Abstract:
:The use of bicarbonate dialysate and high-flux and reprocessed dialyzers has raised concerns about the reverse transfer of dialysate contaminants into the blood compartment. This in vitro study was performed to investigate the reverse transfer of soluble Pseudomonas aeruginosa bacterial products across a polyether sulfone (PES), a newly developed synthetic polymer dialyzer. In vitro dialysis was carried out at 37 degreesC in a closed countercurrent recirculating loop dialysis circuit with a new PES dialyzer. An equal mixture of heparinized whole blood (from healthy volunteers) with pyrogen-free tissue culture medium was circulated in the blood compartment, and bicarbonate dialysate was circulated in the dialysate compartment. After 15 min of dialysis, the dialysate was challenged sequentially with 10(-4), 10(-3), and 10(-2) dilutions of a P. aeruginosa culture supernatant. 1-ml samples were drawn from the blood compartment 5 and 15 min after each challenge and incubated upright at 37 degrees C. At the end of 24 h, Triton X-100 was added, in order to extract total interleukin (IL) 6 and IL-8 production by the whole-blood mixture. These cytokines were measured by electrochemiluminescence assays. At dilutions of 10(-4) and 10(-3), the reverse transfer of soluble bacterial products across the dialyzer was negligible. Five and 15 min after contaminating the dialysate with the highest concentration (10(-2) dilution), the increase in IL-6 production was 239 +/- 170% (p = 0.06) and 886 +/- 444% (p = 0.02), respectively. However, comparing the IL-6-inducing potency of the 10(-2) bacterial supernatant dilution to the spontaneous IL-6 production in the blood compartment during dialysis with the same dilution of dialysate contaminant, there was a dramatic reduction in IL-6 production by 94 and 89% at 5 and 15 min, respectively. Similarly, 5 and 15 min after contaminating the dialysate with the 10(-2) dilution, the increase in IL-8 production was 357 +/- 147% (p = 0.07) and 630 +/- 229% (p = 0.04), respectively. However, comparing the IL-8-inducing potency of the 10(-2) bacterial supernatant dilution to the spontaneous IL-8 production in the blood compartment during dialysis with the same dilution of dialysate contaminant, there was a dramatic reduction in IL-8 production by 93 and 92% at 5 and 15 min, respectively. These results demonstrate that PES dialyzers markedly attenuate passage of cytokine-inducing substances from contaminated dialysate, using a method that detects the entire cytokine synthetic output in the blood compartment.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Jaber BL,Gonski JA,Cendoroglo M,Balakrishnan VS,Razeghi P,Dinarello CA,Pereira BJdoi
10.1159/000014336subject
Has Abstractpub_date
1998-01-01 00:00:00pages
210-9issue
4eissn
0253-5068issn
1421-9735pii
bpu16210journal_volume
16pub_type
杂志文章abstract::Despite advancements in dialysis therapy, the subjective clinical examination still remains the standard of care in managing volume removal in chronic dialysis. While there is no definitive trial establishing that dry weight management guided by an assistive technology is superior to the clinical method, there is ampl...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000321840
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:To test the safety and efficacy of the Aethlon Hemopurifier, a lectin affinity cartridge, in clearing hepatitis C virus (HCV) from the blood of HCV-positive end-stage renal disease patients undergoing dialysis. Viral RNA was measured using real-time quantitative reverse transcriptase polymerase chain re...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000167011
更新日期:2009-01-01 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::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: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::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::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
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Intradialytic hypotension (IDH) is a major challenge to safely performing haemodialysis. Blood volume depletion due to fluid removal is a major cause of hypotension, so more emphasis should be placed on finding alternative modalities to traditional constant rate ultrafiltration. SUMMARY:Intermittent back-fi...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000503878
更新日期:2019-01-01 00:00:00
abstract::Heart failure results in significant morbidity and mortality in the United States. Chronic heart failure is often complicated by renal insufficiency. Further, acute decompensated heart failure is often complicated by worsening renal function or the development of diuretic resistance. Heart failure complicated by renal...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000207198
更新日期:2009-01-01 00:00:00
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
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:We have reported that vitamin D deficiency may be implicated in the pathogenesis of hypoalbuminemia observed in patients with end-stage renal disease, but the mechanism remains to be clarified. The aim of the present study was to determine whether supplementation with alfacalcidol might increase protein inta...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000076855
更新日期:2004-01-01 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::Dialysis fluid produced by state-of-the-art water preparation and distribution is contaminated with gram-negative bacteria and cytokine-inducing substances (CIS) derived from these microorganisms. The presence of a biofilm increases the risk of continuous contamination of dialysis fluid. Depending on the type of dialy...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000074932
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Anemia is a major complication of end-stage renal disease. Hemodialysis itself is regarded as a stimulus activating inflammation. Pro-inflammatory cytokines are able to suppress erythropoiesis. In this pilot study, we analyzed the changes in methylation status of promoters of immune response genes in cell-fr...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000356094
更新日期:2013-01-01 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::Many organic solutes accumulate in end-stage renal disease (ESRD) and some are poorly removed with urea-based prescriptions for hemodialysis. However, their toxicities have been difficult to assess. We have employed an animal model, the zebrafish embryo, to test the toxicity of uremic serum compared to control. Serum ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000348456
更新日期:2013-01-01 00:00:00
abstract::We report the clinical course of 29 patients with Wegener's granulomatosis (WG) treated with plasma exchange (PE) in Norway in the period from 1988 to 1999. Median follow-up was 41.5 months. The mean number of exchanges was 8.5 +/- 5.8 (range 2-32). Median serum creatinine concentration was 400 micromol/l (range 90-1,...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000047004
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/AIMS:To determine adsorption and transmembrane clearances (CLTM) of rezafungin, a novel long-acting echinocandin, in continuous venovenous hemofiltration (CVVH). METHODS:A validated ex vivo bovine blood CVVH model using polysulfone and AN69 hemodiafilters was used to evaluate urea and rezafungin CLTM at 3 d...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000489212
更新日期:2018-01-01 00:00:00
abstract::Evidence that protein restriction retards the progression of chronic renal failure in man is mostly derived from anecdotic data and retrospective studies with inappropriate controls and inferior methodology for evaluating renal function. Data from a prospective randomized study in Stockholm demonstrate that more frequ...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000169562
更新日期:1988-01-01 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::In patients with chronic kidney disease (CKD), peptides and proteins circulate at altered concentrations versus in healthy individuals. We have characterized proteome samples from 7 pooled CKD stage 5 patients not yet on dialysis and with no known co-morbidities. We also analyzed pooled plasma samples from 7 healthy a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000178773
更新日期:2008-01-01 00:00:00
abstract::Renal anemia is the result of reduced erythropoietin (EPO) biosynthesis in the diseased kidney and also in part the result of a reduced life span of red blood cells (RBCs). An increase in density and a decrease in enzyme equipment (aspartate aminotransferase; GOT) of RBCs reflect cell age. In the following study, the ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169976
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Satisfactory and noninvasive diagnostic tools for coronary artery disease (CAD) are not available in hemodialysis patients. We aimed to elucidate a reliable tool to diagnose CAD in these patients. METHODS:102 hemodialysis patients received 2D speckle-tracking echocardiography with left ventricular (LV) stra...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000323536
更新日期:2011-01-01 00:00:00
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
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Plastic cannulas have been used to cannulate arteriovenous fistulas (AVFs) for hemodialysis (HD) in Japan for many years. However, the effect of early cannulation with plastic cannulas on AVF patency is not known. OBJECTIVE:We analyzed the relationship between first cannulation time (FCT) and patency rate...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000503678
更新日期:2020-01-01 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::Dialysis dependence at hospital discharge after acute kidney injury (AKI) requiring renal replacement therapy (RRT) in the intensive care unit (ICU) is found in 10-15% of survivors. In case of severe AKI in the ICU, it is necessary to reconcile two objectives: the creation of an adequate temporary angioaccess for RRT ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000341721
更新日期:2012-01-01 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
abstract:BACKGROUND:Omni® (B. Braun, Germany) is a new-generation, continuous renal replacement therapy (CRRT) machine designed to improve user interface, minimize downtime and optimize renal dose delivery. It was never tested in humans. METHODS:We used Omni® to provide CRRT in 10 critically ill patients. We collected therapy ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000451053
更新日期:2017-01-01 00:00:00