Is steam sterilization really making any difference in dialysis-induced cytokine release?

Ethylene oxide (ETO) is presently the most commonly used sterilization method for medical devices. Although alternative sterilization modes such as steam sterilization have been suggested, the effect of steam on dialysis-induced cytokine release is unknown. We enrolled 9 patients on chronic hemodialysis and evaluated at different intervals IL-1beta production while treated with ETO (NC 1785-Bellco) and steam sterilized NC 1785S-Bellco) Synthetically Modified Cellulose (SMC).

Assessment of efficiency using on-line urea kinetic modeling in hemodiafiltration.

Urea kinetics has recently been re-evaluated using an on-line urea monitoring system applied to hemodiafiltration. This system allows evaluation of different components possibly responsible for the gap between prescribed and delivered dose of dialysis, such as access and cardiopulmonary recirculation, and altered dialysis parameters, such as blood flow and dialysate flow rates. Furthermore, the system allows prediction of postdialysis rebound urea concentrations.

Cytokine production in haemodiafiltration: a multicentre study.

Background: Bacterial contamination of dialysate may enhance cytokine production in haemodialysis. We tested the hypothesis that intracellular cytokines could be enhanced in a large group of patients exposed to backfiltration of dialysate over a long period of observation.

Methods: The intracellular cytokine (interleukin-1 receptor antagonist and interleukin-1beta) concentrations in chronic uraemic patients undergoing haemodiafiltration, which is known to be associated with backfiltration (Group II, 12 patients), were compared to those found in patients treated with a modified haemodiafiltration modality without backfiltration (Group I, 16 patients), in patients shifted from one modality to the other (Group III, 27 patients) and in 10 patients on haemodialysis (Group IV) in a 1-year multicentre study.

Hemodiafiltration without replacement fluid. An experimental study.

Paired filtration dialysis (PFD) is the only hemodiafiltration (HDF) technique in which the ultrafiltrate is continuously available but not mixed with the dialysate. As is the case during all convective or predominantly convective techniques, use of a replacement fluid is necessary in an amount equal to the difference between the ultrafiltrate and the desired patient weight loss. This replacement fluid must have an adequate electrolytic composition (Na+, Ca++, and buffer), and must be sterile and pyrogen free.

Use of uncoated activated carbon hemoperfusion in acute poisoning: in vitro studies.

In acute poisoning the main purpose of any therapeutic approach is a rapid removal of the drug or poison from body tissues. This approach suggested to undertake a study for the development of an uncoated activated carbon hemoperfusion column suitable for acute poisoning. Th clearances were significantly superior compared with a similar device manufactured using coated carbon.