Middle-molecule clearance at 20 and 35 ml/kg/h in continuous venovenous hemodiafiltration.

Abstract:

BACKGROUND:Of 5 clinical trials testing dose response of continuous renal replacement therapy (CRRT) in acute kidney injury, 2 showed a benefit, 2 showed none, and 1 appeared equivocal. However, blood-membrane interactions may dominate macromolecule transport in continuous venovenous hemodiafiltration, reducing the impact of dose adjustment. The dosing arms in the Acute Renal Failure Trial Network (ATN) study may have delivered similar clearances for middle molecules. METHODS:We simulated the 2 CRRT doses in the ATN study using a synthetic polydisperse macromolecular probe in bovine blood. Clearance of tracers between 10 and 100 kDa molecular weight was measured during 6 h of therapy. RESULTS:Middle-molecule clearance differed by less than 2 ml/min between the 2 dosing arms. CONCLUSION:The CRRT prescription used in the ATN study appears to have achieved dose separation for small molecules while holding middle-molecule clearance nearly constant. This may explain the outcome difference between the ATN study and earlier studies, and suggests subsequent trial designs.

journal_name

Blood Purif

journal_title

Blood purification

authors

Hofmann CL,Fissell WH

doi

10.1159/000266483

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

259-63

issue

3

eissn

0253-5068

issn

1421-9735

pii

000266483

journal_volume

29

pub_type

杂志文章
  • Pathogenesis and management of upper-extremity ischemia following angioaccess surgery.

    abstract::Thirty-four patients with end-stage renal disease requiring hemodialysis developed over the course of 7 years (1987-1994) severe ischemia in the extremity carrying the angioaccess secondary to arterial 'steal'. Seven of these patients were treated with access ligation, 4 with banding reducing the flow through the acce...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000170286

    authors: Haimov M,Schanzer H,Skladani M

    更新日期:1996-01-01 00:00:00

  • Vascular access vulnerability in intensive hemodialysis: a significant Achilles' heel?

    abstract:BACKGROUND:Frequent hemodialysis (HD) may be associated with an increased risk of vascular access complications. Studies addressing vascular access outcomes in frequent HD show conflicting results. METHODS:We searched Medline for trials looking at vascular access outcomes in frequent HD. RESULTS:Nineteen studies met ...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000362106

    authors: Cornelis T,Usvyat LA,Tordoir JH,Wang Y,Wong M,Leunissen KM,van der Sande FM,Kotanko P,Kooman JP

    更新日期:2014-01-01 00:00:00

  • Plasma cysteine/cystine reduction potential correlates with plasma creatinine levels in chronic kidney disease.

    abstract:BACKGROUND/AIMS:Oxidative stress has been considered a nontraditional risk factor for cardiovascular disease in the chronic kidney disease (CKD) population, possibly triggered by uremic toxicity. METHODS:A chromatographic method with coulometric detection was adapted to directly and simultaneously determine cysteine (...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000342627

    authors: Rodrigues SD,Batista GB,Ingberman M,Pecoits-Filho R,Nakao LS

    更新日期:2012-01-01 00:00:00

  • Dietary and pharmacological control of calcium and phosphate metabolism in dialysis patients.

    abstract::Chronic kidney disease-mineral and bone disorder is a new term defining a complex syndrome which underlines the need of a systemic approach to disturbances of calcium and phosphate metabolism in patients with renal failure. In recent years, the availability of new phosphorus binders and the appearance of new selective...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000209250

    authors: Bover J,Andrés E,Lloret MJ,Aguilar A,Ballarín J

    更新日期:2009-01-01 00:00:00

  • Effect of Furosemide on Urinary Oxygenation in Patients with Septic Shock.

    abstract:BACKGROUND:Renal medullary hypoxia precedes the development of acute kidney injury in experimental sepsis and can now be assessed by continuous measurement of urinary oxygen tension (PuO2). OBJECTIVES:We aimed to test if PuO2 measurements in patients with septic shock would be similar to those shown in experimental se...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000501512

    authors: Osawa EA,Cutuli SL,Bitker L,Canet E,Cioccari L,Iguchi N,Lankadeva YR,Eastwood GM,Evans RG,May CN,Bellomo R

    更新日期:2019-01-01 00:00:00

  • When should renal replacement therapy for acute kidney injury be initiated and discontinued?

    abstract:BACKGROUND:Critically ill patients with acute kidney injury (AKI) are at high risk for death and frequently require initiation of renal replacement therapy (RRT). There is wide variation in clinical practice on the indications for and timing of initiation and discontinuation of RRT. Numerous clinical and biochemical fa...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000157325

    authors: Gibney RT,Bagshaw SM,Kutsogiannis DJ,Johnston C

    更新日期:2008-01-01 00:00:00

  • Dialysate Calcium Levels: Do They Matter?

    abstract:BACKGROUND:Calcium (Ca) is an essential element that plays a critical role in many biological processes. In dialysis patients, the regulation of Ca balance is highly complex, given the absence of kidney function, endocrine disturbances and the use of drugs such as phosphate binders, vitamin D analogues, and calcimimeti...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000494584

    authors: van der Sande FM,Ter Meulen KJA,Kotanko P,Kooman JP

    更新日期:2019-01-01 00:00:00

  • Peritoneal Dialysis Treatment Modality Option in Acute Kidney Injury.

    abstract:BACKGROUND:Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMM...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000452703

    authors: Ponce D,Gobo-Oliveira M,Balbi AL

    更新日期:2017-01-01 00:00:00

  • Anticoagulation for continuous arteriovenous hemofiltration in children.

    abstract::Continuous arteriovenous hemofiltration requires continuous anticoagulation to prevent early hemofilter clotting. We used heparin given continuously in the arterial line of the extracorporeal circuit as anticoagulant in children with initially normal coagulation status, and heparin and/or prostacyclin in high-risk ble...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000169489

    authors: Zobel G,Trop M,Muntean W,Ring E,Gleispach H

    更新日期:1988-01-01 00:00:00

  • Peritonitis - does peritoneal dialysis modality make a difference?

    abstract:BACKGROUND/AIMS:Peritonitis remains a significant problem for patients on peritoneal dialysis (PD). There is a certain amount of controversy as to whether peritoneal modality is itself a risk factor for peritonitis, with one modality higher than another. METHODS:A literature review was done (August 2009) searching und...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000245641

    authors: Piraino B,Sheth H

    更新日期:2010-01-01 00:00:00

  • Regulation of the response to bacterial lipopolysaccharide by endogenous and exogenous lipopolysaccharide binding proteins.

    abstract::Bactericidal/permeability-increasing protein (BPI) is a natural constituent of human neutrophils. Recombinant BPI has been shown to bind to bacterial lipopolysaccharide (LPS), and to neutralize the ability of LPS to stimulate inflammatory cells in vitro and in vivo. BPI shares sequence homology and immunocrossreactivi...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000170107

    authors: Marra MN,Thornton MB,Snable JL,Leong S,Lane J,Wilde CG,Scott RW

    更新日期:1993-01-01 00:00:00

  • Microcirculation: Physiology, Pathophysiology, and Clinical Application.

    abstract::This paper briefly reviews the physiological components of the microcirculation, focusing on its function in homeostasis and its central function in the realization of oxygen transport to tissue cells. Its pivotal role in the understanding of circulatory compromise in states of shock and renal compromise is discussed....

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000503775

    authors: Guven G,Hilty MP,Ince C

    更新日期:2020-01-01 00:00:00

  • Epidemiology of acute renal failure in ICUs: a multi-center prospective study.

    abstract:BACKGROUND AND AIM:Acute kidney injury (AKI) is a common complication in intensive care units (ICUs). However, its incidence and outcome vary in several studies depending on definitions used or even the geographic origin of the study. We aimed to evaluate the epidemiology of AKI in ICUs in Greece. METHOD:Prospective m...

    journal_title:Blood purification

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000231986

    authors: Andrikos E,Tseke P,Balafa O,Cruz DN,Tsinta A,Androulaki M,Pappas M,Ronco C

    更新日期:2009-01-01 00:00:00

  • Peritoneal membrane evaluation in routine clinical practice.

    abstract:BACKGROUND/AIMS:Establishment of reference values for small solute transport, sodium sieving and effluent CA125 with 3.86% (4 h) peritoneal equilibration test (PET), and comparison with fast-fast PET with regard to small solute transport categories. METHODS:Cross-sectional study; 69 prevalent patients. Sodium sieving ...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000113009

    authors: Rodrigues AS,Silva S,Bravo F,Oliveira JC,Fonseca I,Cabrita A,Krediet RT

    更新日期:2007-01-01 00:00:00

  • Uremia-specific alterations in lipid metabolism.

    abstract::Uremic patients suffer from a secondary form of complex dyslipidemia consisting of quantitative and qualitative abnormalities in serum lipoproteins resulting in altered lipoprotein composition and metabolism. The most prominent are an increase in serum triglyceride levels (due to elevated very-low-density lipoprotein ...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000063557

    authors: Wanner C,Krane V

    更新日期:2002-01-01 00:00:00

  • Endotoxin removal: bringing the mission to North America.

    abstract::The EUPHRATES trial (Evaluating Use of Polymyxin B Hemoperfusion in a Randomized Controlled Trial of Adults Treated for Endotoxemia and Septic Shock) is the first biomarker-driven trial in sepsis. This unique trial is being run in a blinded manner, further contributing to the robustness of its design. This paper will ...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000356832

    authors: Foster D,Klein DJ,Guadagni G,Walker PM

    更新日期:2014-01-01 00:00:00

  • Lower serum magnesium is associated with cardiovascular risk factors and mortality in haemodialysis patients.

    abstract:BACKGROUND:Hypomagnesaemia is a cardiovascular (CV) risk factor in the general population. The aim of this study was to evaluate the relationship between pre-dialysis magnesium (Mg) and CV risk markers, [including pulse pressure (PP), left ventricular mass index (LVMI) and vascular calcifications (VC)], and mortality i...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000366124

    authors: João Matias P,Azevedo A,Laranjinha I,Navarro D,Mendes M,Ferreira C,Amaral T,Jorge C,Aires I,Gil C,Ferreira A

    更新日期:2014-01-01 00:00:00

  • Enhanced functional performance characteristics of a new polysulfone membrane for high-flux hemodialysis.

    abstract::Elimination of uremic solutes with molecular weights up to 60 kD, without significant loss of albumin is an important therapeutic goal to optimize outcomes in chronic hemodialysis patients. To characterize a newly developed polysulfone dialyzer (APS-650) a comparative analysis was performed with a highly advanced poly...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000063099

    authors: Klingel R,Ahrenholz P,Schwarting A,Röckel A

    更新日期:2002-01-01 00:00:00

  • Effects of Multidisciplinary Team Care Based on 5E's Renal Rehabilitation for Peritoneal Dialysis Patients in Guangxi Zhuang Autonomous Region of China: A Randomized Controlled Trial.

    abstract:BACKGROUND:The number of patients with peritoneal dialysis (PD) in China has been increasing year after year, but there are still some challenge in the management of PD patients, and the efficient and effective method has yet to be developed. Multidisciplinary team (MDT) is to create a standardized, individualized, and...

    journal_title:Blood purification

    pub_type: 杂志文章,随机对照试验

    doi:10.1159/000496823

    authors: Luo Y,Huang Y,Chen X,Meng G,Zhang Y

    更新日期:2019-01-01 00:00:00

  • Daily protein intake and patient outcomes in severe acute kidney injury: findings of the randomized evaluation of normal versus augmented level of replacement therapy (RENAL) trial.

    abstract:BACKGROUND AND AIMS:We aimed to examine the association between daily protein intake (DPI) and outcomes in patients from the Randomized Evaluation of Normal versus Augmented Level (RENAL) trial. METHODS:We analyzed the association between DPI and clinical outcomes using multivariable logistic regression, Cox proportio...

    journal_title:Blood purification

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1159/000363175

    authors: Bellomo R,Cass A,Cole L,Finfer S,Gallagher M,Lee J,Lo S,McArthur C,McGuinness S,Norton R,Myburgh J,Sheinkestel C,RENAL Study Investigators.

    更新日期:2014-01-01 00:00:00

  • Plasmapheresis Therapy in Kidney Transplant Rejection.

    abstract::Kidney transplantation (KT) is considered an optimal treatment strategy for end-stage renal disease. But human leukocyte antigen-sensitized, ABO-incompatible and antibody-mediated rejection might be the alarming hurdles in KT. Therapeutic plasma exchange is the mainstay of the antibody reduction therapy for reducing a...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000493521

    authors: Xie P,Tao M,Peng K,Zhao H,Zhang K,Sheng Y,Ankawi G,Ronco C

    更新日期:2019-01-01 00:00:00

  • Development of intermittent infusion hemodiafiltration using ultrapure dialysis fluid with an automated dialysis machine.

    abstract::To reduce the potential occurrence of hypotension during a dialysis treatment, intermittent infusion hemodiafiltration (I-HDF) using back filtration with an ultrapure dialysis fluid was developed. Under typical I-HDF treatment conditions, some 200-300 ml of ultrapure dialysis fluid was infused into the blood component...

    journal_title:Blood purification

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1159/000346371

    authors: Mineshima M,Eguchi K

    更新日期:2013-01-01 00:00:00

  • Therapeutic Plasma Exchange in Neonates and Infants: Successful Use of a Miniaturized Machine.

    abstract::Therapeutic plasma exchange (TPE) in neonates and small infants is a treatment method at the forefront that may become a potentially life-saving procedure in a wide array of severe conditions. Indications for TPE in the pediatric population have been mainly derived from adult literature, with neonatal hyperbilirubinem...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000470827

    authors: Vidal E,Garzotto F,Parolin M,Manenti C,Zanin A,Bellettato M,Remuzzi G,Goldstein SL,Murer L,Ronco C

    更新日期:2017-01-01 00:00:00

  • Development and validation of a new dry weight estimation method using single frequency bioimpedance in hemodialysis patients.

    abstract:BACKGROUND:We proposed a new method to estimate dry weight (DW) using single frequency bioimpedance. METHODS:We hypothesized that the change in whole body resistance at 50 kHz (R(50)) was proportional to the ultrafiltration volume (UFV) during a hemodialysis (HD) session. When the targeted resistance estimated in heal...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000330337

    authors: Dou Y,Cheng X,Liu L,Bai X,Wu L,Guo W,Zhao X,Wang F,Cao L,Zuo L

    更新日期:2011-01-01 00:00:00

  • Entropy of uremia and dialysis technology.

    abstract::The second law of thermodynamics applies with local exceptions to patient history and therapy interventions. Living things preserve their low level of entropy throughout time because they receive energy from their surroundings in the form of food. They gain their order at the expense of disordering the nutrients they ...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000345755

    authors: Ronco C

    更新日期:2013-01-01 00:00:00

  • Associations between global population health indicators and dialysis variables in the Monitoring Dialysis Outcomes (MONDO) consortium.

    abstract:BACKGROUND:The number of patients receiving renal replacement therapy (RRT) increases annually and worldwide. Differences in the RRT incidence, prevalence, and modality vary between regions and countries for reasons yet to be clarified. AIMS:Gain a better understanding of the association between hemodialysis (HD)-rela...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000368980

    authors: Calice-Silva V,Hussein R,Yousif D,Zhang H,Usvyat L,Campos LG,von Gersdorff G,Schaller M,Marcelli D,Grassman A,Etter M,Xu X,Kotanko P,Pecoits-Filho R

    更新日期:2015-01-01 00:00:00

  • Serum levels of 5-s-cysteinyldopa are correlated with skin colors in hemodialysis patients but not in peritoneal dialysis patients.

    abstract:BACKGROUND:Diffuse hyperpigmentation is common in patients with chronic renal failure undergoing hemodialysis (HD) or peritoneal dialysis (PD). We previously reported that serum levels of 5-S-cysteinyldopa (5SCD, a pheomelanin precursor) and pheomelanin were significantly elevated in HD patients. METHODS:Skin color wa...

    journal_title:Blood purification

    pub_type: 杂志文章,多中心研究

    doi:10.1159/000230812

    authors: Murakami K,Nakanishi Y,Wakamatsu K,Yamamoto K,Kohriyama N,Hasegawa M,Tomita M,Nabeshima K,Hiki Y,Asano S,Kawashima S,Ito Y,Fujita Y,Asada H,Nakai S,Sugiyama S,Ito S

    更新日期:2009-01-01 00:00:00

  • Peritoneal membrane failure in peritoneal dialysis patients.

    abstract::A review is given of the conditions associated with peritoneal membrane failure, and the possible causes. Ultrafiltration failure is the most important manifestation. It is mostly associated with high transport rates of low molecular weight solutes suggesting the presence of a large vascular surface area. Enlargement ...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000065202

    authors: Krediet RT,Van Esch S,Smit W,Michels WM,Zweers MM,Ho-Dac-Pannekeet MM,Struijk DG

    更新日期:2002-01-01 00:00:00

  • Haemolipodialysis.

    abstract::Haemodialysis is associated with increased oxidant stress. This appears to be due to (1) an increased production of free radicals during haemodialysis, (2) a net reduction of many antioxidants and (3) factors intrinsic to the uremic state. These alterations can lead to cardiovascular disease and many of the pathologie...

    journal_title:Blood purification

    pub_type: 杂志文章,评审

    doi:10.1159/000014384

    authors: Wratten ML,Navino C,Tetta C,Verzetti G

    更新日期:1999-01-01 00:00:00

  • Continuous hemofiltration in 2009: what is new for clinicians regarding pathophysiology, preferred technique and recommended dose?

    abstract::In the last years, publications have questioned the classical dose of 35 ml/kg, but are those studies strong enough in terms of scientific power in order to change our practice? We will try to settle some recommendations for clinicians. Manipulation of dose, porosity, and combinations have yielded promising findings. ...

    journal_title:Blood purification

    pub_type: 杂志文章

    doi:10.1159/000227282

    authors: Honoré PM,Joannes-Boyau O,Collin V,Boer W,Jennes S

    更新日期:2009-01-01 00:00:00