Abstract:
:Several strategies have been proposed to increase dialysis efficiency in order to reduce dialysis treatment time. Paired filtration dialysis (two-chamber technique) is a new technique combining the advantages of highly permeable membranes and convective transport with the high depurative efficacy of diffusion. The system operates with two units in series (hemofilter + dialyzer) with membranes of polysulfone and hemophan, respectively. A detailed analysis of the hydraulic properties of the system and its possible optimization in terms of depurative efficiency is reported in this paper. In vitro and in vivo tests provided data sufficient to draw some hypotheses on a new utilization of the system. The system appears to be adequate for operating under conditions of high blood flows, however, some limitations were evidenced during our evaluation: the convective component may be insufficient and further increases are impossible because of the limiting effect of the low surface area of the hemofilter; the configuration in which the weight loss is achieved in the hemofilter exposes to the risk of backfiltration in the dialyzer, reducing the benefits of a highly biocompatible system, and the use of acetate in the dialysate and/or lactate in the substitution fluid may interfere with a satisfactory correction of metabolic acidosis. On the basis of our evaluations, some changes can be proposed such as: (1) increased surface area of the hemofilter; (2) use of blood flows higher than 300 ml/min; (3) use of bicarbonate in the dialysate and in the replacement solution; (4) increased convective component with ultrafiltration rates of 50-60 ml/min and full replacement with substitution fluid in between the two filters, and (5) weight loss achieved in the dialyzer with a constantly positive transmembrane pressure. With such a modification of the operative conditions, paired filtration dialysis can be probably applied as a highly efficient dialysis technique in a large number of patients with a significant reduction of dialysis treatment time.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Ronco C,Feriani M,Brendolan A,Chiaramonte S,Milan M,Dell'Aquila R,Scabardi M,Bragantini L,Conz P,La Greca Gdoi
10.1159/000169955subject
Has Abstractpub_date
1990-01-01 00:00:00pages
126-40issue
3eissn
0253-5068issn
1421-9735journal_volume
8pub_type
杂志文章abstract:BACKGROUND/AIMS:Intravenous iron infusion is the accepted way of supplementation of that compound in uremic patients. The aim of the study was to evaluate whether this treatment affects intraperitoneal homeostasis in patients on peritoneal dialysis. METHODS:Blood and peritoneal dialysate samples were collected from 10...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000210038
更新日期:2009-01-01 00:00:00
abstract::Chronic kidney disease (CKD) is associated with multiple detrimental consequences to the cardiovascular and musculoskeletal systems. The effects of CKD are even more significant when they begin in childhood as they affect growth and (neuro-) development as well. The division into stages of CKD serves as a guideline fo...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000321850
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Asymmetric dimethylarginine (ADMA) levels are increased in hemodialysis (HD) patients. Reports on the effect of various dialysis strategies on ADMA, symmetric dimethylarginine (SDMA) and L-arginine levels are inconclusive. PATIENTS/METHODS:In this randomized crossover study, 15 patients were dialyzed for 4 ...
journal_title:Blood purification
pub_type: 杂志文章,随机对照试验
doi:10.1159/000104868
更新日期:2007-01-01 00:00:00
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
更新日期:2014-01-01 00:00:00
abstract::Reprocessing of used dialyzers with chemical disinfectants is practiced commonly in the United States and in some areas of Western Europe. Concern over residual toxic or allergenic agents has encouraged the search for other practical methods to disinfect or sterilize used hemodialyzers. The use of moist heat has been ...
journal_title:Blood purification
pub_type:
doi:10.1159/000170132
更新日期:1993-01-01 00:00:00
abstract::The recent Kidney Disease Outcomes Quality Initiative (K/DOQI) classification of chronic kidney disease (CKD) includes transplant recipients. Although there are important differences between kidney transplant recipients (KTRs) and patients with native kidney disease, the inclusion of KTRs along with other CKD patients...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000067871
更新日期:2003-01-01 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::During the past few years, it has become increasingly evident that residual renal function (RRF) is an important and independent predictor of poor outcome in patients with chronic kidney disease (CKD). Although the causes of this observation are not fully understood, it appears that the loss of RRF impairs both fluid ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000078699
更新日期:2004-01-01 00:00:00
abstract::To evaluate objectively the effects of recombinant human erythropoietin (rHuEPO) administration on nutritional status in stable dialyzed patients, we used urea kinetic modeling (UKM) analysis and dietary protein intake evaluation by dietary assessment. Fifteen patients (9 females, 6 males; mean age 46.9 +/- 15.6 years...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169982
更新日期:1990-01-01 00:00:00
abstract::A new plate dialyzer, Gambro PRO-3, with a polycarbonate-polyether membrane (Gambrane) was tested. The membrane thickness is 16 micron and the dialyzer surface area 0.77 m2. 11 regular hemodialysis patients who were treated 3 times per week were studied and 32 dialyses were performed. Clearances of urea, creatinine, u...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169426
更新日期:1986-01-01 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::Clinical trials using very low protein supply supplemented with amino acid or keto acid preparations have shown the possibility of slowing the rate of decline of renal function in patients with advanced chronic renal failure together with preservation of nutritional status. The possible mechanisms by which this effect...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,评审
doi:10.1159/000169557
更新日期:1988-01-01 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::The evidence concerning online hemodiafiltration (HDF) includes the following: (1) the increase of removal of uremic toxin, (2) the prevention of dialysis rerated hypotension, (3) the recovery of survival, and (4) the recovery of dialysis related uncertain symptoms. Although clinical evidence has been noted, the hypot...
journal_title:Blood purification
pub_type: 社论
doi:10.1159/000487917
更新日期:2018-01-01 00:00:00
abstract::In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169411
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is a clear association between one allele of the interleukin-1 receptor-antagonist gene (IL-1RN) and inflammatory diseases in which IL-1 is implicated. We evaluated patient survival and technique survival of peritoneal dialysis (PD) patients, while analyzing independent risk factors, in a PD progr...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000088988
更新日期:2005-01-01 00:00:00
abstract::Immune deficiency is one of the numerous consequences of chronic renal failure. We can hypothesize that an abnormal natural killer (NK) cell response is present in patients with end-stage renal disease (ESRD). To characterize the immune defect in ESRD patients, we performed a NK cell subset analysis in 66 patients wit...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000350839
更新日期:2013-01-01 00:00:00
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
更新日期:2010-01-01 00:00:00
abstract::'Net ultrafiltration' in peritoneal dialysis refers to the difference between the osmotically induced ultrafiltration into the peritoneal cavity and the fluid loss from the cavity during dialysis. Recent research has demonstrated that, during a 3- to 4-hour experimental dialysis, 5-25% of the total fluid loss is via l...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170041
更新日期:1992-01-01 00:00:00
abstract::Acute kidney injury (AKI) is a common complication in pediatric and neonatal intensive care units (ICU). Renal replacement therapy (RRT) is frequently needed in children in whom supportive therapy is not enough to satisfy their metabolic demands or to be able to provide adequate nutrition. The decision to begin dialys...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000345186
更新日期:2013-01-01 00:00:00
abstract::The present working hypothesis regarding adequacy issues in peritoneal dialysis is that dialysis is a major determinant of protein intake and therefore nutritional status in these patients. Present data however is controversial. This is in part due to differences in methodology and the calculations used for the data p...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170201
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:To identify factors of health-related quality of life (HRQOL) of Chinese end-stage renal disease patients undergoing hemodialysis (HD). METHODS:In all, 315 HD patients were recruited from a tertiary hospital in Suzhou, -China. Each patient completed the Kidney Disease Quality of Life Short Form. It generate...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000485962
更新日期:2018-01-01 00:00:00
abstract::For maintenance hemodialysis (MHD) patients, the blood is in low hypercoagulable state due to the use of heparin or low molecular weight heparin during dialysis. It is not rare to see hematoma in the puncture site. In recent years, several cases have been reported of spontaneous kidney rupture, but no hip hematoma, le...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000446177
更新日期:2016-01-01 00:00:00
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 imp...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000266483
更新日期:2010-01-01 00:00:00
abstract::During hemodialysis, amino acids (AA) are lost in the ultrafiltrate with consequent modification of their plasma profile. The aim of this cross-sectional study was to evaluate intradialytic changes of plasma AA levels during a single session of hemodiafiltration with endogenous reinfusion (HFR) versus acetate-free bio...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000320133
更新日期:2010-01-01 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/AIMS:Cardiovascular diseases (CVD) are the leading cause of mortality in hemodialysis (HD) patients. Recently, non-alcoholic fatty liver disease (NAFLD) has been recognized as a new risk factor for adverse CVD events in the general population. Our aim was to analyze the incidence of NAFLD in HD patients by u...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000360270
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND/AIMS:Chronic kidney disease (CKD) and periodontitis (PD) are serious public-health concerns. Vitamin D is a fat-soluble steroid hormone that interacts with its nuclear receptor (VDR) to regulate a variety of biological processes, such as bone metabolism, immune response modulation and transcription of severa...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000109235
更新日期:2007-01-01 00:00:00
abstract::For human beings trace elements are essential nutrients with a gamut of functions. They are for instance indispensable components of many enzymes, so they have some regulatory functions and they may affect immune reactions and free radical generation. Altered blood levels of different trace elements have been describe...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000014394
更新日期:1999-01-01 00:00:00
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
更新日期:2007-01-01 00:00:00