Towards an individualized determination of dialysis adequacy: a narrative review with special emphasis on incremental hemodialysis

Although the 24-hour collection of dialysate provides a very accurate measure of the adequacy of dialysis, it is not known if it can also determine peritoneal membrane transport characteristics. In this prospective study, 101 24-hour dialysate collections were immediately followed by a standard peritoneal equilibration test (PET). Four- and 24-h dialysate-to-plasma (D/P) ratios were determined for creatinine and urea. The correlation coefficients between these two tests were 0.86 for the adjusted D/P creatinine and 0.71 for the D/P urea, whereas the standard errors of estimate were 0.054 and 0.060, respectively. Patients were classified into one of four transport groups on the basis of the mean and standard deviation of the adjusted D/P creatinine values, and these values were similar to those generated from the PET data. Rates of ultrafiltration were also defined for patients undergoing 2.0- and 2.5-L dwells. A survey of a subset of these patients demonstrated that the 24-h collection was preferred to the PET for determining transport characteristics. Therefore, the 24-h dialysate collection can be used to monitor both peritoneal membrane transport characteristics and adequacy. This technique, which has been named the "dialysis adequacy and transport test," has the potential for significant cost savings when it is used for the routine follow-up of both peritoneal transport and adequacy of dialysis.

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Pediatric donation after circulatory determination of death (pDCD): A narrative review

Paediatric Respiratory Reviews ◽

10.1016/j.prrv.2018.03.006 ◽

2019 ◽

Vol 29 ◽

pp. 3-8

Author(s):

Matthew J. Weiss ◽

Wendy Sherry ◽

Laura Hornby

Keyword(s):

Narrative Review ◽

Determination Of Death

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24-Hour Dialysate Collection for Determination of Peritoneal Membrane Transport Characteristics: Longitudinal Follow-Up Data for the Dialysis Adequacy and Transport Test (Datt)

Peritoneal Dialysis International ◽

10.1177/089686089601600607 ◽

1996 ◽

Vol 16 (6) ◽

pp. 590-593 ◽

Cited By ~ 18

Author(s):

Michael V. Rocco ◽

Jean R. Jordan ◽

John M. Burkart

Keyword(s):

Peritoneal Dialysis ◽

Membrane Transport ◽

Standard Error ◽

Peritoneal Membrane ◽

Dialysis Adequacy ◽

Peritoneal Transport ◽

The Mean ◽

Cr Concentration ◽

Over Time

Objective To determine the ability of the dialysis adequacy and transport test (DATT) to monitor changes in peritoneal transport characteristics over time. Setting University-based peritoneal dialysis program. Patients One hundred patients on continuous ambulatory peritoneal dialysis who underwent 226 simultaneous DATTs and peritoneal equilibration tests (PET). Methods Retrospective analysis of DA TT and PET data. Results The mean 24-hour dialysate-to-plasma creatinine (cr) concentration ratio (DIP cr) from the DATT was 0.70±0.10, and the mean four-hour DIP crfrorn the PET was 0.68 ± 0.10. The correlation coefficient between the fourhour and 24-hour DIP cr was 0.81, and the standard error of estimate was 0.065. The mean (±SD) difference between the four-hour and 24-hour DIP cr was 0.023 ± 0.061. Fifty eight patients had two or more sequential DA TTs and PETs. For these 94sets of sequential DATTs and PETs, the mean (±SD) difference between the change in the four-hour DIP cr and the change in the 24-hour DIP cr was 0.020 ± 0.024, and the standard error of estimate was 0.064. In 17 patients a change in dwell volume from 2.0 L to 2.5 L occurred between the first and second measures of peritoneal membrane transport characteristics. The mean (±SD) difference between the change in the four-hour DIP cr and the change in the 24-hour DIP cr was 0.036 ± 0.055, and the standard error of estimate was 0.087. Conclusion The DATT can be used to monitor for changes in peritoneal transport over time. It should not be used in patients receiving cycler therapy or in patients whose dwell times and dextrose concentrations vary markedly from day to day.

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Update on Biomarkers Associated to Cardioembolic Stroke: A Narrative Review

Life ◽

10.3390/life11050448 ◽

2021 ◽

Vol 11 (5) ◽

pp. 448

Author(s):

Ana Catarina Fonseca ◽

Pedro Coelho

Keyword(s):

External Validation ◽

Left Ventricular ◽

Narrative Review ◽

Cardioembolic Stroke ◽

Cardiac Monitoring ◽

Stroke Recurrence ◽

Wall Motion Abnormalities ◽

Selection Of Patients ◽

Selection Of

Background: In the last years, several studies were conducted that evaluated biomarkers that could be helpful for cardioembolic stroke diagnosis, prognosis, and the determination of risk of stroke recurrence. Methods: We performed a narrative review of the main studies that evaluated biomarkers related to specific cardioembolic causes: atrial fibrillation, patent foramen ovale, atrial cardiomyopathy, and left ventricular wall motion abnormalities. Results: BNP and NT-proBNP are, among all biomarkers of cardioembolic stroke, the ones that have the highest amount of evidence for their use. NT-proBNP is currently used for the selection of patients that will be included in clinical trials that aim to evaluate the use of anticoagulation in patients suspected of having a cardioembolic stroke and for the selection of patients to undergo cardiac monitoring. NT-proBNP has also been incorporated in tools used to predict the risk of stroke recurrence (ABC-stroke score). Conclusions: NT-proBNP and BNP continue to be the biomarkers most widely studied in the context of cardioembolic stroke. The possibility of using other biomarkers in clinical practice is still distant, mainly because of the low methodological quality of the studies in which they were evaluated. Both internal and external validation studies are rarely performed for most biomarkers.

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Online hemofiltration in incremental dialysis prescription

Portuguese Journal of Nephrology & Hypertension ◽

10.32932/pjnh.2021.01.098 ◽

2021 ◽

Vol 34 (4) ◽

Author(s):

Sofia Correia ◽

◽

Filipa Silva ◽

Joana Tavares ◽

António Cabrita ◽

...

Keyword(s):

Renal Function ◽

Potential Benefit ◽

Residual Renal Function ◽

Additional Benefit ◽

Dialysis Adequacy ◽

Major Complications ◽

Incremental Hemodialysis

Incremental dialysis is increasingly recognized as a safe and beneficial method of initiating dialysis. Different centers use distinct prescription methods. We discuss the advantages of incremental hemodialysis and the potential benefit of preserving residual renal function as we present our experience. We reviewed the data from 20 incident patients, with a mean follow‑up of 9.5 months, who started dialysis with our prescription method, using hemofiltration as the preferred depurative technique. All patients tolerated treatment well; no major complications were reported. Dialysis adequacy targets were achieved. While data are clearly limited, we raise the hypothesis that convective techniques could bring additional benefit in preserving residual renal function in incident patients, and that this strategy should be studied and compared with others.

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Galactic orbits of stars

Symposium - International Astronomical Union ◽

10.1017/s0074180900105340 ◽

1966 ◽

Vol 25 ◽

pp. 93-97

Author(s):

Richard Woolley

Keyword(s):

Globular Cluster ◽

Potential Field ◽

High Velocity ◽

Velocity Vector ◽

Variable Stars ◽

The Sun ◽

Proper Motions ◽

Rr Lyrae ◽

The Galaxy

It is now possible to determine proper motions of high-velocity objects in such a way as to obtain with some accuracy the velocity vector relevant to the Sun. If a potential field of the Galaxy is assumed, one can compute an actual orbit. A determination of the velocity of the globular clusterωCentauri has recently been completed at Greenwich, and it is found that the orbit is strongly retrograde in the Galaxy. Similar calculations may be made, though with less certainty, in the case of RR Lyrae variable stars.

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Distance to SN 1987A and the LMC

Symposium - International Astronomical Union ◽

10.1017/s0074180900118959 ◽

1999 ◽

Vol 190 ◽

pp. 549-554

Author(s):

Nino Panagia

Keyword(s):

Angular Size ◽

Large Magellanic Cloud ◽

Magellanic Cloud ◽

Light Curves ◽

Distance Modulus ◽

Absolute Size ◽

Sn 1987A

Using the new reductions of the IUE light curves by Sonneborn et al. (1997) and an extensive set of HST images of SN 1987A we have repeated and improved Panagia et al. (1991) analysis to obtain a better determination of the distance to the supernova. In this way we have derived an absolute size of the ringRabs= (6.23 ± 0.08) x 1017cm and an angular sizeR″ = 808 ± 17 mas, which give a distance to the supernovad(SN1987A) = 51.4 ± 1.2 kpc and a distance modulusm–M(SN1987A) = 18.55 ± 0.05. Allowing for a displacement of SN 1987A position relative to the LMC center, the distance to the barycenter of the Large Magellanic Cloud is also estimated to bed(LMC) = 52.0±1.3 kpc, which corresponds to a distance modulus ofm–M(LMC) = 18.58±0.05.

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International determination of the total motion of the pole

Symposium - International Astronomical Union ◽

10.1017/s0074180900177824 ◽

1961 ◽

Vol 13 ◽

pp. 29-41

Author(s):

Wm. Markowitz

Keyword(s):

Secular Motion ◽

The Future

A symposium on the future of the International Latitude Service (I. L. S.) is to be held in Helsinki in July 1960. My report for the symposium consists of two parts. Part I, denoded (Mk I) was published [1] earlier in 1960 under the title “Latitude and Longitude, and the Secular Motion of the Pole”. Part II is the present paper, denoded (Mk II).

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Time and Latitude in South Africa

International Astronomical Union Colloquium ◽

10.1017/s0252921100026816 ◽

1972 ◽

Vol 1 ◽

pp. 27-38

Author(s):

J. Hers

Keyword(s):

South Africa ◽

Cape Town ◽

Astronomical Observations ◽

Royal Observatory ◽

The Republic ◽

Astronomical Determination ◽

Limited Accuracy ◽

Better Than

In South Africa the modern outlook towards time may be said to have started in 1948. Both the two major observatories, The Royal Observatory in Cape Town and the Union Observatory (now known as the Republic Observatory) in Johannesburg had, of course, been involved in the astronomical determination of time almost from their inception, and the Johannesburg Observatory has been responsible for the official time of South Africa since 1908. However the pendulum clocks then in use could not be relied on to provide an accuracy better than about 1/10 second, which was of the same order as that of the astronomical observations. It is doubtful if much use was made of even this limited accuracy outside the two observatories, and although there may – occasionally have been a demand for more accurate time, it was certainly not voiced.

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