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Blood Purification

Carlo Basile, Francesco Gaetano Casino
No abstract text is available yet for this article.
April 18, 2019: Blood Purification
Claudio Ronco
No abstract text is available yet for this article.
April 11, 2019: Blood Purification
Gianluca Villa, Silvia De Rosa, Sara Samoni, Mauro Neri, Chelazzi Cosimo, Stefano Romagnoli, Mattia Gavagni, Claudio Ronco, A Raffaele De Gaudio
Worldwide, the widespread use of extracorporeal blood purification therapies (EBPTs) is progressively increasing in everyday clinical practice, particularly in critical care settings. The efficacy of EBPTs on removal of inflammatory mediators is already well established in the literature. Nonetheless, clinical research is particularly cumbersome in this setting, and many clinical trials aiming at exploring the effect of EBPTs on outcomes have failed in demonstrating consistent results regarding 28-day- or hospital-mortality rates...
April 11, 2019: Blood Purification
Sana F Khan, Claudio Ronco, Mitchell H Rosner
Glucose-based peritoneal dialysis (PD) solutions are the predominantly used dialysate in PD patients. Glucose absorption has been shown to be associated with several unfavorable metabolic complications. Several studies have shown positive effects of exercise in end-stage renal disease patients. This paper provides an overview of glucose-associated metabolic complications, and proposed exercise regimens to counteract the caloric load associated with glucose absorption.
April 4, 2019: Blood Purification
Takeshi Shigematsu, Takahiro Kuragano, Takenobu Kamimura, Sayuri Kawada, Rie Imamura, Yoshihiko Nishian, Miki Miyamoto, Takashi Miyamoto, Takeshi Nakanishi
BACKGROUND/AIM: In this study, we compared the dialysis efficiency, oxidative stress, and nutritional conditions between predilution on-line hemodiafiltration (pre-OL-HDF) and conventional hemodialysis (HD) using a super-flux dialyzer (CHD). METHOD: This was a crossover study of 38 maintenance HD patients. All patients were treated with CHD for the first 4 months (1st CHD period), then were switched to pre-OL-HDF for 4 months (pre-OL-HDF period), and were returned to CHD for the next 4 months (2nd CHD period)...
April 3, 2019: Blood Purification
Satoko Sakurai, Norio Hanafusa, Takanobu Nomura, Ken Tsuchiya, Kosaku Nitta, Masaomi Nangaku
BACKGROUND/AIMS: Japan's aging population has prominent epidemiological and patient characteristics. The number of hemodialysis patients aged ≥70 years is increasing. Age-adjusted mortality is improving, but some cause-specific mortalities remain unchanged, including infectious disease and malignancy, requiring combative strategies. However, survival trends for patients aged 90 years or older are not known. METHODS: We examined annual data reported by the -Japanese Society for Dialysis Therapy Renal Data Registry for the period 1987-2014 to determine survival trends...
April 3, 2019: Blood Purification
Tomomi Tamura, Kohei Unagami, Masayuki Okazaki, Mizuki Komatsu, Kosaku Nitta
BACKGROUND/AIMS: Although hypomagnesemia was found to be a risk for cardiovascular diseases in the general population, the relationship between serum magnesium (Mg) levels and prognosis of patients on maintenance hemodialysis (MHD) has not been extensively studied. This study sought to determine the relationship of serum Mg levels with aortic arch calcification (AoAC) and mortality in Japanese MHD patients. METHODS: We measured serum Mg levels in a cohort of 392 patients on MHD, classified the patients into 3 groups according to these levels, and followed their course for 4 years...
April 3, 2019: Blood Purification
Yoshinari Hatanaka, Terumi Higuchi, Yurie Akiya, Tomomi Horikami, Ritsukou Tei, Tetsuya Furukawa, Hiroyuki Takashima, Hyoe Tomita, Masanori Abe
BACKGROUND: Patients on hemodialysis (HD) are known to be at risk of carnitine deficiency. The aims of this study were to investigate the prevalence of carnitine deficiency in patients on dialysis and to compare the likelihood of a reduction in the serum carnitine level on HD with that on hemodiafiltration (HDF). METHODS: The prevalence of carnitine deficiency, defined as a serum free carnitine level < 20 μmol/L, and that of carnitine insufficiency, defined as an acyl/free carnitine ratio > 0...
April 3, 2019: Blood Purification
Francisco Maduell, Lida Rodas, José Jesús Broseta, Miquel Gomez, Marc Xipell, Elena Guillen, Enrique Montagud-Marrahi, Marta Arias-Guillén, Néstor Fontseré, Manel Vera, Nayra Rico
BACKGROUND: A novel class of membranes, medium cut-off (MCO) membranes, has recently been designed to achieve interesting removal capacities for middle and large middle molecules in hemodialysis (HD) treatments. The few studies published to date have reported contradictory results regarding middle-sized molecules when comparing MCO dialyzers versus dialyzers used in online hemodiafiltration (OL-HDF). METHODS: A prospective, single-center study was carried out in 22 patients...
April 3, 2019: Blood Purification
Takeshi Nakanishi, Takahiro Kuragano
No abstract text is available yet for this article.
April 3, 2019: Blood Purification
Ken Sakai, Youji Hyoudou, Hiroshi Nihei, Takeshii Kawamura
BACKGROUND/AIMS: To examine the relationship of extracellular fluid (ECF) volume and osmotic excess with treatment modality, we retrospectively analyzed spontaneous body weight loss and osmotic excretion versus true body weight after kidney transplantation in peritoneal dialysis (PD) patients and preemptive transplant recipients compared with hemodialysis (HD) patients. We also examined maximum bladder volume in other transplant recipients on PD. METHODS: From 2005 to 2011, 42 PD patients underwent kidney transplantation at our institution...
April 3, 2019: Blood Purification
Kazuhiro Toyoda, Takahiro Kuragano, Hiroaki Kawada, Tomo Taniguchi, Takeshi Nakanishi
BACKGROUND/AIM: In maintenance hemodialysis (MHD), protein-energy malnutrition and chronic inflammation can be critical and are two of the main causes of mortality. METHOD: We compared the change in nutrition and inflammatory conditions between younger and older MHD patients during a 2-year period. Furthermore, using Kaplan-Meier analysis, we evaluated the correlations between changes in each parameter and any adverse events. RESULT: During the observational period, body mass index (BMI) and serum albumin levels decreased significantly in older patients...
April 3, 2019: Blood Purification
Hidetomo Nakamoto, Takehito Kobayashi, Toru Noguchi, Takeru Kusano, Keigo Ashitani, Hiroyuki Imaeda, Michiko Maezono
BACKGROUND/AIMS: In this study, we investigated the severity and frequency of uremic pruritus and itch-associated insomnia in patients with end-stage renal disease (ESRD) or chronic kidney disease (CKD). METHODS: This questionnaire-based study included outpatients with ESRD or CKD who were attending Tokorozawa Renal Clinic in Saitama Prefecture or Musashi Ranzan Hospital and were stable on treatment. The questionnaire was completed by patients on hemodialysis (HD) before a dialysis session and by patients on peritoneal dialysis (PD) or conservative treatment at the time of an outpatient hospital visit...
April 3, 2019: Blood Purification
Kosuke Mizusaki, Yukiko Hasuike, Tomoko Kimura, Yasuyuki Nagasawa, Takahiro Kuragano, Yusuke Yamada, Michio Nojima, Shingo Yamamoto, Takeshi Nakanishi, Masaharu Ishihara
BACKGROUND/AIMS: α-Klotho is mainly expressed in the kidneys, and its soluble form can prevent vascular calcifications. Inhibition of the mammalian target of rapamycin (mTOR) upregulates Klotho. We assessed serial changes in the levels of soluble Klotho (sKlotho) in recipients before and after renal transplantation and investigated the effects of an mTOR inhibitor. METHODS: Serum sKlotho levels were measured in 36 recipients before and 1 year after transplantation and compared between those taking everolimus and those not taking everolimus...
April 3, 2019: Blood Purification
Chie Ogawa, Ken Tsuchiya, Kosaku Nitta, Kunimi Maeda
Optimal iron level in hemodialysis patients remains a subject of debate. The reticulocyte hemoglobin content (CHr) is believed to reflect the concentration of iron required in the most recent hematopoiesis in the bone marrow. CHr is not influenced by any factors that measure direct hemoglobin (Hb) of reticulocytes and is considered a reliable indicator. The supply of iron for Hb synthesis is regulated by hepcidin-25 (Hep-25). However, CHr and Hep-25 measurements are not covered by the Japanese medical insurance system...
April 3, 2019: Blood Purification
Toshihide Hayashi, Nobuhiko Joki, Yuri Tanaka, Masaki Iwasaki, Shun Kubo, Ai Matsukane, Yasunori Takahashi, Yoshihiko Imamura, Koichi Hirahata, Hiroki Hase
BACKGROUND/AIMS: There is lack of definitive evidence about the association between erythropoiesis-stimulating agent (ESA) responsiveness in the pre-dialysis phase and mortality. Therefore, we conducted a hospital-based, retrospective, cohort study to assess the predictive value of ESA response for prognosis in incident hemodialysis patients. METHODS: A total of 108 patients without preexisting cardiovascular disease who had been started on maintenance hemodialysis were studied...
April 3, 2019: Blood Purification
Tatsunori Toida, Yuji Sato, Hiroyuki Komatsu, Kazuo Kitamura, Shouichi Fujimoto
BACKGROUND/AIMS: Uric acid (UA) levels are affected by changes in dialysis; however, the relationship between the pre- and postdialysis UA difference (UAD) and mortality remains unclear. METHODS: A total of 1,073 patients receiving maintenance hemodialysis (HD) were enrolled in this cohort study and followed up for 5 years. Patients were divided into quartile categories according to baseline UAD. Cox's regression analyses were used to investigate the relationship between UAD categories and all-cause and cardiovascular (CV) mortalities while adjusting for potential confounders...
April 3, 2019: Blood Purification
Misao Tsukada, Naoko Miwa, Norio Hanafusa, Nobue Tanaka, Ken Tsuchiya, Kosaku Nitta
BACKGROUND/AIMS: Aortic arch calcification (AoAC) is a fatal complication in dialysis. AoAC progression-related molecules in continuous ambulatory peritoneal dialysis (CAPD) remain unclear. METHODS: AoAC was estimated using plain chest radiography scoring (AoACS) in 30 CAPD patients (age 49.3 ± 13.4 years). AoAC progression was defined as increased AoACS on follow-up chest X-ray at the end of the study (progressors). Fibroblast growth factor-23 and osteoprotegerin (OPG) were measured...
April 3, 2019: Blood Purification
Hirokazu Honda, Kenji Tanaka, Tetsuo Michihata, Keigo Shibagaki, Toshitaka Yuza, Keiichi Hirao, Naohisa Tomosugi, Takanori Shibata
AIMS: This study assessed the impact of iron administration on serum fibroblast growth factor 23 (FGF23) levels. METHODS: Of 123 hemodialysis (HD) patients treated with erythropoiesis-stimulating agents, 22 received once-weekly intravenous iron and 17 received daily oral iron with iron-containing phosphate binders. Intact FGF23 and biomarkers of iron metabolism were measured from blood samples drawn before each HD session, at baseline and on days 3, 5, 7, and 14...
April 3, 2019: Blood Purification
Fumihiko Furuya, Ai Motosugi, Kazutaka Haraguchi, Shunichiro Hanai, Toshihisa Ishii, Yasuno Yamaguchi, Kenichiro Kitamura
BACKGROUND: Peripheral arterial disease (PAD) has increased in association with the increase in the numbers of patients with kidney disease or diabetes. The aim of this study was to assess the prevalence of PAD in hemodialysis patients with diabetes. METHODS: To examine the usefulness of the cardio-ankle vascular index (CAVI) to screen for the presence of PAD, cross-sectional studies of 100 patients undergoing chronic hemodialysis were performed. The CAVI and other inflammatory markers were evaluated...
April 3, 2019: Blood Purification
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