Citrate versus Acetate-Based Dialysate in On-Line Haemodiafiltration. A Prospective Cross-Over Study

2015 ◽  
Vol 39 (1-3) ◽  
pp. 181-187 ◽  
Author(s):  
Manuel Molina Nuñez ◽  
Rosa de Alarcón ◽  
Susana Roca ◽  
Gracia Álvarez ◽  
María Soledad Ros ◽  
...  
Keyword(s):  
Anticoagulant Effect ◽  
Acid Base ◽  
C Protein ◽  
Inflammatory Parameters ◽  
Ionic Calcium ◽  
On Line ◽  
Acid Base Status ◽  
Beta 2 ◽  
Two Phases ◽  
Beta 2 Microglobulin

Background and Aims: A bicarbonate dialysate acidified with citrate (CD) has been reported to have local anticoagulant effect and improves biocompatibility. This study examines the effect of CD on dialysis efficiency, coagulation, acid-base status, electrolytes, and inflammation in patients in on-line hemodiafiltration (OL-HDF). Methods: 35 patients in OL-HDF were enrolled in a prospective, cross-over study for a 24-week period and two phases alternating CD and acetate dialysate fluid (AD). Parameters on study were predialysis levels of bicarbonate and ionic calcium, reactive C Protein (CRP), and beta-2 microglobulin (B2MG) and postdialysis levels of activated tromboplastine time, bicarbonate, and ionized calcium. Results: No significant differences in coagulation parameters, pH, and predialysis bicarbonate were found. The postdialysis bicarbonate and postdialysis calcium were lower with CD. Dialysis efficiency was greater with CD. Regarding inflammatory parameters, both CRP and B2MG were lower using CD. Conclusion: The use of CD is safe and effective in OL-HDF, and it improves dialysis efficacy, postdialysis alkalosis, and inflammation.

Long-Term On-Line Hemodiafiltration Reduces Predialysis Beta-2-Microglobulin Levels in Chronic Hemodialysis Patients

2001 ◽  
Vol 19 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Chun-Liang Lin ◽  
Chih-Wei Yang ◽  
Chin-Chen Chiang ◽  
Ching-Tung Chang ◽  
Chiu-Ching Huang
Keyword(s):  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
On Line ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Remarkable Removal of Beta-2-Microglobulin by On-Line Hemodiafiltration

1998 ◽  
Vol 18 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Willy Lornoy ◽  
Ignace Becaus ◽  
Jean-Marie Billiouw ◽  
Luc Sierens ◽  
Paul van Malderen
Keyword(s):  
On Line ◽  
Beta 2 ◽  
Beta 2 Microglobulin

A Comparison of Bicarbonate Kinetics and Acid-base Status in High Flux Hemodialysis and On-Line Post-Dilution Hemodiafiltration

2012 ◽  
Vol 35 (4) ◽  
pp. 288-300 ◽  
Author(s):  
Hélène Morel ◽  
Michel Y. Jaffrin ◽  
Clément Lux ◽  
Marianne Renou ◽  
Claire Fessier ◽  
...  
Keyword(s):  
High Flux ◽  
Acid Base ◽  
On Line ◽  
Acid Base Status

On-Line Hemodiafiltration with Pre- and Postdilution: Impact on the Acid-Base Status

1998 ◽  
Vol 21 (6) ◽  
pp. 321-327 ◽  
Author(s):  
P. Ahrenholz ◽  
R.E. Winkler ◽  
W. Ramlow ◽  
M. Tiess ◽  
O. Thews
Keyword(s):  
Delivery System ◽  
High Flux ◽  
Line Formation ◽  
Acid Base ◽  
On Line ◽  
Acid Base Status ◽  
Acid Base Disturbance ◽  
Esrd Patients ◽  
Base Disturbance ◽  
Excessive Compensation

With on-line formation of the substitution fluid, high substitution rates in predilution (PRD) and postdilution (POD) can be obtained (Fresenius 4008 On-Line HDF, Gambro AK 100 Ultra). The substitution fluid is branched off from the dialysate produced by the dialysate delivery system of the HDF machine. Under these conditions it is desirable to consider the effect of the different treatment modes on the acid-base status. Using Fresenius 4008 On-Line HDF machines, ESRD-patients were treated alternately with high-flux hemodialysis (HD), postdilution HDF (POD-HDF) and predilution HDF (PRD-HDF), while all other treatment parameters were kept constant, in particular the bicarbonate dialysate concentration. Plasma-HCO3, - pH and -pCO2 were measured and compared with the results of a multicompartment bicarbonate model developed by Thews. Also plasma-pO2 and K+ were measured. The results showed no significant differences between HD, POD- and PRD-HDF. Acidosis was corrected effectively and no excessive compensation of the acid-base disturbance was observed.

To Manage Infantile Hypertrophic Pyloric Stenosis by "Double-Y Pyloromyotomy" is a better Surgical Approach

2014 ◽  
Vol 1 (2) ◽  
pp. 143-147
Author(s):  
Md. Ansar Ali ◽  
Kaniz Hasina ◽  
Shahnoor Islam ◽  
Md. Ashraf Ul Huq ◽  
Md. Mahbub-Ul Alam ◽  
...  
Keyword(s):  
Weight Gain ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Treatment Modalities ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Postoperative Vomiting ◽  
Acid Base ◽  
Feeding Regimes ◽  
Acid Base Status ◽  
Postoperative Feeding

Background: Different treatment modalities and procedures have been tried for the management of infantile hypertrophic pyloric stenosis. But surgery remains the mainstay for management of IHPS. Ramstedt’s pyloromyotomy was described almost over a hundred years ago and to date remains the surgical technique of choice. An alternative and better technique is the double-Y pyloromyotomy, which offer better results for management of this common condition.Methods: A prospective comparative interventional study of 40 patients with IHPS was carried out over a period of 2 years from July 2008 to July 2010. The patients were divided into 2 equal groups of 20 patients in each. The study was designed that all patients selected for study were optimized preoperatively regarding to hydration, acid-base status and electrolytes imbalance. All surgeries were performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes were used. The patients were operated on an alternate basis, i.e., one patient by Double-Y Pyloromyotomy(DY) and the next by aRamstedt’s Pyloromyotomy (RP). Data on patient demographics, operative time, anesthesia complications, postoperative complications including vomiting and weight gain were collected. Patients were followed up for a period of 3 months postoperatively. Statistical assessments were done by using t test.Results: From July 2008 through July 2010, fourty patients were finally analyzed for this study. Any statistical differences were observed in patient population regarding age, sex, weight at presentation, symptoms and clinical condition including electrolytes imbalance and acid-base status were recorded. Significant differences were found in postoperative vomiting and weight gain. Data of post operative vomiting and weight gain in both groups were collected. Vomiting in double-Y(DY) pyloromyotomy group (1.21 ± 0.45days) vs Ramstedt’s pyloromyotomy (RP) group(3.03 ± 0.37days) p= 0.0001.Weight gain after 1st 10 days DY vs RP is ( 298 ± 57.94 gm vs193±19.8 gm p=0.0014), after 1 month (676.67±149.84 gm vs 466.67 ± 127.71 gm, p=0.0001), after 2months (741.33± 278.74 gm vs 490±80.62 gm, p=0.002) and after 3 months (582±36.01gm vs 453.33±51.64 gm, p=0.0001).No long-term complications were reported and no re-do yloromyotomy was needed.Conclusion: The double-Y pyloromyotomy seems to be a better technique for the surgical management of IHPS. It may offer a better functional outcome in term of postoperative vomiting and weight gain.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19532

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