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 molecule removal including β-2 microglobulin. Further advances in technology allowed better control over the structure and permeability of membranes. Different polymers and improved spinning modalities led to significant advances in solute removal and hemocompatibility. Inner surface modification produced a reduction in membrane thrombogenicity and protein-membrane interaction with a less tendency to fouling and permeability decay. Further evolution in technology led to the development of a new class of membranes referred to as protein-leaking membranes or super-flux or high cutoff (HCO). These membranes are more permeable than conventional HF membranes and allow some passage of proteins, including albumin. The rationale for these membranes is the need for increased clearance of low molecular weight proteins and protein-bound solutes. However, albumin loss in protein-leaking HCO membranes represents a limitation whose effect in patients is still controversial. The last evolution in the field of membranes is the development of a new class defined as "high retention onset" (HRO) due to the peculiar high sieving value in the middle to high molecular weight range. The introduction of HRO membranes in the clinical routine has enabled the development of a new concept therapy called "expanded hemodialysis." Its simple set up and application offer the possibility to use it even in patients with suboptimal vascular access or even with an indwelling catheter. The system does not require particular hardware or unusual nursing skill. The quality of dialysis fluid is, however, mandatory to ensure a safe conduction of the dialysis session. This new therapy is likely to modify the outcome of end-stage kidney disease patients, thanks to the enhanced removal of molecules traditionally retained by current dialysis techniques.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Ronco Cdoi
10.1159/000476012subject
Has Abstractpub_date
2017-01-01 00:00:00pages
I-VIIIissue
2eissn
0253-5068issn
1421-9735pii
000476012journal_volume
44pub_type
社论abstract:BACKGROUND/AIMS:Recent advances in nanotechnology have made it possible to mass-produce ultrathin silicon membranes with pore sizes in the range of nanometers. In this study, we investigate the possibility of employing ultrathin nanoporous silicon membranes with pore diameters of 5 and 20 nm for dialysis of human whole...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000350613
更新日期:2013-01-01 00:00:00
abstract::The central dialysis fluid delivery system (CDDS) has been working exclusively in Japan since 1970, a fact which proves that CDDS is useful in the multi-patient treatment with in-center regular hemodialysis. It is a cost-effective, labor-saving and time-tested system with 40 years of experience. Microbial safety is im...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000213494
更新日期:2009-01-01 00:00:00
abstract::Hypertension is present in most patients with end-stage renal disease and likely contributes to the premature cardiovascular disease in dialysis patients. Previous practice guidelines have recommended that, in patients on chronic dialysis, blood pressure (BP) should be reduced below 130/80 mm Hg. This is based on opin...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000245631
更新日期:2010-01-01 00:00:00
abstract::We have investigated the effect of the direction of the dialysate flow during continuous arteriovenous haemodialysis. Under similar conditions countercurrent flow was more efficient than concurrent flow in terms of both urea clearance (mean +/- SEM), 23.5 +/- 0.5 compared to 18.4 +/- 0.4 ml/min (p less than 0.001) and...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169987
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:We estimated the flow of endotoxins (ET) from dialysates into the blood of patients on hemodialysis (HD) using limulus amebocyte lysate (LAL) assays and endotoxin activity (EA) determined by neutrophil respiratory burst activity. METHODS:A cross-sectional study compared groups given ultrapure bicarbonate (n...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000322622
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:In this study, we focused on whether volume overload plays a role in the development of arterial stiffness. METHODS:Seventy-three prevalent hemodialysis patients were enrolled in a cross-sectional study. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWV), and volume overload was as...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000199432
更新日期:2009-01-01 00:00:00
abstract::Critically ill COVID-19 patients are generally admitted to the ICU for respiratory insufficiency which can evolve into a multiple-organ dysfunction syndrome requiring extracorporeal organ support. Ongoing advances in technology and science and progress in information technology support the development of integrated mu...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000508125
更新日期:2021-01-01 00:00:00
abstract::Severe hypertriglyceridemia (HTG) is associated with acute pancreatitis (AP). Treatment options include total plasma exchange (TPE). We report a case of AP due to severe HTG treated with TPE. ...
journal_title:Blood purification
pub_type:
doi:10.1159/000510647
更新日期:2020-11-24 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:BACKGROUND:To study calcium homeostasis during citrate-based compared to nadroparin-based CVVH in critically-ill patients with acute renal failure. METHODS:11 patients were observed during citrate anticoagulation, 9 with nadroparin and 10 controls. Citrate was chosen for patients with active or at risk for bleeding. ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000101853
更新日期:2007-01-01 00:00:00
abstract::Along with the numerous technological improvements in molecular biology, polymerase chain reaction, which permits analysis of sequences of a very small amount of biological material, enables evaluation of hemodialysis-induced gene transcription of inflammatory cytokines. Blood samples drawn from 22 hemodialysis patien...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000014310
更新日期:1998-01-01 00:00:00
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
更新日期:2009-01-01 00:00:00
abstract::Secondary hyperparathyroidism (SHPT) occurs in patients with chronic renal failure complicated with renal bone disease and soft tissue/vascular calcification. In dialysis patients with severe SHPT, medical treatment may fail and parathyroidectomy (PTX) is indicated for definitive treatment. Severe hypocalcemia from hu...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000479616
更新日期:2017-01-01 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: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
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:We studied the influence of acute renal failure (ARF) on the relationship between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and hemodynamic parameters. METHODS:The echocardiographic parameters and NT-proBNP levels were compared between 26 mechanically ventilated patients with ARF requiring conti...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000322259
更新日期:2011-01-01 00:00:00
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
更新日期:2019-01-01 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::Effective dialysis therapy is now understood to encompass both small and large solute removal, using approaches that minimize intradialytic symptoms and maximize patient safety. Achieving the goal of providing effective dialysis for an expanding population of patients with increasingly complex medical problems at a ti...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000167001
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The incidence of central venous catheter-related bloodstream infection (CRBSI) for continuous renal replacement therapy (CRRT) in kidney intensive care unit (ICU) patients is worthy of particular attention and recently, we analyzed clinical characteristics and risk factors of CRBSI for CRRT in our kidney ICU...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000495024
更新日期:2019-01-01 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:Various cytokines are increased in hemodialysis (HD) patients, and are considered prognostic markers. Metabolic acidosis is common among chronic HD patients and is associated with survival. The relationship between acidosis and cytokines in HD patients has not been fully explored. The study aim was to measur...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000346689
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The relationship between heart rate variability (HRV) and residual renal function (RRF) has not been elucidated previously. METHODS:In this cross-sectional study, HRV was evaluated in 71 peritoneal dialysis patients. Patients were divided into RRF decline group, RRF stable group and anuric group. RESULTS:R...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000338184
更新日期:2012-01-01 00:00:00
abstract::We conducted a prospective randomized controlled study to confirm our earlier observation that prolonged subcutaneous implantation of peritoneal catheter reduced peritonitis rate when compared to retrospective data from patients with catheters placed by conventional access technique. A total of 60 patients were random...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000014331
更新日期:1998-01-01 00:00:00
abstract::In hemodialysis patients, C-reactive protein (CRP), an acute-phase reactant, is a sensitive and independent marker of malnutrition, anemia, and amyloidosis. The aim of the present studies was to evaluate CRP and interleukin 6 levels in plasma samples from long-term hemodialysis patients on different extracorporeal mod...
journal_title:Blood purification
pub_type: 杂志文章,多中心研究
doi:10.1159/000014405
更新日期:2000-01-01 00:00:00
abstract::At present the treatment of hepatitis C virus infection (HCV) has improved because of combined treatment with interferon (IFN) and ribavirin. The association of these two drugs has obtained a positive response in 40-50% of naive patients treated. Patients with relapse after monotherapy with IFN also show positive resp...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000046996
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Interleukin-10 (IL-10), a potent regulatory monokine produced by activated mononuclear cells, provides an efficient autocrine mechanism for controlling proinflammatory cytokine synthesis. We hypothesized that defective synthesis of IL-10 could contribute to the inflammatory state in hemodialysis (HD) patient...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000066958
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:The present study aimed to determine the variables that are associated with a longer dialysis recovery time (DRT) and to define the relationship that exists between DRT and the ultrafiltration rate (UFR) in prevalent chronic hemodialysis (CHD) patients. METHODS:We studied 210 prevalent CHD of 5 hemodialys...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000492919
更新日期:2019-01-01 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 number of geriatric patients on dialysis is increasing. This is due to demographic factors, a wider acceptance of elderly patients on dialysis, and an earlier start of dialysis in this patient group. Recent studies have questioned the effect of dialysis on quality of life in elderly patients with severe comorbidit...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000334153
更新日期:2012-01-01 00:00:00