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 Thermodynamics of primary antioxidant action of flavonols in polar solvents

2019 ◽  
Vol 12 (1) ◽  
pp. 108-118 ◽  
Author(s):  
Martin Michalík ◽  
Ján Rimarčík ◽  
Vladimír Lukeš ◽  
Erik Klein
Keyword(s):  
Reaction Pathway ◽  
Hydrogen Atom Transfer ◽  
Antioxidant Effect ◽  
Antioxidant Action ◽  
Polar Solvents ◽  
Polar Media ◽  
Primary Antioxidant ◽  
Intramolecular Hydrogen

Abstract Very recently, a report on the antioxidant activity of flavonoids has appeared, where authors concluded that Hydrogen Atom Transfer mechanism represents the thermodynamically preferred mechanism in polar media (https://doi.org/10.1016/j.foodres.2018.11.018). Unfortunately, serious errors in the theoretical part of the paper led to incorrect conclusions. For six flavonols (galangin, kaempferol, quercetin, morin, myricetin, and fisetin), reaction enthalpies related to three mechanisms of the primary antioxidant action were computed. Based on the obtained results, the role of intramolecular hydrogen bonds (IHB) in the thermodynamics of the antioxidant effect is presented. Calculations and the role of solvation enthalpies of proton and electron in the determination of thermodynamically preferred mechanism is also briefly explained and discussed. The obtained results are in accordance with published works considering the Sequential Proton-Loss Electron-Transfer thermodynamically preferred reaction pathway.

Outcomes of cardiovascular surgery for chronic dialysis patients in current Japan

2019 ◽  
Vol 27 (6) ◽  
pp. 464-470
Author(s):  
Hiroshi Kurazumi ◽  
Masaya Takahashi ◽  
Shigeru Ikenaga
Keyword(s):  
Survival Rate ◽  
Cardiovascular Surgery ◽  
Hazard Ratio ◽  
Dialysis Patients ◽  
Term Survival ◽  
Long Term Follow Up ◽  
History Of ◽  
Atherosclerosis Obliterans

Background The number of dialysis patients in Japan is rising, with an increasing number requiring cardiovascular surgery. Methods We investigated the short- and long-term outcomes in 70 dialysis patients among a total of 1124 who underwent cardiovascular surgery in our hospital between 2004 and 2016. We investigated outcomes following open surgery and identified factors that affected the prognosis. We also compared the long-term survival rate with the survival rate of the Japanese dialysis population. Results The long-term survival rate was 70.6%, 51.1%, and 19.2% after 3, 5, and 10 years, respectively. The causes of long-term death were heart disease in 8 patients, cerebrovascular disease in 7, cachexia in 3, infection in 2, and other causes in 3. The freedom from cardiac death was 88.7%, 77.9%, and 54.9% after 3, 5, and 10 years, respectively. Multivariate analysis using Cox’s proportional hazard model showed that a history of atherosclerosis obliterans (hazard ratio 5.4, p = 0.05) and mediastinitis (hazard ratio 10.2, p = 0.03) were risk factors for death in long-term follow-up, and a history of atherosclerosis obliterans was an independent risk factor for cardiac death in long-term follow-up (hazard ratio 5.3, p = 0.01). Five-year survival of the study subjects was comparable to that of the Japanese dialysis population. Conclusions The prognosis for dialysis patients after open surgery was equivalent to that of Japanese dialysis patients in general. A high proportion of late postoperative deaths were due to heart disease. Patients with atherosclerosis obliterans had a poor prognosis.

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 Indoxyl Sulfate Elimination in Renal Replacement Therapy: Influence of Citrate- versus Acetate-Buffering Component during Bicarbonate Dialysis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Radomír Hyšpler ◽  
Alena Tichá ◽  
Roman Šafránek ◽  
Petr Moučka ◽  
Zora Nývltová ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Indoxyl Sulfate ◽  
Uremic Toxin ◽  
Dialysis Patients ◽  
Poor Survival ◽  
Male Patients ◽  
The Difference ◽  
Residual Diuresis ◽  
Dialysis Fluids

Indoxyl sulfate has been identified as a major factor in the dysregulation of several genes. It is classified as a poorly dialyzable uremic toxin and thus a leading cause in the poor survival rate of dialysis patients. A monocentric, prospective, open cohort study was performed in 43 male patients undergoing chronic renal replacement therapy in a single hemodialysis center. The aim of the study was to determine the influence of acetate- versus citrate-buffered dialysis fluids in hemodialysis (HD) and postdilution hemodiafiltration (HDF) settings on the elimination of indoxyl sulfate. Also, additional factors potentially influencing the serum concentration of indoxyl sulfate were evaluated. For this purpose, the predialysis and postdialysis concentration ratio of indoxyl sulfate and total protein was determined. The difference was of 1.15 (0.61; 2.10), 0.89 (0.53; 1.66), 0.32 (0.07; 0.63), and 0.44 (0.27; 0.77) μmol/g in acetate HD and HDF and citrate HD and HDF, respectively. Acetate HD and HDF were superior when concerning IS elimination when compared to citrate HD and HDF. Moreover, residual diuresis was determined as the only predictor of lower indoxyl sulfate concentration, suggesting that it should be preserved as long as possible. This trial is registered with EU PAS Register of Studies EUPAS23714.

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

scholarly journals Antioxidant Action of Solid Preparation of Xingnaojing in SHRSP

2013 ◽  
Vol 8 (5) ◽  
pp. 1934578X1300800 ◽  
Author(s):  
Yang Liu ◽  
Naomi Yasui ◽  
Aya Kishimoto ◽  
Jian-ning Sun ◽  
Katsumi Ikeda
Keyword(s):  
Lipid Peroxidation ◽  
Antioxidant Status ◽  
Total Antioxidant Status ◽  
Thiobarbituric Acid ◽  
Antioxidant Effect ◽  
Antioxidant Action ◽  
Thiobarbituric Acid Reactive Substances ◽  
Hypertensive Rats ◽  
Spontaneously Hypertensive ◽  
Total Antioxidant

We investigated the antioxidant action of a solid preparation of Xingnaojing (XNJ) and ascorbic acid (AA) in stroke-prone spontaneously hypertensive rats (SHRSP). The total antioxidant states in the plasma, systolic blood pressure, and heart rate were measured every 2 weeks, and lipid peroxidation, expressed as thiobarbituric acid-reactive substances in plasma, was measured in the 6th week. The results showed that AA and XNJ significantly increased the total antioxidant status in plasma and reduced malondialdehyde in the plasma. These data suggest that during 6-week administration, XNJ has antioxidant action on SHRSP, which may relate to its generalized inhibition of lipid peroxidation and promotion of the total antioxidant state. These results demonstrated that orally treated XNJ has an antioxidant effect on SHRSP plasma.

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
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