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/AIMS:Severe sepsis and septic shock continue to be major clinical challenges due to high associated mortality. Lipopolysaccharide (LPS) is a component of the cell membrane of Gram-negative bacteria, and is believed to initiate septic-induced signaling, inflammation and organ damage, including acute renal fai...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000315920
更新日期:2010-01-01 00:00:00
abstract::Angiotensin-induced proteinuria was examined at the glomerular-tubular level in rats. Ultra-micro-disc electrophoresis was employed to determine albumin concentration of rat proximal tubular fluid samples under control conditions and during the infusion of 0.15 mug/min X 100 g body weight angiotensin II using micropun...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000398226
更新日期:1975-01-01 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::Home hemodialysis (HHD) started in Japan in 1969. It has been done in the largest number of patients with the purpose of better social reintegration, followed by patients for whom commuting to a hospital is geographically difficult. In a subanalysis of the JSDT patient registry, the survival rate at 9 years for male p...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000336942
更新日期:2012-01-01 00:00:00
abstract::Mixed-dilution hemodiafiltration (mixed HDF) controlled by the transmembrane pressure (TMP) feedback, improves the depurative capacity of the more traditional HDF techniques by fully exploiting the convective mechanism of small- and middle-molecular-weight solute removal. The feedback allows the TMP to be set and prof...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000107242
更新日期:2007-01-01 00:00:00
abstract::Continuous renal replacement therapy (CRRT) has many potential indications that extend beyond the traditional removal of uremic waste products. Many of these stem from the capacity of CRRT to remove middle-sized molecules and its suitability for haemodynamically unstable patients. Using CRRT for immunomodulation to re...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000485605
更新日期:2018-01-01 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::In order to prevent a disease, its temporal nature (or at least when it starts) needs to be clearly defined. In acute kidney injury (AKI), this is usually not possible because the current diagnostic criteria are retrospective. Contrast-induced nephropathy (CIN) and cardiac surgery-associated acute kidney injury (CSA-A...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000329387
更新日期:2011-01-01 00:00:00
abstract::Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disease in man and is caused by germline mutations in PKD1 or PKD2. Affected patients develop progressively enlarged kidneys due to the growth of multiple renal epithelial cysts. Several studies have demonstrated marked intrafamilia...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000328701
更新日期:2011-01-01 00:00:00
abstract::Membranoproliferative glomerulonephritis (MPGN) is characterised by mesangial expansion and hypercellularity and capillary wall thickening with capillary wall and mesangial deposits of immunoglobulin and/or complement. Two main forms are described in humans: MPGN type I with subendothelial and mesangial electron-dense...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000314775
更新日期:2011-01-01 00:00:00
abstract::Many physiological processes relate to two aspects of kidney function: (1) excretory and secretory (excretion of electrolytes and water, elimination of metabolic end products and uremic toxins, regulation of the acid-base status), and (2) endocrine functions (regulating bone and mineral metabolism and red blood cell p...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000337836
更新日期:2012-01-01 00:00:00
abstract::Antibodies and B cells are increasingly recognized as major modulators of allograft function and survival. Improved immunohistochemical and serologic diagnostic procedures have been developed to monitor antibody responses against HLA antigens during the last decade. Acute and chronic allograft rejection can occur in H...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000170845
更新日期:2009-01-01 00:00:00
abstract::Ablation of renal tissue makes the subject sensitive to hypertension-inducing mechanisms, especially those due to fluid expansion, either by Na-volume or whole blood. Such hypertensive mechanisms are prevented by deviation of urine flow into a vein. Ablation of the renal medulla, by acute hydronephrosis or chemically,...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000401655
更新日期:1978-01-01 00:00:00
abstract::Cardiorenal syndrome (CRS) type 3 is a subclassification of the CRS whereby an episode of acute kidney injury (AKI) precipitates and contributes to the development of acute cardiac injury. There is limited understanding of the pathophysiologic mechanisms of how AKI contributes to acute cardiac injury and/or dysfunctio...
journal_title:Contributions to nephrology
pub_type: 共识发展会议,杂志文章
doi:10.1159/000349971
更新日期:2013-01-01 00:00:00
abstract::Apart from the critical selection of patients, surgical results in renovascular surgery depend mainly on technical problems. To overcome most frequent technical handicaps, such as a deep abdominal cavity, intervening structures, additional distal stenoses and limited ischemic tolerance time, several technical principl...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000399387
更新日期:1976-01-01 00:00:00
abstract::The relationship between hyperuricemia and hypertensive disorders is well established; however, until today, the role of uric acid in the clinical course of severe preeclampsia has not been elucidated. Some recent studies suggest that at the time of presentation, subjects with severe preeclampsia frequently have signi...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000484285
更新日期:2018-01-01 00:00:00
abstract::Many peritoneal dialysis patients are overhydrated. Overhydration may lead to hypertension and left ventricular hypertrophy, and may be related to inflammation and malnutrition. The presence of overhydration is not always detected by clinical examination. Especially patients with peritoneal ultrafiltration failure and...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000093510
更新日期:2006-01-01 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::Renal replacement therapy performed for end-stage renal disease patients now occurs almost exclusively with hollow-fiber dialyzers. Because renal replacement therapy utilizing such a device requires goals to be set with regard to the rate and extent of solute removal, a thorough understanding of the mechanisms by whic...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000107232
更新日期:2007-01-01 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:BACKGROUND:An arteriovenous fistula (AVF) is considered the gold standard modality of vascular access (VA) for maintenance hemodialysis (HD) because of its superior patency, few complications, provision of high quality of life, and low risk of patient mortality. The rapid growth of the aging population and the high pre...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000496530
更新日期:2019-01-01 00:00:00
abstract::The results of a nationwide statistical survey of peritoneal dialysis (PD) in Japan (PD registry) were reported at the end of 2012. There were 9,514 PD patients at the end of 2012 (3.1%), indicating 128 fewer than in the 2011 survey (9,642 patients). There were 347 non-PD+catheter patients, and 175 patients were start...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000380975
更新日期:2015-01-01 00:00:00
abstract::Peritoneal dialysis (PD) is an underutilized renal replacement therapy in the developing world. It offers advantages of simplicity, reduced need of training, lack of dependence on infrastructure and location. The population is extremely underserved by healthcare and means to achieve it. PD is unavailable in many Afric...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000223805
更新日期:2009-01-01 00:00:00
abstract::The pathophysiology of acute kidney injury involves a complex interplay among vascular, tubular, and inflammatory factors followed by a repair process that can either restore epithelial differentiation and function to normal or result in progressive fibrotic chronic kidney disease. Innate and acquired immunity play an...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000313738
更新日期:2010-01-01 00:00:00
abstract::The use of 99Tcm-labelled DMSA as a static renal imaging agent has been analyzed semi-quantitatively in 366 patients. Study with this agent proved to be of most value in patients with equivocal space-occupying lesions of the kidney, provided useful information in various destructive diseases of the kidney when used fo...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000401784
更新日期:1978-01-01 00:00:00
abstract::The purpose of this study is to retrospectively analyze the clinical characteristics of patients with diabetes mellitus who started dialysis therapy. First, we reviewed 120 cases of end-stage renal failure due to diabetic nephropathy who started dialysis therapy in 1996 and 1997. Presenting features were as follows: m...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000101005
更新日期:2007-01-01 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::Diabetic nephropathy (DN) remains a major complication of diabetes leading to end-stage renal disease (ESRD). The number of diabetic patients with ESRD who require renal replacement therapy has been increasing, implicating unsuccessful prevention of diabetic renal complication. This unfavorable outcome reflects insuff...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000325657
更新日期:2011-01-01 00:00:00
abstract::This chapter reviews a body of evidence concerning the anatomic pathology, pathogenesis, epidemiology and possible etiologic agents of benign essential hypertension in human populations. A core finding serves as the starting point for further reasoning: intimal fibroplasia of renal interlobular arteries (arteriosclero...
journal_title:Contributions to nephrology
pub_type: 杂志文章,评审
doi:10.1159/000314908
更新日期:2011-01-01 00:00:00
abstract::40 patients with bone disease due to chronic renal failure have been treated with 1 alpha-hydroxyvitamin D3 or 1,25-dihydroxyvitamin D3 for a total of 750 patient-months. Both compounds were very effective in relieving bone pain and muscle weakness, and in reversing the radiographic and biochemical indices of disturbe...
journal_title:Contributions to nephrology
pub_type: 杂志文章
doi:10.1159/000403270
更新日期:1980-01-01 00:00:00