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Hemodialysis: Clinical Updates and Advances

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

Deadline for manuscript submissions: 30 September 2025 | Viewed by 818

Special Issue Editor


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Guest Editor
Department of Nephrology, Center for Acute and Complicated Dialysis and Vascular Access, University Medical Center Ljubljana, Ljubljana, Slovenia
Interests: hemodialysis; vascular access; apheresis; intensive care nephrology; ultrasonography

Special Issue Information

Dear Colleagues,

Hemodialysis is the most common form of renal replacement therapy for end-stage renal failure worldwide, saving the lives of millions of patients. After some time of tranquility, the field now has many new issues emerging. We have new evidence of the superiority of hemodiafiltration; we have new medium cut-off membranes for clinical practice; we have new drugs for anemia and mineral and bone disease (MBD) treatment, to mention just a few hottest topics. The issue of vascular calcifications and their reversibility is an area of intense research. Vascular access also presents a permanent challenge and a possibility for improvement. This Special Issue aims to attract some of the recent research advancements in the field, with a focus on clinical studies and the application of hemodialysis techniques.

Dr. Gubensek Jakob
Guest Editor

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Keywords

  • hemodiafiltration
  • medium cut-off membranes
  • expanded hemodialysis
  • vascular calcifications
  • renal anemia
  • vas-cular access
  • arterio-venous fistula
  • anticoagulation
  • outcomes

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Published Papers (2 papers)

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Research

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11 pages, 669 KiB  
Article
Validation of Hemoglobin and Hematocrit Measurements from a Dialysis Machine Sensor Compared to Laboratory Analysis
by Niccolò Morisi, Marco Ferrarini, Laura Veronesi, Giovanni Manzini, Silvia Giovanella, Gaetano Alfano, Lucia Stipo, Fabio Olmeda, Giulia Ligabue, Grazia Maria Virzì, Valentina Di Pinto, Luigi Rovati and Gabriele Donati
J. Clin. Med. 2025, 14(15), 5242; https://doi.org/10.3390/jcm14155242 - 24 Jul 2025
Abstract
Background: Continuous monitoring of hemoglobin (HB) and hematocrit (HCT) during hemodialysis could improve fluid management and patient safety. The Fresenius 5008 dialysis machine includes an ultrasound-based sensor that estimates HB and HCT values, though its accuracy compared to standard laboratory measurements remains unclear. [...] Read more.
Background: Continuous monitoring of hemoglobin (HB) and hematocrit (HCT) during hemodialysis could improve fluid management and patient safety. The Fresenius 5008 dialysis machine includes an ultrasound-based sensor that estimates HB and HCT values, though its accuracy compared to standard laboratory measurements remains unclear. Methods: This exploratory observational study assessed the agreement between sensor-derived and laboratory-derived HB and HCT values in 20 patients at the start of hemodiafiltration. A total of 177 paired blood samples were collected. Results: Sensor values significantly underestimated laboratory HB (9.61 vs. 11.31 g/dL) and HCT (27% vs. 34%) (p < 8 × 10−25). Correlations were strong for both parameters (HB: r = 0.788; HCT: r = 0.876). Regression analyses revealed consistent proportional bias. Applying a fixed correction of +1.69 g/dL for HB and +7.55% for HCT eliminated the statistical differences and reduced intercepts in regression models. Bland–Altman plots confirmed improved agreement post-correction. Albumin levels correlated modestly with error magnitude. Conclusions: HB and HCT values from the Fresenius 5008 sensor are strongly correlated with laboratory data but are systematically underestimated at treatment start, likely due to hemodilution. Applying fixed correction factors improves accuracy and supports the sensor’s use for real-time monitoring. Full article
(This article belongs to the Special Issue Hemodialysis: Clinical Updates and Advances)
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Review

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17 pages, 1369 KiB  
Review
Carnitine Supplementation in Chronic Hemodialysis Patients—A Literature Review
by Marina Kljajić, Lea Katalinić, Lovro Krajina, Anja Kovačić, Marta Kovačić and Nikolina Bašić-Jukić
J. Clin. Med. 2025, 14(14), 5052; https://doi.org/10.3390/jcm14145052 - 16 Jul 2025
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Abstract
Background/Objectives: Carnitine deficiency is common in hemodialysis patients and may contribute to anemia, inflammation, dyslipidemia, and muscle symptoms. This review explores the potential benefits of L-carnitine supplementation in this population. Methods: A thorough literature search of the PubMed database was conducted to identify [...] Read more.
Background/Objectives: Carnitine deficiency is common in hemodialysis patients and may contribute to anemia, inflammation, dyslipidemia, and muscle symptoms. This review explores the potential benefits of L-carnitine supplementation in this population. Methods: A thorough literature search of the PubMed database was conducted to identify clinical trials and studies assessing the effects of L-carnitine supplementation on adult hemodialysis patients. Key outcomes included the effects on inflammation, lipid profile, anemia, glycemic control, and muscle function. Results: Evidence suggests that L-carnitine may reduce inflammatory markers and improve lipid profiles by lowering triglycerides and increasing high-density lipoprotein (HDL). Several studies reported reduced erythropoietin need and improved hemoglobin levels. However, some studies did not find benefits of carnitine supplementation on the mentioned parameters. Results for muscle cramps, glycemic control, and cardiac function remain inconsistent. Conclusions: L-carnitine supplementation shows potential benefits in the management of hemodialysis complications. However, further well-designed trials are needed to confirm efficacy and optimize treatment protocols. Full article
(This article belongs to the Special Issue Hemodialysis: Clinical Updates and Advances)
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