A Pilot Study on the Replacement of Fibrinogen with Fibrinogen Concentrates During Therapeutic Plasma Exchange with Mild to Moderate Bleeding Risk-A Comparison with Fresh Frozen Plasma and Albumin Replacement.

: Therapeutic plasma exchange (TPE) removes coagulation factors and leads to depletion coagulopathy. The aim of the study was to compare hemostasis between TPE procedures without coagulation factor replacement (electrolyte group), the partial replacement of fibrinogen with fibrinogen concentrates (fibrinogen group) and partial coagulation factors replacement with fresh frozen plasma (partial FFP group). : A total of 73 TPE procedures in patients with fibrinogen levels 1-2 g/L were divided into three study groups depending on clinically estimated bleeding risk.

Hemostasis assessment with standard coagulation tests and rotational thromboelastometry (ROTEM) during therapeutic plasma exchange treatment.

Aims: In therapeutic plasma exchange (TPE), large amounts of plasma with all components, including antibodies, albumin, coagulation factors and inhibitors, are removed and usually replaced with replacement fluid without coagulation factors. Hemostatic parameters should be closely monitored in patients at risk of bleeding or with large volume exchanges with a short recovery interval. In this prospective study, we compared standard coagulation parameters and the rotational thromboelastometry (ROTEM) point-of-care test to identify hemostatically severely compromised patients treated with TPE.

Bone mineral disturbances in patients with chronic kidney disease stage 5 not yet on dialysis.

Aims: This retrospective study evaluates the success of a treatment strategy for secondary hyperparathyroidism in our cohort of patients with chronic kidney disease stage 5 who were not yet on dialysis.

Materials And Methods: 81 predialysis patients from the outpatient clinic of the Department of Nephrology, University Medical Center Ljubljana were reviewed. We focused on serum markers for bone mineral metabolism including intact parathyroid hormone (PTH), phosphate, corrected calcium, and the usage of phosphate-binding agents and vitamin D analogs.

Malnutrition in Renal Failure: Pleiotropic Diagnostic Approaches, Inefficient Therapy and Bad Prognosis.

Malnutrition is very common and connected with high morbidity and mortality of patients on chronic hemodialysis. A cross-sectional, longitudinal study was performed in maintenance dialysis patients intending to determine association between modified Subjective Global Assessment (SGA), serum albumin and mortality. Cross-sectional study of phase angle (PhA) values and other indices of bioelectrical impedance body analysis (BIA) were correlated to biochemical data and malnutrition-inflammation score (MIS).

Citrate Extended High Cut-Off Hemodiafiltration for Renal Recovery in Patients With Multiple Myeloma.

We proposed a combination of convective and diffusive transport mechanisms as high cut-off (HCO) post-dilution hemodiafiltration dialysis technique to optimize serum immunoglobulin free light chains (FLCs) removal which may improve dialysis dependent renal failure in patients with multiple myeloma. To reduce bleeding risk regional citrate anticoagulation was successfully used for the first 7 h followed by 1 h anticoagulant-free hemodiafiltration to avoid citrate accumulation. We retrospectively assessed the effect of FLCs reduction on the renal outcome of 28 patients treated with 133 citrate extended post-dilution HCO (Theralite 2100; Gambro, Lund, Sweden) hemodiafiltration sessions between 2010 and 2016.