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New Insights into Peritoneal Dialysis and Hemodialysis: 2nd Edition
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New Insights into Peritoneal Dialysis and Hemodialysis: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 26 January 2026 | Viewed by 2841

Special Issue Editor

Dr. Grazia Maria Virzì

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Guest Editor
Department of Nephrol Dialysis and Transplant, San Bortolo Hospital, 36100 Vicenza, Italy
Interests: dialysis; uremia; cardiorenal syndrome; organ crosstalk; kidney; biomarkers; chronic kidney disease; inflammation
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Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to the Special Issue entitled “New Insights into Peritoneal Dialysis and Hemodialysis: 2nd Edition”. In the first volume, we published 11 papers. For more details, please visit https://www.mdpi.com/journal/jcm/special_issues/463Z42Y7A5.

The incidence of end-stage renal disease is increasing year by year, and it is one of the most commonly fatal diseases in patients. Kidney replacement therapy (KRT) has made significant progress in recent decades, with about 70% of people receiving KRT undergoing dialysis, of whom about 10% undergo peritoneal dialysis and 90% undergo hemodialysis.

Nephrologists will face significant challenges in the future as the number of patients requiring KRT increases. In addition, some important pathophysiological features of patients, including accelerated systemic atherosclerosis, vascular calcification, inflammation, frailty, cognitive impairment, etc., have recently been revealed. The daily lives of dialysis patients are also restricted by fatigue, depression, and comorbidities. These disease states have complex effects on adverse events and prognosis in hemodialysis patients.

This Special Issue of the Journal of Clinical Medicine will explore the current state of dialysis, including hemodialysis and peritoneal dialysis. Future challenges and current research will be noted, including, but not limited to, the clinical application of hemodialysis and peritoneal dialysis, dialysis preparation, vascular access function, complications, dialysis membranes and techniques, unfavorable adverse effects, and other topics related to diagnosis, treatment, and management in patients. We welcome you to submit your latest original articles or reviews to provide clinicians with the latest insights concerning this field.

Dr. Grazia Maria Virzì
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hemodialysis
  • peritoneal dialysis
  • end-stage renal disease
  • kidney replacement therapy (KRT)
  • pathophysiology
  • di-alysis membranes
  • dialysis preparation
  • dialysis modality
  • cardiovascular events
  • vascular access
  • PD-related perito-nitis
  • unfavorable adverse effects
  • complications
  • challenges
  • inflammation

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Related Special Issue

Published Papers (2 papers)

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Research

13 pages, 643 KB  
Article
Dialysis and Acid–Base Balance: A Comparative Physiological Analysis of Boston and Stewart Models
by Nikolaos Kroustalakis, Eleftheria Maragkaki, Ariadni Androvitsanea, Ioannis Petrakis, Eleni Drosataki, Kleio Dermitzaki, Christos Pleros, Andreas Antonakis, Dimitra Lygerou, Eumorfia Kondili, Dimitris Georgopoulos and Kostas Stylianou
J. Clin. Med. 2025, 14(22), 8206; https://doi.org/10.3390/jcm14228206 - 19 Nov 2025
Viewed by 364
Abstract
Background: The relative merits of the Henderson–Hasselbalch (HH) versus Stewart frameworks for interpreting dialysis-associated acid–base shifts remain debated. Dialysis alters systemic pH through exogenous bicarbonate delivery, chloride displacement, and removal of organic anions. We compared these approaches across hemodialysis (HD) and peritoneal dialysis [...] Read more.
Background: The relative merits of the Henderson–Hasselbalch (HH) versus Stewart frameworks for interpreting dialysis-associated acid–base shifts remain debated. Dialysis alters systemic pH through exogenous bicarbonate delivery, chloride displacement, and removal of organic anions. We compared these approaches across hemodialysis (HD) and peritoneal dialysis (PD). Methods: We studied 53 HD patients with paired pre/post-HD blood gas and chemistry (106 observations) and 41 PD patients cross-sectionally, totaling 147 datasets. Derived variables followed the Figge/Stewart implementation [apparent SID (SIDa), effective SID (SIDe), strong ion gap (SIG), albumin-corrected anion gap (AGc)]. For HD, changes in pH (ΔpH) were modeled using HH predictors (ΔHCO3−, ΔPCO2) and Stewart predictors (ΔSIDa, ΔATOT, ΔPCO2). For cross-sectional data (pre-HD, post-HD, and PD), HH- and Stewart-based level models were fitted. Stewart-predicted pH was also computed using the Figge and the simplified Constable electroneutrality equation. Results: HD increased pH by 0.11, driven by ΔHCO3− = +5.7 mΕq/L, ΔCl− = −2.3 mEq/L, and declines in unmeasured anions (ΔSIG = −3.9; ΔAGc = −3.3). SIDa increased only marginally (+1.3 mEq/L), whereas SIDe rose by +5.3 mEq/L and fully tracked the alkalinization. In Δ-models, HH explained 90% of variance in ΔpH (R2 = 0.903) compared with 51% for Stewart (R2 = 0.514). In level models, HH explained 96% of pH variance versus 36% for Stewart. Bland–Altman analysis showed systematic overestimation of pH by the Figge and Constable approach (bias + 0.111), most pronounced pre-HD. PD patients had consistently higher AGc and SIG values than HD patients, indicating a greater burden of unmeasured anions. Conclusions: Alkalinization during HD is primarily attributable to bicarbonate gain, chloride displacement, and organic-anion clearance. The HH framework provides superior predictive performance for ΔpH, while closed-system Stewart formulations based on SIDa underestimate alkalinization. However, a broader physicochemical interpretation using SIDe and SIG, which incorporate bicarbonate and unmeasured anions, coherently describes the observed physiology. Future applications of the Stewart approach in dialysis should emphasize SIDe and SIG to better reflect the open-system physiology of both HD and PD. Our findings suggest that the HH model remains more predictive of alkalinization, while SIDe and SIG refine the physicochemical understanding. Full article
(This article belongs to the Special Issue New Insights into Peritoneal Dialysis and Hemodialysis: 2nd Edition)
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12 pages, 543 KB  
Article
Assessment of Safety and Efficacy of Expanded Hemodialysis with Medium Cut-Off Dialyzer Compared to Haemodiafiltration
by Matteo Marcello, Marco Simonini, Anna Lorenzin, Valentina Corradi, Grazia Maria Virzì, Carlotta Caprara, Alessandra Brendolan, Claudia Benedetti, Paolo Lentini, Monica Zanella and Claudio Ronco
J. Clin. Med. 2025, 14(6), 1798; https://doi.org/10.3390/jcm14061798 - 7 Mar 2025
Cited by 1 | Viewed by 2077
Abstract
Background: Removal of large uraemic toxins is still a challenge. Haemodiafiltration (HDF) has produced some results, although large convective volume, optimal vascular access to increase the blood flow rate and strict water quality management are required. Medium cut-off, high-retention-onset membranes have been recently [...] Read more.
Background: Removal of large uraemic toxins is still a challenge. Haemodiafiltration (HDF) has produced some results, although large convective volume, optimal vascular access to increase the blood flow rate and strict water quality management are required. Medium cut-off, high-retention-onset membranes have been recently developed, introducing the concept therapy called expanded haemodialysis (HDx). Furthermore, vitamin E-coated membrane has potential beneficial effects on inflammation and oxidative stress. Methods: A prospective longitudinal multicentre study was conducted for 3 months among 24 chronic haemodialysis patients. Patients were randomly assigned into either HDF with high-flux membrane or HDx with Theranova or ViE-X membrane. The primary goal was to assess albumin loss among the three types of dialyzers. Secondary goals included assessment of depurative efficacy for uraemic toxins and clinical outcomes. Results: Mean albumin loss was significantly higher in patients undergoing HDx with Theranova membrane, without any difference in serum albumin concentration among the three groups. Instantaneous clearance of small and middle molecules was significantly higher in patients undergoing HDF, but we did not find differences in removal ratio and Kt/V. Reduction in the erythropoietin resistance index was observed in patients treated with ViE-X membrane due to their lower dialysis vintage. Conclusions: The higher albumin loss during HDx has no effects on pre-dialysis serum albumin. HDx with Theranova in the presence of lower session length, lower Qb, lower convective dose, and lower instantaneous clearance reached the same dialysis efficacy compared to HDF. Full article
(This article belongs to the Special Issue New Insights into Peritoneal Dialysis and Hemodialysis: 2nd Edition)
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