Uremic toxin removal during hemodialysis is not compromised by protein ingestion or intradialytic exercise

2021 ◽  
Vol 46 ◽  
pp. S556-S557
Author(s):  
F.K. Hendriks ◽  
J.H. Kuijpers ◽  
J.M. van Kranenburg ◽  
F.M. van der Sande ◽  
J.P. Kooman ◽  
...  
Keyword(s):  
Uremic Toxin ◽  
Toxin Removal ◽  
Protein Ingestion ◽  
Intradialytic Exercise

Efficacy of Peritoneal Dialysis during Infusion and Drainage Procedures

2010 ◽  
Vol 30 (6) ◽  
pp. 633-637 ◽  
Author(s):  
Daniel Baczyński ◽  
Stefan Antosiewicz ◽  
Jacek Waniewski ◽  
Zbigniew Nowak ◽  
Zofia Wańkowicz
Keyword(s):  
Peritoneal Dialysis ◽  
Kinetic Modeling ◽  
Dwell Time ◽  
Uremic Toxin ◽  
Dialysis Fluid ◽  
Fluid Exchange ◽  
Peritoneal Transport ◽  
Toxin Removal ◽  
Technique Failure ◽  
Precise Assessment

BackgroundInadequate dialysis is still a major cause of technique failure in peritoneal dialysis (PD). Mathematical models provide the possibility of direct and precise assessment of peritoneal transport of urea and creatinine throughout the dwell and allow calculation of optimal schedules, dwell times, and predicted adequacy of a prescribed regimen. Kinetic modeling is particularly important for automated PD. If the effectiveness of uremic toxin removal that takes place during infusion and drainage of dialysis fluid is not taken into account, the predicted adequacy of the whole PD session may be underestimated.AimsTo estimate the efficacy of urea and creatinine removal during the dialysis fluid exchange procedure.Material and Methods17 patients treated with PD were included in the study. PD effectiveness during dialysate exchange was defined as the quotient k of removed amount of creatinine/BUN during the infusion and drainage of dialysate and during a dwell of the same duration as the dialysate exchange.ResultsThe effectiveness of creatinine and urea removal was reduced during the exchange procedure ( kcreat= 0.68 ± 0.43 and kBUN= 0.87 ± 0.44) and differed between these 2 solutes ( p = 0.0009). The k coefficients for urea and creatinine were well correlated ( R2= 0.83).ConclusionsThe effectiveness of peritoneal transport of creatinine and BUN during the inflow/outflow phase was relatively high compared to that during the same dwell time (68% and 87% respectively). This real effectiveness of the dialysate exchange procedure should be taken into account in the process of planning automated PD sessions, otherwise the predicted overall efficacy of creatinine and urea removal throughout the session may be underestimated. This underestimation is proportional to the number of dwells per day.

scholarly journals The Kidney and Uremic Toxin Removal: Glomerulus or Tubule?

2014 ◽  
Vol 34 (2) ◽  
pp. 191-208 ◽  
Author(s):  
Rosalinde Masereeuw ◽  
Henricus A.M. Mutsaers ◽  
Takafumi Toyohara ◽  
Takaaki Abe ◽  
Sachin Jhawar ◽  
...  
Keyword(s):  
Uremic Toxin ◽  
Toxin Removal

Survival of Hemodialysis Patients and Uremic Toxin Removal

2003 ◽  
Vol 27 (3) ◽  
pp. 218-223 ◽  
Author(s):  
R. Vanholder ◽  
R. De Smet ◽  
G. Glorieux ◽  
A. Dhondt
Keyword(s):  
Hemodialysis Patients ◽  
Uremic Toxin ◽  
Toxin Removal

Middle-Molecule Uremic Toxin Removal via Hemodialysis Augmented with an Immunosorbent Packed Bed

2010 ◽  
Vol 49 (3) ◽  
pp. 1359-1369 ◽  
Author(s):  
Shu Xia ◽  
Nichole Hodge ◽  
Melvin Laski ◽  
Theodore F. Wiesner
Keyword(s):  
Packed Bed ◽  
Uremic Toxin ◽  
Toxin Removal

scholarly journals Successful Treatment of a Critically Ill COVID-19 Patient Using Continuous Renal Replacement Therapy With Enhanced Cytokine Removal and Tocilizumab: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Thomas Tao-Min Huang ◽  
Ying-Chun Chien ◽  
Chih-Hsien Wang ◽  
Sui-Yuan Chang ◽  
Jann-Tay Wang ◽  
...  
Keyword(s):  
Critically Ill ◽  
Immune Modulation ◽  
Precise Measurement ◽  
Life Support ◽  
Kidney Injury ◽  
Adsorptive Capacity ◽  
Uremic Toxin ◽  
Cytokine Therapy ◽  
Toxin Removal ◽  
Extracorporeal Removal

The COVID-19 pandemic has caused multiple deaths worldwide. Since no specific therapies are currently available, treatment for critically ill patients with COVID-19 is supportive. The most severe patients need sustained life support for recovery. We herein describe the course of a critically ill COVID-19 patient with multi-organ failure, including acute respiratory failure, acute kidney injury, and fulminant cytokine release syndrome (CRS), who required mechanical ventilation and extracorporeal membrane oxygenation support. This patient with a predicted high mortality risk was successfully managed with a careful strategy of oxygenation, uremic toxin removal, hemodynamic support, and most importantly, cytokine-targeted intervention for CRS, including cytokine/endotoxin removal, anti-cytokine therapy, and immune modulation. Comprehensive cytokine data, CRS parameters, and biochemical data of extracorporeal removal were provided to strengthen the rationale of this strategy. In this report, we demonstrate that timely combined hemoperfusion with cytokine adsorptive capacity and anti-cytokine therapy can successfully treat COVID-19 patients with fulminant CRS. It also highlights the importance of implementing cytokine-targeted therapy for severe COVID-19 guided by the precise measurement of disease activity.

scholarly journals High performance thin-film nanofibrous composite hemodialysis membranes with efficient middle-molecule uremic toxin removal

2017 ◽  
Vol 523 ◽  
pp. 173-184 ◽  
Author(s):  
Xufeng Yu ◽  
Lingdi Shen ◽  
Yadong Zhu ◽  
Xiong Li ◽  
Yin Yang ◽  
...  
Keyword(s):  
Thin Film ◽  
High Performance ◽  
Uremic Toxin ◽  
Toxin Removal

scholarly journals Acute Hemodynamic Response and Uremic Toxin Removal in Conventional and Extended Hemodialysis and Hemodiafiltration: A Randomized Crossover Study

2014 ◽  
Vol 64 (2) ◽  
pp. 247-256 ◽  
Author(s):  
Tom Cornelis ◽  
Frank M. van der Sande ◽  
Sunny Eloot ◽  
Eline Cardinaels ◽  
Otto Bekers ◽  
...  
Keyword(s):  
Crossover Study ◽  
Hemodynamic Response ◽  
Uremic Toxin ◽  
Toxin Removal ◽  
Randomized Crossover Study

scholarly journals Development of online hemodiafiltration in Japan

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hideki Kawanishi
Keyword(s):  
Survival Rate ◽  
Clinical Evidence ◽  
Antioxidant Effect ◽  
Uremic Toxin ◽  
Antioxidant Action ◽  
Dialysis Patients ◽  
Toxin Removal ◽  
Improvement In Survival

AbstractEvidence concerning online hemodiafiltration (ol-HDF) includes increased uremic toxin removal, prevention of dialysis-related hypotension, improved survival, and recovery of dialysis-related uncertain symptoms. In particular, evidence has been shown regarding prevention of dialysis hypotension and improvement of survival, but the mechanism of its manifestation is still unclear and its effects themselves are questionable. In Japan, pre dilution ol-HDF is mainly performed, and improvement in survival rate has been shown on the condition of convection volume is 40 L/session or more. In particular, the removal of α1-microglubulin (αMG), which is a medium-middle solute, is targeted. The antioxidant action (Heme Scavenger) of αMG, is presumed, but in dialysis patients, the majority in serum are deteriorated (oxidized) αMG. It has been pointed out that removing the deteriorated αMG by ol-HDF may produce new αMG from the liver and lead to recovery of the original antioxidant effect. However, clinical evidence of this mechanism is desired. Obtaining evidence for the indicated αMG removal activity of ol-HDF will lead to advancement in HDF.

scholarly journals In silico comparison of protein-bound uremic toxin removal by hemodialysis, hemodiafiltration, membrane adsorption, and binding competition

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Vaibhav Maheshwari ◽  
Stephan Thijssen ◽  
Xia Tao ◽  
Doris H. Fuertinger ◽  
Franz Kappel ◽  
...  
Keyword(s):  
In Silico ◽  
Uremic Toxin ◽  
Binding Competition ◽  
Toxin Removal
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