were utilized. Nonlinear correlations were explored using restricted cubic splines, and a two-piecewise Cox proportional hazards model was developed around the inflection point.</p><p><strong>Results: </strong>During a median follow-up of 44 months, 231 (29.50%) patients occurred mortality. Multivariate Cox regression confirmed that both lower and higher TyG indices independently predicted all-cause mortality (all P < 0.05). The predictive value of a high TyG index for all-cause mortality remained consistent across age, sex, BMI, and diabetes subgroups. A restricted cubic spline unveiled a J-shaped relationship between the two variables in initial-hemodialysis patients. A TyG index exceeding 8.83 exhibited a positive correlation with all-cause mortality (HR, 1.78; 95% CI: 1.27-2.46, P < 0.001).</p><p><strong>Conclusions: </strong>A J-shaped relatonship was identified between the TyG index and all-cause mortality in initial-hemodialysis patients in China. The threshold of 8.83 for all-cause mortality.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324444","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}

{"title":"Concurrent use of kidney replacement therapy and temporary left ventricular assist device in cardiogenic shock: A systematic review and meta-analysis.","authors":"Oliver Lim, Kamalesh Anbalakan, Ryan Ruiyang Ling, Bryan Tan, Vivien Mak, Ying Chen, Manish Kaushik, Matthew Jose Chakaramakkil, Kollengode Ramanathan","doi":"10.1159/000546854","DOIUrl":"https://doi.org/10.1159/000546854","url":null,"abstract":"<p><strong>Background: </strong>The use of temporary left ventricular assist devices (T-LVADs) for circulatory support in cardiogenic shock is increasing along with complications like acute kidney injury requiring kidney replacement therapy (KRT). While KRT is linked to mortality in cardiogenic shock, data on mortality in patients receiving both T-LVAD and KRT is limited.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis, searching three databases from inception through 30 December 2023 for studies reporting on patients with concurrent T-LVAD and KRT support during cardiogenic shock. We performed random effects meta-analyses, looking at in-hospital mortality as our primary outcome. Subgroup analysis was performed based on the continent, timing of KRT, and type of T-LVAD. Risk of bias was assessed with the Joanna Briggs Institute checklists and certainty of evidence with the GRADE approach.</p><p><strong>Results: </strong>We included 35 studies after screening through 89 full-text articles, consisting of 2277 individuals receiving T-LVAD and 722 (30.9%, 95% CI: 25.8-36.6) receiving concurrent KRT. In-hospital mortality was pooled across six studies, with 91 non-survivors (65.5%) amongst 139 individuals (95% CI: 57.2-72.9). Concurrent KRT and T-LVAD was associated with higher in-hospital (OR 3.48, 95% CI: 2.20-5.49) and overall mortality (OR 2.19, 95% CI 1.01-4.76) compared to patients not on KRT. The proportion of patients on KRT were significantly (pinteraction=0.0004) larger in Europe (37.2%, 95% CI: 32.2-42.4) than North America (18.2%, 95% CI: 12.0-26.7). Region, type of T-LVAD and publication year did not significantly impact any of the mortality outcomes.</p><p><strong>Conclusion: </strong>Patients on concurrent KRT and T-LVAD suffer significantly greater odds of mortality compared to patients not receiving KRT during their hospital admission. A substantial proportion of patients receiving T-LVADs require KRT. Further studies with head-to-head comparisons between KRT and non-KRT treatment arms are warranted to confirm our findings, in addition to identifying at-risk populations that require KRT and potential interventions to improve survival in this subset of patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-23"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324441","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}

{"title":"Endotoxin, Virus and Bacterial Removal: Why, When and How?","authors":"Lui G Forni, Vedran Premuzic","doi":"10.1159/000546923","DOIUrl":"https://doi.org/10.1159/000546923","url":null,"abstract":"<p><p>Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection and where underlying circulatory, cellular, and metabolic abnormalities contribute to a greater risk of mortality than that posed by sepsis alone this may be considered septic shock where circulatory support is needed in the face of a raised lactate level. The main pillars of therapy remain source control and appropriate timely antibiotics, resuscitation where needed and adequate source control. However in the setting of organ failure further support may be needed. Here we discuss the potential benefits from removal of pathogens using available extracorporeal techniques. Although randomised controlled trials supporting such an approach are remin elusive this is due to change in the next few years with current studies being performed.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324442","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}

{"title":"Evaluation of a Training Program in Peritoneal Dialysis Catheter Insertion for Nephrologists in South America.","authors":"Isabel Cristina Saravia Bermeo, Gonzalo Ramírez-Guerrero, Milene Angulo Juliao, Daniel Molina Comboni, Cristhian Bueno Lara, Maria Adelaida Zapata Zapata","doi":"10.1159/000546598","DOIUrl":"https://doi.org/10.1159/000546598","url":null,"abstract":"<p><strong>Introduction: </strong>For patients requiring renal replacement therapy (RRT), peritoneal dialysis (PD) offers an alternative to maintain quality of life. The long-term success of PD depends on using a safe, functional, and durable peritoneal catheter (PC). This study aimed to assess the outcomes of a training program for nephrologists on PD catheter insertion in South American dialysis centers.</p><p><strong>Methods: </strong>This longitudinal, retrospective, multicenter study was conducted in Colombia, Chile, Ecuador, and Bolivia. Patients who underwent PC insertion between January 2022 and May 2023 were included, with procedures performed by nephrologists trained in a specialized program. Data on population characteristics, procedural details, and catheter function at the first, third, and sixth months were collected.</p><p><strong>Results: </strong>A total of 117 subjects were included (median age 59 years, 50.4% men). Hypertension and diabetes were the primary causes of kidney disease (34.19% and 49.57%, respectively). Bladder emptying and prophylactic antibiotics were administered before the procedure. Most PC insertions (86.32%) were performed under local anesthesia, with the modified Seldinger technique. Catheter implantation was successful in 96.58% of cases. Elective PD was performed in 69.91% of patients, while 30.01% required urgent PD. Within the first two weeks, complications occurred in 7.08% of patients, including catheter tip migration and flow failure. At one, three, and six months of follow-up, complications were observed in 1.79%, 3.77%, and 11.00% of patients, respectively. Catheter patency was maintained in 99.10%, 96.22%, and 96.00% of patients at one, three, and six months, respectively.</p><p><strong>Conclusions: </strong>Optimal peritoneal access can be achieved through educational programs for nephrologists on catheter insertion, ensuring proper placement and maintenance, and resulting in low complication rates in PD patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324443","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}

{"title":"Protein-Bound Uremic Toxins Removal with MCO Membranes: A Pilot Study Showing No Superiority over High-Flux Dialysis.","authors":"Francisca Aranda, Bárbara Segovia-Hernández, Constanza Verdugo, Cristian Pedreros-Rosales, Armando Rojas, Gonzalo Ramírez-Guerrero","doi":"10.1159/000546721","DOIUrl":"https://doi.org/10.1159/000546721","url":null,"abstract":"<p><strong>Background: </strong>Protein-bound uremic toxins such as advanced glycation end products (AGEs) are poorly cleared by conventional dialysis. Medium cut-off (MCO) membranes have been proposed to enhance their removal, but clinical evidence remains limited.</p><p><strong>Methods: </strong>In this prospective pilot study, eight maintenance hemodialysis patients were assigned to receive a single dialysis session using either an MCO or high-flux (HF) membrane. Serum levels of N-carboxymethyllysine (CML), soluble receptor for AGEs (sRAGE), and prolactin were measured pre- and post-dialysis. Reduction ratios corrected for hemoconcentration (RRc) were compared between groups.</p><p><strong>Results: </strong>The median RRc for CML was similar between MCO (36.9%) and HF (35.6%) membranes (p = 0.686). sRAGE reduction was lower with MCO membranes (21.8% vs. 41.9%, p = 0.114), while prolactin clearance was slightly higher (58.1% vs. 50.9%, p = 0.486). No statistically significant differences were observed.</p><p><strong>Conclusion: </strong>MCO membranes did not demonstrate superior removal of protein-bound toxins compared to high-flux membranes in this pilot study. These findings highlight the need for alternative strategies, such as adsorption, and larger studies to define the clinical utility of MCO technology.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324446","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}

{"title":"Application of Remote Dielectric Sensing in Volumetric Evaluation for Maintenance Hemodialysis Patients.","authors":"Chun-Yue Wang, Li Zhou, Yuqing Chen","doi":"10.1159/000546872","DOIUrl":"https://doi.org/10.1159/000546872","url":null,"abstract":"<p><strong>Background: </strong>Fluid overload increases the risk of cardiovascular events and all-cause mortality in hemodialysis patients. Remote dielectric sensing (ReDS) is a newly wearable device which can evaluate the volumetric status via the ratio of fluid and air in pulmonary tissue. In this study we explored whether ReDS can be used in evaluation of volume status in dialysis patients.</p><p><strong>Methods: </strong>We involved maintenance hemodialysis patients in the cross-sectional study and obtained both pre- and post-dialysis ReDS values. We also collected pre- and post-dialysis over hydration values by bioelectrical impedance analysis and biochemistry indicators like brain natriuretic peptide and analyzed their correlations with ReDS values to explore whether ReDS was feasible in fluid assessment for hemodialysis patients.</p><p><strong>Results: </strong>115 maintenance hemodialysis patients were enrolled. The average pre-dialysis ReDS reading was 27.47% ± 4.88% (range from 16.00% to 39.00%), and the median post-dialysis ReDS value was 24% (range from 16% to 37%). ReDS can distinguish fluid overload patients (pre-dialysis over hydration value≥2.5L, p<0.001). ReDS value has a positive correlation with over hydration value (pre-dialysis: R=0.38, p<0.001) and a negative correlation with left ventricular ejection fraction (R=-0.333, p=0.018). ROC analysis showed that cut-off of pre-dialysis ReDS value to discriminate pre-dialysis over hydration value≥2.5L was 26.5%.</p><p><strong>Conclusion: </strong>ReDS has potential in fluid evaluation for maintenance hemodialysis patients and can serve as a useful tool to assist in clinical hydration status assessment.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-22"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324440","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}

{"title":"Optimizing Venous Chamber Design in CRRT: Implications for Reducing Clot Risk and Enhancing Circuit Longevity.","authors":"Minmin Wang","doi":"10.1159/000546913","DOIUrl":"https://doi.org/10.1159/000546913","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324445","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}