Isonatric dialysis biofeedback in hemodiafiltration with online regeneration of ultrafiltrate (HFR): rationale and study protocol for a randomized controlled study.

Dialysate sodium prescription has major implications for hemodialysis tolerance but also for dialyzed patients' cardiovascular morbidity as a determinant factor of blood pressure. Biofeedback systems have been developed to drive dialysate conductivity in order to reach a prescribed serum sodium concentration, indirectly evaluated by a dialysate or an ultrafiltrate conductivity measurement. A biofeedback system using hemodiafiltration with online regeneration of ultrafiltrate (HFR) has been specially developed with an isonatric mode maintaining an equal serum sodium concentration between start and end of the dialysis session, combined with ultrafiltration and conductivity profiles.

Reduction of free immunoglobulin light chains using adsorption properties of hemodiafiltration with endogenous reinfusion.

In this work we investigated the acute effects of hemodiafiltration with endogenous reinfusion (HFR therapy) on the removal of free immunoglobulin light chains (FIgLCs), which may be considered members of the family of uremic toxins. In two groups of patients - group 1 (polyclonal FIgLCs production) and group 2 (monoclonal plasma cell proliferative disorders), we analyzed the pre- and postdialysis levels of kappa- and lambda-chains. In group 1 we observed a significant reduction of FIgLCs (p < 0.

Assessment of the heparin-binding AN69 ST hemodialysis membrane: II. Clinical studies without heparin administration.

Binding polyanionic unfractionated heparin over the modified AN69 polyacrylonitrile membrane, the surface electronegativity of which has been neutralized by polyethyleneimine (AN69-ST), renders the membrane more hemocompatible. This property was tested in two groups of long-term hemodialysis patients. Results were rated as massive or partial clotting of a dialyzer at the end of the session.

Assessment of heparin binding to the AN69 ST hemodialysis membrane: I. Preclinical studies.

The AN69 ST membrane was designed to render the surface of the native polyacrylonitrile polymer less cationic. This was achieved by layering the membrane with the polycationic biopolymer polyethyleneimine. This new membrane is able to bind heparin to its surface, through electrical interactions, without altering the reactivity of the sulfonate groups of the membrane, regularly distributed in the membrane bulk.

Optimal anticoagulation strategy in haemodialysis with heparin-coated polyacrylonitrile membrane.

Background: Binding of polycationic unfractionated heparin onto the modified AN69 polyacrylonitrile membrane, whose surface electronegativity has been neutralized by layering polyethyleneimine (AN69ST), produces stable coating. We investigated whether the heparin-coated membrane was suitable for regular haemodialysis with low heparin doses.

Methods: Sheep were instrumented for extracorporeal circulation perfusing a dialyser equipped with either the AN69ST or the original AN69 membrane.