Agreement between different parameters of dialysis dose in achieving treatment targets: results from the NECOSAD study.

Background: The recommended parameter of dialysis dose differs between K-DOQI and the European Best Practice Guidelines. It is not well known to what extent an agreement exists between the different parameters, nor if target and delivered dialysis dose are prescribed according to the urea reduction rate (URR), single-pool Kt/V (spKt/V) or equilibrated double-pool Kt/V (eKt/V) and which parameter is most strongly related to mortality.

Methods: In 830 haemodialysis patients from the NECOSAD cohort URR, spKt/V and eKt/V were calculated and compared according to a classification regarding the recommended treatment targets (70%, 1.

Variations in predialytic plasma conductivity in dialysis patients: effect on ionic mass balance and blood pressure.

In this study, variations in plasma conductivity (PC), as a surrogate marker of plasma sodium, as well as its relation with intradialytic ionic mass balance (IMB) and blood pressure were assessed in 73 patients. Plasma conductivity and IMB were retrieved on a treatment to treatment basis during a 6-month period. Dialysate sodium concentration was 140 mmol/L.

The influence of bicarbonate/lactate-buffered PD fluids on N{ε}-(carboxyethyl)lysine and N{ε}-(carboxymethyl)lysine in peritoneal effluent.

Objective: Accumulation of advanced glycation end products (AGEs) may be involved in the pathogenesis of peritoneal membrane dysfunction. As glycoxidation may play an important role in AGE formation, peritoneal dialysis fluids with low levels of glucose degradation products (GDPs) might result in a reduction in AGE concentration in the peritoneal effluent. The aim of this study was to compare the effects of conventional glucose-containing dialysis solutions and low GDP level fluids on the concentration of the AGEs N(ε)-(carboxymethyl)lysine (CML) and N(ε)-(carboxyethyl)lysine (CEL) in peritoneal effluent.

Ionic dialysance and the assessment of Kt/V: the influence of different estimates of V on method agreement.

Background: Ionic dialysance was recently introduced as a means to assess Kt/V (K(ID)t/V). With this method, urea distribution volume (V) has to be estimated. The primary aim of the present study was to assess the agreement between equilibrated Kt/V assessed by urea kinetic modelling (eKt/V) with K(ID)t/V taking into account different estimates of V, and to assess the monthly variation in V.

An evaluation of blood volume changes during ultrafiltration pulses and natriuretic peptides in the assessment of dry weight in hemodialysis patients.

Changes in blood volume (BV) during dialysis as well as plasma levels of brain natriuretic peptide (BNP) and N-terminal (NT) pro-BNP levels are possible tools to assess dry weight in hemodialysis (HD) patients. The aim of the study was to compare these parameters with other non-invasive techniques used to assess dry weight in HD patients, and to study their relation with intradialytic hypotension (IDH) and the presence of cardiovascular disease BV changes during HD, both during regular dialysis and during an ultrafiltration pulse, plasma levels of NT pro-BNP and BNP, and vena cava diameter index (VCDI) were assessed in a cohort of 66 HD patients, which was subdivided according to tertiles of total body water (TBW) corrected for body weight, assessed by bioimpedance analysis. Parameters were also related to the presence of IDH and history of cardiovascular disease.

The effect of sodium profiling and feedback technologies on plasma conductivity and ionic mass balance: a study in hypotension-prone dialysis patients.

Background: Sodium profiling improves haemodynamic tolerance in haemodialysis (HD) patients but may also influence sodium homeostasis. Changes in blood volume and plasma conductivity (PC) during HD can be modelled by feedback technology, but their effects on sodium homeostasis are not widely studied.

Methods: This randomized crossover study compared PC and ionic mass balance (IMB) as surrogate markers of sodium balance between standard HD [dialysate conductivity (DC) 14.

Blood volume control by biofeedback and dialysis-induced symptomatology. A short-term clinical study.

In earlier studies, a reduction in intradialytic procedures was observed in patients with severe intradialytic hypotension symptomatology by the use of blood volume controlled biofeedback systems. However, few data are present on the use of biofeedback-controlled treatments in patients experiencing minor intradialytic symptoms. In the present study, 157 standard and 158 biofeedback-controlled treatments were compared during a 2-month period in 16 hemodialysis patients.

Ionic mass balance and blood volume preservation during a high, standard, and individualized dialysate sodium concentration.

Background: Although a higher dialysate sodium concentration (DNa) is frequently used to improve haemodynamic stability during haemodialysis, few studies have compared ionic mass balance (IMB) during different DNa. Moreover, DNa is usually a standard prescription, whereas inter-individual pre-dialytic serum sodium levels may differ widely. The aims of the study were to assess IMB and the decline in blood volume (DeltaBV) during isovolaemic HD as well as during HD combined with ultrafiltration (UF) during DNa [140], DNa [144], and an individualized DNa [ind], in which DNa is equal to pre-HD plasma conductivity x 10.