Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy最新文献

{"title":"Intradialytic Exercise Training Versus Cognitive Training to Reduce Sedentary Behavior in Patients Undergoing Hemodialysis: A Pilot Study.","authors":"Kohji Iwai, Tomoharu Okubo, Takahiro Okumura, Wataru Hachiya","doi":"10.1002/1744-9987.70193","DOIUrl":"https://doi.org/10.1002/1744-9987.70193","url":null,"abstract":"<p><strong>Introduction: </strong>Reduced physical activity and prolonged sedentary behavior (SB) are associated with poor prognosis in patients undergoing hemodialysis. Although intradialytic exercise training (IET) is increasingly implemented, its effect on SB remains unclear. This study compared the effects of IET and cognitive training on SB.</p><p><strong>Methods: </strong>In this multicenter pilot crossover study, patients aged 70-80 years undergoing maintenance hemodialysis completed 12 weeks of IET and 12 weeks of intradialytic cognitive training, separated by a 2-week washout period. Sedentary time (≤ 1.5 METs) and step counts were assessed using an accelerometer before and after each intervention.</p><p><strong>Results: </strong>Nine participants completed the study. IET significantly reduced SB on all days and non-dialysis days (p = 0.02), whereas cognitive training showed no significant change. Reductions were significantly greater following IET. Step counts did not change.</p><p><strong>Conclusion: </strong>IET reduced SB, whereas cognitive training did not, suggesting its clinical relevance in dialysis care.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458268","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}

{"title":"The Next Decade of Therapeutic Apheresis: Bridging Innovation, Evidence, and Global Access.","authors":"Rasheed A Balogun","doi":"10.1002/1744-9987.70194","DOIUrl":"https://doi.org/10.1002/1744-9987.70194","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451192","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}

{"title":"Effectiveness of Resistance Intradialytic Exercise Compared to Aerobic Intradialytic Exercise for Patients With Chronic Kidney Disease: A Randomized Controlled Clinical Trial.","authors":"Klebson da Silva Almeida, Gisela Cristiane Miyamoto, Daniel da Costa Torres, Ian Setubal Reis Chaves, Jonas do Carmo Paschoalin, Braúlio Lima Nascimento, Luciana Dias Chiavegato","doi":"10.1002/1744-9987.70175","DOIUrl":"https://doi.org/10.1002/1744-9987.70175","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease undergoing hemodialysis commonly experience reduced physical function, fatigue, poor sleep quality, and impaired health-related quality of life. Intradialytic exercise has been proposed as a non-pharmacological strategy to improve these outcomes.</p><p><strong>Methods: </strong>Randomized clinical trial with 35 hemodialysis patients randomly allocated to a resistance group (RG) or aerobic group (AG). Exercises were performed during hemodialysis for 12 weeks. The primary outcome was handgrip strength (HGS). Secondary outcomes included the 30-second sit-to-stand test (30sec-STS), gait speed (GS), frailty, fatigue, sleep quality, and health-related quality of life (HRQL).</p><p><strong>Results: </strong>In intragroup analyses, RG improved HGS (MD: 2.4; 95% CI: 0.3-4.5), 30sec-STS, GS, mental fatigue, and sleep quality, whereas AG improved 30sec-STS, GS, and HRQL measured by EQ-VAS. In intergroup analyses, AG was more effective than RG in reducing general fatigue (MD: 2.2; 95% CI: 0.4-4.0) and improving HRQL utility (MD: -0.04; 95% CI: -0.10 to -0.04). No significant between-group differences were observed for HGS or the other outcomes. No adverse events or harms were reported.</p><p><strong>Conclusions: </strong>Resistance and aerobic intradialytic exercise were both feasible and safe. Resistance exercise improved handgrip strength within-group; however, no significant between-group difference was observed for handgrip strength (the primary outcome). Aerobic exercise was more effective in improving general fatigue and health-related quality of life.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439405","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}

{"title":"Impact of Cell-Free and Concentrated Ascites Reinfusion Therapy on eGFR.","authors":"Ryo Takaki, Kaori Kohatsu, Shigeki Kojima, Yugo Shibagaki, Tomoya Nishino, Tsutomu Sakurada","doi":"10.1002/1744-9987.70188","DOIUrl":"https://doi.org/10.1002/1744-9987.70188","url":null,"abstract":"<p><strong>Background: </strong>Whether cell-free and concentrated ascites reinfusion therapy (CART) improves renal function remains unclear. We investigated the effects of CART on renal function.</p><p><strong>Methods: </strong>We retrospectively analyzed changes in renal function after CART in 157 patients (264 sessions) with or without chronic kidney disease (CKD) who underwent the treatment between June 1, 2010, and March 31, 2022.</p><p><strong>Results: </strong>The most common underlying disease was malignant ascites (93.6%), most frequently caused by breast (n = 49, 31.2%) and ovarian (n = 31, 19.7%) cancers. The mean patient age was 61.6 ± 12.2 years (women, 82.1%). The median processed ascites volume was 4.26 [3.40-6.43] L, and the mean number of CART sessions per patient was 1.66 ± 1.38. No severe adverse events were observed. The estimated glomerular filtration rate (eGFR) significantly increased after CART (from 64.5 [47.5-82.9] to 65.1 [50.5-85.6] mL/min/1.73 m²; p = 0.004), particularly in patients with CKD stage G3b and G4 (G3b: from 35.4 [33.0-38.6] to 45.9 [36.1-52.5] mL/min/1.73 m²; p = 0.005, G4: from 25.1 [21.0-26.8] to 27.3 [21.1-35.3] mL/min/1.73 m²; p = 0.045).</p><p><strong>Conclusion: </strong>CART may be associated with an increase in eGFR, particularly in patients with CKD.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451147","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}

{"title":"Sequential Management Enabling Continuation of Peritoneal Dialysis in Autosomal Dominant Polycystic Kidney Disease Despite Multiple Complications.","authors":"Rie Tatsugawa, Akira Hirano, Hiroyuki Kadoya","doi":"10.1002/1744-9987.70192","DOIUrl":"https://doi.org/10.1002/1744-9987.70192","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439472","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}

{"title":"Anti-Oxidative Capacity, but Not Oxidative Burden, Predicts Mortality Among Patients With End-Stage Kidney Disease.","authors":"Szu-Ying Lee, Tzu-Ming Jao, Chia-Ter Chao, Jenq-Wen Huang","doi":"10.1002/1744-9987.70187","DOIUrl":"https://doi.org/10.1002/1744-9987.70187","url":null,"abstract":"<p><strong>Purpose: </strong>Oxidative stress is a key driver of chronic kidney disease and its complications. However, integrative measures capturing the oxidative burden and anti-oxidative defense remain under-explored as prognostic tools. We investigated whether composite oxidative (OxyScore) and anti-oxidative (Anti-OxyScore) indices are associated with mortality in patients undergoing maintenance hemodialysis.</p><p><strong>Methods: </strong>We analyzed a prospectively established multicentric cohort of patients with end-stage kidney disease (ESKD) receiving chronic hemodialysis. Comprehensive clinical, biochemical, and functional data were collected. Composite oxidative and anti-oxidative indices were derived from predefined biomarker panels. Patients were stratified into high and low OxyScore or Anti-OxyScore groups. Cox proportional hazards models were used to evaluate associations between OxyScore, Anti-OxyScore, and all-cause mortality.</p><p><strong>Results: </strong>Totally 145 patients were included, with comparable baseline characteristics between groups. During follow-up, high Anti-OxyScore was independently associated with increased mortality risk (adjusted hazard ratio [aHR] 1.916, 95% confidence interval [CI] 1.119-3.281), whereas OxyScore was not significantly associated with mortality after adjustment (aHR 2.100, 95% CI 0.820-5.380).</p><p><strong>Conclusion: </strong>Anti-oxidative capacity, rather than oxidative burden alone, independently predicts mortality in patients with ESKD. These findings underscore the prognostic relevance of impaired anti-oxidative defense and support the use of composite anti-oxidative indices as clinically meaningful biomarkers in this population.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427638","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}

{"title":"Interpreting Peritoneal Protein Losses and Dietary Protein Intake in Peritoneal Dialysis.","authors":"Yuecai Yuan, Dongxiang Zheng","doi":"10.1002/1744-9987.70186","DOIUrl":"https://doi.org/10.1002/1744-9987.70186","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414511","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}

{"title":"Intraprocedural Yield Estimation Using Interim Product CD34+ Concentration Improves the Prediction Accuracy in Allogeneic Peripheral Blood Stem Cell Harvest.","authors":"Kazuya Okada, Mayumi Murata, Yoshihiro Yabuta, Ryoko Ishida, Mina Higuchi, Fumie Tasaka, Tomoko Imanaka, Junko Nakamura, Ryosuke Takaya, Takashi Nagayama, Hiroyuki Muranushi, Takayuki Sato, Takeshi Maeda, Tatsuhito Onishi, Yasunori Ueda","doi":"10.1002/1744-9987.70189","DOIUrl":"https://doi.org/10.1002/1744-9987.70189","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate prediction of final CD34+ cell yield may reduce donor burden by limiting processed blood volume (PBV) during allogeneic peripheral blood stem cell harvest.</p><p><strong>Methods: </strong>We retrospectively analyzed 86 procedures in 81 healthy donors. Predictions based on preprocedure peripheral blood CD34+ cell concentration and interim collection-product CD34+ cell concentration, measured when PBV reached approximately 50 mL/kg, were compared. Absolute prediction error was compared within procedures. We also evaluated CD34 percent change (CD34% change), defined as the relative change in product CD34+ cell concentration from interim sampling to the final product, and factors associated with CD34% change ≤ -10%.</p><p><strong>Results: </strong>Interim-CD34-based prediction showed a smaller absolute prediction error than Pre-CD34-based prediction (p = 0.034). Median CD34% change was -3.6%, and CD34% change ≤ -10% occurred in 27.9% of procedures. Higher preprocedure platelet count was associated with this decrease.</p><p><strong>Conclusion: </strong>Interim-CD34-based prediction improved yield estimation and may enable PBV optimization during apheresis while maintaining target doses.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427694","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}

{"title":"Increased Skeletal Parathyroid Hormone Responsiveness and Risk of Decreased Lumbar Bone Mineral Density in Patients Receiving Chronic Hemodialysis: A 5-Year, Retrospective, Longitudinal Study.","authors":"Hirofumi Sumi, Shu Ushimaru, Kazuhiro Shiizaki, Shozo Yano, Naoto Tominaga","doi":"10.1002/1744-9987.70185","DOIUrl":"10.1002/1744-9987.70185","url":null,"abstract":"<p><strong>Background: </strong>Parathyroid hormone (PTH) stimulates bone resorption, causing fractures. Skeletal PTH responsiveness varies widely among patients undergoing hemodialysis (HD). We examined whether skeletal PTH responsiveness can be a determining and/or dynamic factor of bone mineral density (BMD) in patients undergoing chronic HD.</p><p><strong>Methods: </strong>We conducted a 5-year retrospective longitudinal study among patients undergoing chronic HD between 2018 and 2023. The tartrate-resistant acid phosphatase-5b (TRACP-5b)/intact PTH (iPTH) ratio was used as an index of skeletal PTH responsiveness. The relationship between the TRACP-5b/iPTH ratio and BMD in 2018, and the relationship between changes (Δ) in the TRACP-5b/iPTH ratio and BMD over 5 years were investigated. Furthermore, in the linear regression analyses for ΔBMD, we used the median values of every 3-month data over a 5-year period to minimize the influence of short-term fluctuations in concentrations. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>The TRACP-5b/iPTH ratio and BMD at the lumbar spine (LS) and femoral neck (FN) in 2018 were not inversely correlated. However, the relationship between the ΔTRACP-5b/iPTH ratio and ΔLS-BMD in the 5-year period was significantly inversely correlated. Significant variables in the single regression analyses for ΔBMD were adjusted for age, sex, body mass index, or serum albumin concentration, and multiple regression analyses were performed with two variables, including each adjusted variable. Only the ΔTRACP-5b/iPTH ratio showed a significant inverse correlation with ΔLS-BMD in all models, not with ΔFN-BMD in any models.</p><p><strong>Conclusions: </strong>A long-term increase in skeletal PTH responsiveness is associated with a greater reduction in LS-BMD in patients undergoing chronic HD.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414451","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}

{"title":"Early Vasoactive-Inotropic Response Trajectories After Polymyxin B Hemoperfusion in Septic Shock: A Single-Center Retrospective Cohort Study.","authors":"Wei-Hung Chang, Kuan-Pen Yu, Li-Kuo Kuo, Chung Lee","doi":"10.1002/1744-9987.70179","DOIUrl":"https://doi.org/10.1002/1744-9987.70179","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize early weight-indexed vasoactive-inotropic score (VIS) trajectories after polymyxin B hemoperfusion (PMX-HP) in septic shock and examine association with 28-day mortality.</p><p><strong>Methods: </strong>We retrospectively studied 64 adult intensive care unit patients treated with PMX-HP from July 2013 to December 2019. VIS was calculated after body-weight indexing. T1 was before the first session, T2 after the final session, and T3 24 h later. Immediate sustained response required T2 reduction without T3 rebound; delayed response required later reduction; adverse trajectory included no response, rebound, or death before T3.</p><p><strong>Results: </strong>Twenty-nine patients (45.3%) had immediate sustained response, two (3.1%) delayed response, and 33 (51.6%) adverse trajectory. Twelve died before planned T3. Among 60 verified timestamps, median shock-to-treatment interval was 17.3 h (interquartile range, 6.6-27.7); median session duration was 2.0 h (interquartile range, 2.0-2.3). Twenty-eight-day mortality was 31.0%, 0.0%, and 63.6%, respectively. Adverse trajectory had higher unadjusted odds of 28-day mortality than immediate sustained response (odds ratio, 3.89; 95% confidence interval, 1.35-11.22). In an age- and Acute Physiology and Chronic Health Evaluation II-adjusted model excluding delayed response, the adjusted odds ratio was 4.17 (95% confidence interval, 1.35-12.86; p = 0.013). Landmark sensitivity analysis was directionally consistent but imprecise.</p><p><strong>Conclusions: </strong>Failure to achieve sustained early reduction in weight-indexed vasoactive support, rebound, or death before reassessment identified an adverse early clinical course. Findings support cautious risk stratification, not causal evidence of treatment efficacy.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407700","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}