Abstract:
:The recent interest in the role of the intestine in the cardiovascular stability of uremic patients, specifically on dialysis, but potentially also in chronic kidney disease, must be seen against the background of the recent great interest in the role of the gut in chronic heart failure [Curr Opin Clin Nutr Metab Care 2008;11:632-639]. There has been a long-standing interest in the role of the intestine in renal failure, mainly concerning the role of metabolites of bacterial metabolism in the gut as potential uremic toxins. This area has recently been given a new twist by the finding that increased endotoxin concentrations in the blood of dialyzed patients are associated with hypotensive episodes and myocardial 'stunning'. Recent studies suggest that intradialytic underperfusion of myocardial areas, the so-called stunning, may be related to the entry of bacterial endotoxin and/or cytokines across the mucosal barrier into the circulation, where they have a negative impact on myocardial function (and presumably beyond the negative cardiac side effect also contribute to catabolism and malnutrition). Entry of bacterial endotoxin during dialysis sessions is presumably the result of intermittent underperfusion of the intestine if the effective blood volume is rapidly reduced causing breakdown of the mucosal barrier. Apart from the impact on myocardial perfusion, the entry of bacterial endotoxin and/or cytokines across the mucosal barrier may also contribute to malnutrition, wasting and reduced life expectancy in hemodialyzed patients. Such a causal relationship is absolutely plausible in view of an extensive literature on congestive heart failure where clinical and experimental evidence indicates that bacterial endotoxin and/or cytokines may escape from a hypoperfused edematous gut, entering the circulation, triggering an inflammatory response, upregulating circulating cytokines and interfering with the function of the heart through several pathogenic mechanisms.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Ritz Edoi
10.1159/000321848subject
Has Abstractpub_date
2011-01-01 00:00:00pages
70-6issue
1-3eissn
0253-5068issn
1421-9735pii
000321848journal_volume
31pub_type
杂志文章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
更新日期:2015-01-01 00:00:00
abstract::Hemofiltration (HF) induces a significant reduction in parathormone (PTH). This effect is related not only to the convective removal of PTH molecules but also to the biological suppression of parathyroid glands by plasma-ionized calcium (iCa) increase. The acute inhibitory effect on parathyroid gland activity, ionized...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000170236
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND/AIMS:This study evaluated the mechanism of hemodynamic improvement in polymyxin B-immobilized fiber (PMX) treatment. METHODS:Fifteen septic patients with endotoxemia and/or gram negative infection were treated with PMX. Plasma concentrations of calcitonin gene-related peptide (CGRP) and nitric oxide metabol...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000070696
更新日期:2003-01-01 00:00:00
abstract::A 50-year-old man with the rare McLeod syndrome, associated with glomerular lesion to the end stage of chronic renal failure and death, is reported. McLeod syndrome is an X-linked recessive disorder on the basis of abnormal expression of the Kell blood group antigens and absence of erythrocyte surface Kx antigen. Most...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014353
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIMS:Dialysis membrane has been implicated in selenium (Se) deficiency in hemodialysis (HD). Intradialytic Se removal into dialysate through different membranes was investigated. METHODS:We studied 19 patients on standard HD with low-flux polysulfone membrane (group A), 10 patients on standard HD with ethyl...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000441438
更新日期:2016-01-01 00:00:00
abstract::Contradictory data are reported in the literature concerning the diffusion kinetics of inorganic phosphates (iPh) between red blood cells and plasma during haemodialysis. Accordingly, we performed mass balance and equilibration studies to analyze the diffusion kinetics of iPh in vivo and in vitro. Mass balance analysi...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014470
更新日期:2001-01-01 00:00:00
abstract::Tranquilizers, analgetics and antidepressants are applied in different ranges in the treatment of patients on hemodialysis. Due to many different pharmacokinetic properties, no perfect rules for dosage in acute or chronic hemodialysis exist. Adequate applicable drugs without adaptation disregarding different states of...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169404
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Extended haemodialysis (EHD) has been associated with better outcomes compared to conventional (CHD) regimes. The cardiovascular (CV) profile of these patients has not been assessed in detail. METHODS:We report baseline demographic and CV phenotype of 36 CHD and 36 EHD participants to a longitudinal multice...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000485231
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:It was recently reported that the severity of coronary and carotid atherosclerosis in patients with end-stage kidney disease (ESKD) has improved over the last two decades. However, the frequency of coronary artery events observed at the initiation of dialysis remains high. SUMMARY:Recently, 5 different clin...
journal_title:Blood purification
pub_type: 评论,杂志文章
doi:10.1159/000441582
更新日期:2015-01-01 00:00:00
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
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:We derived a novel equation for calculating weekly urea standard Kt/V (stdKt/V) during hemodialysis (HD) based on urea mass removed, comparable to the approach during peritoneal dialysis. METHODS:Theoretical consideration of urea mass balance during HD led to the following equation for stdKt/V, namely,...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000493178
更新日期:2019-01-01 00:00:00
abstract::The study was made in vitro of reactions elicited by contact of granulocytes suspended in autologous plasma with three polymers: polyacrylonitrile (AN); polyetherpoly-carbonate (PC), and regenerated cellulose (Cu). Alterations in basal metabolism and biological function of the human blood granulocytes induced by inter...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000170015
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND/AIMS:Increasing evidence suggests that clinical signs of periodontal disease are independently associated with renal impairment. However, no studies have examined the possible linkage of kidney disease with serum antibody to oral pathogens. METHODS:The periodontal disease status was assessed in an older com...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000096411
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Removal of protein-bound uremic toxins by dialysis therapy is limited. The effect of oral adsorbent AST-120 in chronic dialysis patients has rarely been investigated. METHODS:AST-120 was administered 6.0 g/day for 3 months in 69 chronic dialysis patients. The blood concentrations of indoxyl sulfate, p-creso...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000357641
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Hypertension affects almost all chronic kidney disease patients and is related to poor outcomes. Sodium intake is closely related to blood pressure (BP) levels in this population and decreasing its intake consistently improves the BP control particularly in short-term controlled trials. However, most patient...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000485154
更新日期:2018-01-01 00:00:00
abstract:AIMS:This study was aimed at comparing the incidence of arterial hypertension and blood pressure (BP) variance in hospital and out-of-hospital hemodialysis (HD) patients during HD sessions. METHODS:A cross-sectional study was conducted for 1 week at all the HD centers in Dalmatia, Croatia. The pre-, intra-, and post-d...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000474931
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND/AIM:The relationship between body mass index (BMI) and intradialytic hypotension (IDH) has been inconsistently reported, but no further research has investigated the correlation between body composition and IDH so far. This study aimed to determine whether the lean tissue index (LTI), fat tissue index (FTI),...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000504245
更新日期:2020-01-01 00:00:00
abstract::Endothelial dysfunction of the optic microcirculation is considered to be the main pathogenetic mechanism in nonarteritic ischemic optic neuropathy. The aim of the present work was to assess whether a clinical improvement is correlated with a reduction in the endothelial activation markers by means of LDL apheresis (L...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000094574
更新日期:2006-01-01 00:00:00
abstract::Peritoneal transport rates, a critical determinant of peritoneal dialysis efficiency, vary widely among patients and may be easily categorized by standardized peritoneal equilibration test. Measurements of creatinine and glucose transfer are particularly useful in selecting optimal dialysis prescription. Patients with...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000169582
更新日期:1989-01-01 00:00:00
abstract::In previous reports of the Frequent Hemodialysis Network trials, frequent hemodialysis (HD) reduced extracellular fluid (ECF) and left ventricular mass (LVM), with more pronounced effects observed among patients with low urine volume (UVol). We analyzed the effect of frequent HD on interdialytic weight gain (IDWG) and...
journal_title:Blood purification
pub_type: 杂志文章,随机对照试验
doi:10.1159/000441966
更新日期:2016-01-01 00:00:00
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
更新日期:1996-01-01 00:00:00
abstract::Hyporesponsiveness to erythropoietin stimulating agents (ESAs) is a condition associated with increased mortality. Even after identifying the condition, the causes are difficult to treat and only partially reversible in end-stage renal disease patients. Thus, the role of more recent hemodialysis (HD) techniques in imp...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000485314
更新日期:2018-01-01 00:00:00
abstract::The low water permeability feature of original cellulosic membranes was considered an advantage in the absence of dialysis equipment that are capable of controlling water removal. The advent of ultrafiltration control systems led to the development and use of high-flux (HF) membranes that allowed improved middle molec...
journal_title:Blood purification
pub_type: 社论
doi:10.1159/000476012
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Wilson's disease (WD) can present in a fulminant form with hepatocellular dysfunction, hemolysis and multiorgan failure (Wilson's crisis). We present a previously healthy young woman with severe WD whose WD severity score was 13. A score >11 indicates a poor chance of survival and liver transplantation will ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000218090
更新日期:2009-01-01 00:00:00
abstract::Doubt has remained as to whether or not the K/DOQI recommended targets for adequacy of dialysis for peritoneal dialysis patients is appropriate (weekly Kt/V 2 + creatinine clearance 50-60 l/1.73 m(2)). The ADEMEX trial can be interpreted as indicating that lower targets might be acceptable. The HEMO trial, not yet pub...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000067869
更新日期:2003-01-01 00:00:00
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
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND/AIMS:Optimization of vascular access use in the 'fistula first' era requires comprehension of its clinical behavior. Little is known about mature arteriovenous fistula (AVF) performance and the role of fistula location. Widely used access flow (Qa) was used to analyze complication risks and functionality aft...
journal_title:Blood purification
pub_type: 杂志文章,多中心研究
doi:10.1159/000197561
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Standard low-flux haemodialysis (HD) is not very efficacious, and patient morbidity and mortality rates are still very high. According to the initial study design, the MPO study reported that high-flux HD (hf-HD) showed a significant 37% relative risk reduction of mortality in patients with serum albumin ≤4 ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000437410
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Calcium loading has been associated with cardiovascular risk in hemodialysis (HD) patients. However, it remains to be elucidated whether alterations of intradialytic calcium buffering add to the increased cardiovascular disease burden in this high-risk population. METHODS:Intradialytic calcium kin...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000508060
更新日期:2020-01-01 00:00:00
abstract::There is a wide variability in the utilization of peritoneal dialysis throughout Europe that cannot be explained by differences in medical factors alone. Over the last years, the utilization of peritoneal dialysis has even changed in individual countries. The main factors of this variation are not medical, but rather ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000089446
更新日期:2006-01-01 00:00:00