scholarly journals Immunological Effects of a Single Hemodialysis Treatment

Medicina ◽  
2020 ◽  
Vol 56 (2) ◽  
pp. 71 ◽  
Author(s):  
Andrea Angeletti ◽  
Fulvia Zappulo ◽  
Chiara Donadei ◽  
Maria Cappuccilli ◽  
Giulia Di Certo ◽  
...  
Keyword(s):  
Adaptive Response ◽  
Chronic Hemodialysis ◽  
Hemodialysis Treatment ◽  
Immune Balance ◽  
Immunological Effects ◽  
Exogenous Factors ◽  
Immune System Modulation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Innovative Techniques

Immune disorders, involving both innate and adaptive response, are common in patients with end-stage renal disease under chronic hemodialysis. Endogenous and exogenous factors, such as uremic toxins and the extracorporeal treatment itself, alter the immune balance, leading to chronic inflammation and higher risk of cardiovascular events. Several studies have previously described the immune effects of chronic hemodialysis and the possibility to modulate inflammation through more biocompatible dialyzers and innovative techniques. On the other hand, very limited data are available on the possible immunological effects of a single hemodialysis treatment. In spite of the lacking information about the immunological reactivity related to a single session, there is evidence to indicate that mediators of innate and adaptive response, above all complement cascade and T cells, are implicated in immune system modulation during hemodialysis treatment. Expanding our understanding of these modulations represents a necessary basis to develop pro-tolerogenic strategies in specific conditions, like hemodialysis in septic patients or the last session prior to kidney transplant in candidates for receiving a graft.

Treatment with Cinacalcet in Hemodialysis Patients with Severe Secondary Hyperparathyroidism, Influences Bone Mineral Metabolism and Anemia Parameters

2020 ◽  
Vol 15 (3) ◽  
pp. 249-263
Author(s):  
Maria Aktsiali ◽  
Theodora Papachrysanthou ◽  
Ioannis Griveas ◽  
Christos Andriopoulos ◽  
Panagiotis Sitaras ◽  
...  
Keyword(s):  
Bone Mineral ◽  
Mineral Metabolism ◽  
Treatment Options ◽  
Dry Weight ◽  
Chronic Hemodialysis ◽  
Protective Agent ◽  
Positive Correlation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: Due to the premium rate of Chronic Kidney Disease, we have increased our knowledge with respect to diagnosis and treatment of Bone Mineral Disease (BMD) in End- Stage Renal Disease (ESRD). Currently, various treatment options are available. The medication used for Secondary Hyper-Parathyroidism gives promising results in the regulation of Ca, P and Parathormone levels, improving the quality of life. The aim of the present study was to investigate the relation of cinacalcet administration to not only parathormone, Ca and P but also to anemia parameters such as hematocrit and hemoglobin. Materials and Methods: retrospective observational study was conducted in a Chronic Hemodialysis Unit. One-hundred ESRD patients were recruited for twenty-four months and were evaluated on a monthly rate. Biochemical parameters were related to medication prescribed and the prognostic value was estimated. Cinacalcet was administered to 43 out of 100 patients in a dose of 30-120 mg. Results: Significant differences were observed in PTH, Ca and P levels with respect to Cinacalcet administration. Ca levels appeared to be higher at 30mg as compared to 60mg cinacalcet. Furthermore, a decreasing age-dependent pattern was observed with respect to cinacalcet dosage. A positive correlation was observed between Dry Weight (DW) and cinacalcet dose. Finally, a positive correlation between Hematocrit and Hemoglobin and cinacalcet was manifested. Conclusions: Cinacalcet, is a potential cardiovascular and bone protective agent, which is approved for use in ESRD patients to assist SHPT. A novel information was obtained from this study, regarding the improvement of the control of anemia.

L-Carnitine Consecutively Administered to Patients on Hemodialysis Improves Beta-Cell Response

2003 ◽  
Vol 26 (4) ◽  
pp. 304-307 ◽  
Author(s):  
E. Vazelov ◽  
A-M. Borissova ◽  
G. Kirilov ◽  
B. Assenova ◽  
M. Tchetirska ◽  
...  
Keyword(s):  
Beta Cell ◽  
Chronic Hemodialysis ◽  
Dialysis Session ◽  
Carnitine Level ◽  
Peripheral Tissues ◽  
Before And After ◽  
Oxidative Processes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Beta Cell Response

Eight patients with end stage renal disease (ESRD) on chronic hemodialysis (CHD) treatment were supplemented with 1 g L-carnitine intravenously (i.v.) after each dialysis session for one month. A Tolbutamide test was done and blood sugar (BS), serum C-peptide (CP) were measured at 0, 20 and 60 minutes, as well as the plasma L-carnitine level before and after treatment. Delta CP and the area under CP curve were ascertained. After L-carnitine application delta CP was significantly increased (1.33 ± 0.63 vs. 2.24 ± 1.0 nmol/L; p <0.05) and also the area of the stimulated secretion under the CP curve (14.93 ± 11.11 vs. 36.88 ± 25.36 nmol/L × 60 min.; p <0.05). The fasting BS-level was significantly lower after the treatment - 3.85 ± 0.43 vs. 4.76 ± 1.02 mmol/L; p <0.05 and plasma L-carnitine level significantly increased (72.8 ± 43.2 vs. 35.2 ± 18.3 mcmol/L; p <0.05) Improving the oxidative processes in peripheral tissues, L-carnitine increases the peripheral effectiveness of insulin and relieves the overstretched beta-cell apparatus.

scholarly journals Outcomes of Chronic Hemodialysis Patients in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Melanie Chan ◽  
Marlies Ostermann
Keyword(s):  
Intensive Care Unit ◽  
Renal Function ◽  
Intensive Care ◽  
Kidney Injury ◽  
Chronic Hemodialysis ◽  
Current Evidence ◽  
Icu Outcome ◽  
Stage Renal Disease ◽  
End Stage

Patients with end-stage renal disease (ESRD) experience higher rates of hospitalisation, cardiovascular events, and all-cause mortality and are more likely to require admission to the intensive care unit (ICU) than patients with normal renal function. Sepsis and cardiovascular diseases are the most common reasons for ICU admission. ICU mortality rates in patients requiring chronic hemodialysis are significantly higher than for patients without ESRD; however, dialysis patients have a better ICU outcome than those with acute kidney injury (AKI) requiring renal replacement therapy suggesting that factors other than loss of renal function contribute to their prognosis. Current evidence suggests, the longer-term outcomes after discharge from ICU may be favourable and that long-term dependence on dialysis should not prejudice against prompt referral or admission to ICU.

scholarly journals Extended erythrocyte and reticulocyte parameters in the diagnosis of iron deficiency in hemodialysis patients

2020 ◽  
Vol 3 (4) ◽  
pp. 109-113
Author(s):  
Mohammed Nazim Bennaoum ◽  
◽  
Affaf Adda ◽  
Mohamed Chekkal ◽  
Fatima Seghier ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
High Sensitivity ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Red Cells ◽  
Corpuscular Hemoglobin ◽  
Cellular Concentration ◽  
Stage Renal Disease ◽  
End Stage

Objective: Iron deficiency (ID) is a frequent complication in end stage renal insufficiency. These patients have to be diagnosed and treated to reduce the prevalence of anemia. Functional iron deficiency (FID) is a situation that can disrupt biochemical iron tests and mask an eventual association with ID. In this study, we tried to prove the ability of extended parameters of red cells and reticulocytes to diagnose ID without being influenced by FID. Design and methods: 164 chronic hemodialysis patients (CHP) in end stage renal disease were enrolled. Research parameters of red cells and reticulocytes determined on ADVIA 2120i were studied in the diagnosis of ID associated or not with chronic inflammation. Results: Parameters such as corpuscular hemoglobin of mature red cells (CHm), corpuscular hemoglobin of reticulocytes (CHr), cellular concentration of hemoglobin in mature red cells (CHCMm), cellular concentration of hemoglobin in reticulocytes (CHCMr) and percentage of microcytic and hypochromic red cells (HYMI) showed a high sensitivity to diagnose ID. However, the distinction of combined iron deficiency (CID) from other entities was not possible with all parameters. In chronic inflammatory states, the decrease of CHm, CHCMm and CHCMr with the rise of percentage hypochromic mature red cells (HYPOm) and reticulocytes (HYPOr) is in favor of CID. So, determination of inflammatory state is needed to complete research parameters of blood count in CHP. Conclusion: Extended erythrocyte and reticulocyte parameters can be useful to check iron status in CHP.

Multidimensional Health Locus of Control as Partial Predictor of Serum Phosphorus in Chronic Hemodialysis

1992 ◽  
Vol 70 (3_suppl) ◽  
pp. 1171-1174 ◽  
Author(s):  
Bob Schneider
Keyword(s):  
Locus Of Control ◽  
Health Locus Of Control ◽  
Chronic Hemodialysis ◽  
Serum Phosphorus ◽  
Dietary Compliance ◽  
Tentative Explanation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Multidimensional Health ◽  
Relationship Of

The Multidimensional Health Locus of Control Scale was administered to 137 chronic hemodialysis outpatients in a survey designed to examine the relationship of these scores to serum phosphorus, a laboratory indicator of dietary compliance in end-stage renal disease. In a multiple regression analysis, scores on the Powerful Others Locus of Control subscale accounted for 8.9% of the variance in serum phosphorus. Discussion includes a tentative explanation of the findings and limitations of the design.

Relationship Between Volume Status and Blood Pressure in Children with End Stage Renal Disease on Chronic Hemodialysis

2007 ◽  
Vol 7 (2) ◽  
pp. 210-215
Author(s):  
Fatina I. Fadel ◽  
Samar M. Sabry ◽  
Azza M.O. Abdel Rahm ◽  
Emad Eldin E. Salama ◽  
Marwa M. El-Sonbaty
Keyword(s):  
Blood Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Chronic Hemodialysis ◽  
Volume Status ◽  
Stage Renal Disease ◽  
End Stage

Clinical Outcomes of Arteriovenous Access in Incident Hemodialysis Patients with Medicare Coverage, 2012–2014

2019 ◽  
Vol 49 (2) ◽  
pp. 156-164 ◽  
Author(s):  
Lauren C. Bylsma ◽  
Heidi Reichert ◽  
Shawn M. Gage ◽  
Prabir Roy-Chaudhury ◽  
Robert J. Nordyke ◽  
...  
Keyword(s):  
Vascular Access ◽  
Venous Catheter ◽  
The United States ◽  
Chronic Hemodialysis ◽  
Continuous Coverage ◽  
Sustained Use ◽  
Arteriovenous Access ◽  
Stage Renal Disease ◽  
End Stage ◽  
Primary Payer

Background: Chronic hemodialysis requires a mode of vascular access through an arteriovenous fistula (AVF), a prosthetic arteriovenous graft (AVG), or a central venous catheter (CVC). AVF is recommended over AVG or CVC due to increased patency and decreased intervention rates for those that mature. AVG are preferred over CVC due to decreased infection and mortality risk. The aims of this study were to evaluate the lifespan of AVF and AVG in maturation, sustained access use, and abandonment. Methods: The United States Renal Data System (USRDS), Medicare claims, and CROWNWeb were used to identify access placements. Patients with a first end-stage renal disease (ESRD) service from January 1, 2012 to June 30, 2014 with continuous coverage with Medicare as primary payer and ≥1 AVF or AVG placed after ESRD onset were included. Maturation was defined as the first use of the access for hemodialysis recorded in CROWNWeb. Sustained access use was defined as 3 consecutive months of use without catheter placement or replacement. Accesses that were never used at any time post-placement were considered abandoned. Results: The cohort included 38,035 AVF placements and 12,789 AVG placements. Sixty-nine percent of AVF and 72% of AVG matured. Fifty-two percent of AVF and 51% of AVG achieved sustained access use. One quarter of AVF and 14% of AVG were abandoned without use as recorded in CROWNWeb. Conclusion: Although considered the gold standard for vascular access, only half of AVF and AVG placements achieved sustained access use. The USRDS database has inherent limitations but provides useful clinical insight into maturation, sustained use, and abandonment.

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