Abstract:
:Cardiovascular disease is a major concern in patients with end-stage kidney disease (ESKD). Inflammation induced by retention of uremic toxins, of which a substantial fraction has a molecular weight in the middle molecular range, has been associated with increased cardiovascular risk. In an attempt to reduce inflammation and thus cardiovascular toxicity in patients with ESKD, hemodiafiltration (HDF) has been promoted to enhance the clearance of middle molecular weight substances during dialysis. However, HDF increases the technical complexity and costs, and requires ultrapure dialysis fluid. Also, HDF becomes less beneficial when it is not possible to achieve sufficient convective volume in all patients. Over the last years, membranes with larger pore sizes, such as medium cut-off and high cut-off, have been introduced. These membranes, applied in hemodialysis mode, appear to have removal rates of middle molecular weight molecules that are comparable to those achieved with HDF, and could thus obviate the need for HDF. However, ultrapure dialysis fluid might still be required if there is a risk of transmigration of contaminants from the dialysate side into the blood because of the increased pore size. This transmigration of pyrogens might upregulate the expression of cytokines and other pro-inflammatory factors, and thus completely neutralize the beneficial effects of higher clearance of middle molecules. This chapter will explore the existing evidence on permeability of membranes with large pores for bacterial degradation products, and based on this information we will try to define the position of these novel membranes among the spectrum of existing membranes.
journal_name
Contrib Nephroljournal_title
Contributions to nephrologyauthors
Van Biesen W,Vanholder R,Schepers E,Glorieux G,Dhondt A,Eloot Sdoi
10.1159/000479265subject
Has Abstractpub_date
2017-01-01 00:00:00pages
168-177eissn
0302-5144issn
1662-2782pii
000479265journal_volume
191pub_type
杂志文章,评审abstract:BACKGROUND:A reason for the higher frequency of vascular access-related infections in buttonhole cannulation patients remains to be elucidated. If the higher frequency of infections is associated with a factor(s) inherent to the buttonhole method (e.g. existence of a buttonhole track or other factors), the frequency of...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000431163
更新日期:2015-01-01 00:00:00
abstract::The reabsorption capacity of albumin was determined by a clearance technique following a single load of bovine or rat serum albumin in conscious rats. The maximum reabsorption capacity of both albumin amounted to 5.6--6.2 micrograms/min . 100 g BW and there seemed to be a nonselective mechanism for the two albumins. T...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000428782
更新日期:1980-01-01 00:00:00
abstract::Liver insufficiency is a dramatic syndrome with multiple organ involvement. A multiplicity of toxic substances (hydrophilic like ammonia and lipophilic like bilirubin or bile acids or mercaptans) are released into the systemic circulation, thus altering many enzymatic cellular processes. Patients frequently die while ...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000102130
更新日期:2007-01-01 00:00:00
abstract::In recent years the concept of biocompatibility is not limited to the dialytic membranes, but has been substituted by a more general viewpoint where all the parameters of the dialytic treatment are taken into consideration: the interaction of blood-surfaces (the dialyzer in all its components and the hematic lines), t...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000096813
更新日期:2007-01-01 00:00:00
abstract::Peritoneal dialysis (PD) as a therapy with all its advantages has not grown as would have been expected except in certain pockets, notably in Asia. In our opinion, from patient and their family interviews, a perception among prospective PD patients of inaccessibility to the referral PD Unit (RPU), usually for patients...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000337816
更新日期:2012-01-01 00:00:00
abstract::As a marker for bone formation, bone Gla protein (BGP) levels in the circulation have been measured in clinical research and management for metabolic bone diseases. We evaluated the clinical availability of a newly developed two-site immunoradiometric assay (IRMA) for human BGP and determined the serum BGP concentrati...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000420137
更新日期:1991-01-01 00:00:00
abstract::To study the participation of the antibody avidity in the pathogenesis of lupus nephritis, we measured the antibody avidity to native DNA by the method of Minden and Farr (14) in patients with SLE. The avidity to native DNA was almost less than 40%. The avidity and the histological activity of lupus nephritis were wel...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000399698
更新日期:1975-01-01 00:00:00
abstract::Over last half century, the concept of acute renal failure has evolved and with it our estimates of the incidence, prevalence and mortality. Indeed, until very recently no standard definition of acute renal failure was available, and this lack of a common language created confusion and made comparisons all but impossi...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000102010
更新日期:2007-01-01 00:00:00
abstract::Acute renal failure (ARF) is the rapid loss of the renal filtration function, which is characterized by metabolic acidosis, high potassium levels, a body fluid imbalance, and so on. The overall mortality rate of ARF is about 45%; however, the mortality rate of sepsis-induced ARF is about 70%. In addition, sepsis is th...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000314849
更新日期:2010-01-01 00:00:00
abstract::A direct and independent association between serum phosphate (P) levels and mortality has been reported. High circulating P concentrations, still within the normal range, was associated with unfavourable outcomes in normal subjects as well as in chronic kidney disease (CKD) patients. Experimental data support the noti...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000468915
更新日期:2017-01-01 00:00:00
abstract::Acute deterioration in kidney function often occurs in patients with acute and chronic liver disease admitted to hospital. The true incidence of acute kidney injury (AKI) is unknown due to the difficulty in accurately measuring kidney function in patients with liver failure, and the lack of a consensus definition of A...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000313759
更新日期:2010-01-01 00:00:00
abstract::A review is given on methods that can be used for the assessment of dry body weight in peritoneal dialysis patients. Besides clinical examination, the use of natriuretic hormone concentrations in plasma, and the value of multifrequency bio-impedance analysis is discussed. Ultrafiltration targets as formulated in vario...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000223785
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Hemodialysis-associated pruritus (HAP) is often treatment-resistant, and is a serious comorbidity that adversely affects prognosis and reduces patient quality of life through sleep disruption and depression. SUMMARY:HAP can arise from a combination of several causes; accordingly, it is often resistant to tr...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000485705
更新日期:2018-01-01 00:00:00
abstract::Chronic kidney disease (CKD) patients present an inflammatory process that induces endothelial damage and therefore plays a role in the high rates of cardiovascular morbidity and mortality reported in these patients. Although new therapies have reduced the elevated serum levels of inflammatory mediators such as cytoki...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000327134
更新日期:2011-01-01 00:00:00
abstract::Multiple mycloma causes a disproportionate amount of the malignancy-related renal insufficiency. Acute renal insufficiency in myeloma patients can occur due to dehydration, hypercalcemia, side effects of medications (NSAIDs) or tumor lysis syndrome in addition to cast nephropathy, amyloidosis and light chain depositio...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000096767
更新日期:2007-01-01 00:00:00
abstract::Plasma levels of 1,25-(OH)2-D were low in children with hypophosphatemic vitamin D-resistant rickets (HVDRR), but increased after very large doses of 1 alpha-OH-D3. These results suggest that the metabolism of 1,25-(OH)2-D is accelerated in HVDRR. In addition, the lower level of plasma 1,25-(OH)2-D in untreated HVDRR ...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000385992
更新日期:1980-01-01 00:00:00
abstract::PTH is responsible for the maintenance of calcium homeostasis and normocalcemia. Secretion of PTH is stimulated or suppressed by perturbations in the serum calcium level. The calciotropic effects of PTH are mediated primarily by bone, where PTH-stimulated remodeling may release calcium to the extracellular fluid, and ...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000420156
更新日期:1991-01-01 00:00:00
abstract::Dextrans and other macromolecular inert polymers such as polyvinyl pyrrolidone fulfil all the criteria of an ideal test material for measuring glomerular permeability. Following a single intravenous injection of radioactively labelled polydisperse material serial plasma and urine samples can be analysed by gel filtrat...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000398222
更新日期:1975-01-01 00:00:00
abstract::The present studies demonstrate a stimulatory effect of intact parathyroid hormone on hepatic glucose production in vivo. This increased glucose production was accompanied by augmented alanine uptake by the liver. In addition, PTH increased the conversion of 14C-alanine to 14C-glucose. These results suggest that the i...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000384962
更新日期:1980-01-01 00:00:00
abstract::As our knowledge of managing renal anemia with recombinant human erythropoietin has grown, new clinical challenges have emerged. Although initial observational studies produced important favorable results, troubling observations later came from 4 randomized controlled trials that assigned CKD patients to intervention ...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000327173
更新日期:2011-01-01 00:00:00
abstract::A great variety of thrombotic and nonthrombotic events may complicate all types of vascular access (VA) procedures. Thrombotic events are the most frequent complication, caused by stenoses in various locations, representing a common problem for arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs). Monitoring ...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000365912
更新日期:2015-01-01 00:00:00
abstract::Which intermediate metabolite of 23(S)25(R)-1 alpha,25-(OH)2D3-26,23-lactone causes the unique biological functions of 1 alpha,25-(OH)2D3-26,23-lactone different from that of 1 alpha,25-(OH)2D3 was examined comparatively. The three intermediate metabolites, 1 alpha,25(R)26-(OH)3D3, 1 alpha,23(S)25(R)26-(OH)4D3, and 23...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000420165
更新日期:1991-01-01 00:00:00
abstract::Apart from the well-known role of hypertension in cerebrovascular disease, chronic kidney disease is emerging as an independent risk factor for stroke. Although the mechanism underlying the relationship between blood pressure variability, diurnal blood pressure variation disruption (e.g. nondipping) and kidney dysfunc...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000346725
更新日期:2013-01-01 00:00:00
abstract::End-stage renal disease is an almost unique disease area in which patients not only choose their treatment modality but can also change their mind and their treatment as time goes by. The way that information about treatment options is presented to patients is critical in influencing how they process this information,...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000337891
更新日期:2012-01-01 00:00:00
abstract::To investigate the parathyroid function in diabetes mellitus, we performed an oral phosphate load in 6 diabetic patients and 6 nondiabetic subjects without renal failure (serum creatinine less than 1.5 mg/dl). Each subject received a total of 2.0 g of phosphate daily per os on 5 consecutive days. Blood and urine sampl...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000420146
更新日期:1991-01-01 00:00:00
abstract::Insulin resistance (IR) and its associated metabolic derangements are known complications of advanced chronic kidney disease (CKD). The etiology of IR in CKD is multifactorial with likely contributions from vitamin D deficiency, obesity, metabolic acidosis, inflammation, and accumulation of 'uremic toxins' leading to ...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000130659
更新日期:2008-01-01 00:00:00
abstract::The analysis of the hemodynamic parameters involved in the regulation of blood pressure during correction of anemia shows - although peripheral resistance and cardiac output behave qualitatively as in the nonuremic patient - that the extent of change may be inadequate resulting in an increased blood pressure. The unde...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000418720
更新日期:1990-01-01 00:00:00
abstract::Cardiovascular morbidity and the mortality rate are manifoldly greater in chronic kidney disease (CKD) patients. Mineral metabolism (MM) derangements and particularly changes in calcium (Ca) and phosphate (P) metabolism have been included among the large array of putative causal factors of this poor clinical outcome d...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000130680
更新日期:2008-01-01 00:00:00
abstract::Continuous renal replacement therapy is expected to improve unfavorable status in critical care. As precise volume control is most important to maintain the damaged circulation system, blood and solution control should be carried out precisely. Recently, further technical development was achieved in this area, and qua...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000314862
更新日期:2010-01-01 00:00:00
abstract::Other than renal transplantation, the two major treatment options for patients with stage V kidney disease are hemodialysis and peritoneal dialysis. Both therapies have advantages and disadvantages while there are obvious physical differences in the way they are delivered. In clinical practice, one typically uses one ...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000337855
更新日期:2012-01-01 00:00:00