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Comparative Effects of Acetate- and Citrate-Based Dialysates on Dialysis Dose and Protein-Bound Uremic Toxins in Hemodiafiltration Patients: Exploring the Impact of Calcium and Magnesium Concentrations.
Toxins (Basel)
October 2024
Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, 08036 Barcelona, Spain.
Article Synopsis
- Modern hemodialysis typically uses acetate as a buffer, which has been associated with chronic inflammation, while citrate is being explored as a potential alternative for dialysate.
- This study compares the efficacy of acetate- and citrate-based dialysates in terms of dialysis efficiency and the removal of protein-bound uremic toxins in patients undergoing hemodiafiltration.
- Results showed no significant differences in overall dialysis doses or most toxin reduction, but lower calcium and magnesium citrate dialysates led to better clearance of p-cresyl sulfate, indicating a need for further research to optimize dialysate formulas.
Improvements in six aspects of quality of care of incident hemodialysis patients - a real-world experience.
BMC Nephrol
October 2021
Department of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
Background: The transition from chronic kidney disease stage 5 to initiation of hemodialysis has gained increased attention in recent years as this period is one of high risk for patients with an annual mortality rate exceeding 20%. Morbidity and mortality in incident hemodialysis patients are partially attributed to failure to attain guideline-based targets. This study focuses on improvements in six aspects of quality of dialysis care (adequacy, anemia, nutrition, chronic kidney disease-mineral bone disorder (CKD-MBD), blood pressure and vascular access) aligning with KDIGO guidelines, during the first 6 months of hemodialysis.
View Article and Find Full Text PDFEffectiveness of polymyxin B hemoperfusion for sepsis depends on the baseline SOFA score: a nationwide observational study.
Ann Intensive Care
September 2021
Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Tokyo, Japan.
Background: Polymyxin B hemoperfusion (PMX) aims to treat septic shock by removing endotoxin from the patient's blood. However, the relationship between the severity of the patient's organ damage and the survival benefit of PMX treatment is not clear.
Methods: We analyzed the efficacy of PMX on adult sepsis patients using the propensity score matching method and the Japanese Diagnosis Procedure Combination (DPC) national inpatient database from April 2018 to March 2020.
Non-pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.
Cochrane Database Syst Rev
September 2021
Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan.
Background: Acute kidney injury (AKI) is a common complication amongst people who are critically ill, and it is associated with an increased risk of death. For people with severe AKI, continuous kidney replacement therapy (CKRT), which is delivered over 24 hours, is needed when they become haemodynamically unstable. When CKRT is interrupted due to clotting of the extracorporeal circuit, the delivered dose is decreased and thus leading to undertreatment.
View Article and Find Full Text PDFComparing Renal Replacement Therapy Modalities in Critically Ill Patients With Acute Kidney Injury: A Systematic Review and Network Meta-Analysis.
Crit Care Explor
May 2021
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Objectives: To compare different modalities of renal replacement therapy in critically ill adults with acute kidney injury.
Data Sources: We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to 25 May, 2020.
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