With advances in hemodialysis technology and the desire to achieve cardiovascular stability during dialysis, prescribed dialysate sodium concentration has gradually increased over the years. Short-term trials suggest low dialysate sodium (<138 mEq...
Based on our experience in our hemodiafiltration unit we would recommend a personalized isonatremic dialysate bath. We currently prescribe 137 meq (isonatremic) or delta dialysate Na/serum Na less than 2 meq. In addition to the sodium prescribed in t...
The role of medical director of a hemodialysis unit has become increasingly complex. Among the many roles it encompasses, the delivery of safe and effective dialysis treatments requires constant review, synthesis, and interpretation of the medical li...
The optimal dialysate sodium concentration for chronic hemodialysis patients remains controversial. Conflicting data from small observational studies and large cohort study data have not convinced nephrologists to choose either a high or low sodium d...
In haemodialysis, sodium and fluid balance (where intake matches loss) is achieved by ultrafiltration and by diffusion between the plasma water and dialysate. If a patient’s sodium intake does not change, any reduction in fluid gain obtained by...
As the Medical Director of this new dialysis facility, I recommend a fixed sodium dialysate (Nadial) concentration at 138 mEq/L. This relates to my former experience in the Tassin unit in France and the fear of sodium as a powerful uremic toxin. I re...
The composition and quality of the dialysis fluid play an important role in the modulation of dialysis-related complications. During hemodialysis, patient’s blood has a contact with dialysate through a semipermeable membrane. Bacterial endotoxins can...
The choice of dialysate buffer in hemodialysis is crucial, with acetate being widely used despite complications. Citrate has emerged as an alternative because of its favorable effects, yet concerns persist about its impact on calcium and magnesium le...
Intermittent hemodialysis (HD) in high-bleeding-risk patients presents a challenge as circuit anticoagulation using heparin is contraindicated in such cases. Recently, the use of calcium-free citrate-containing dialysate with calcium supplementation...
Acetate is widely used as a dialysate buffer to avoid the precipitation of bicarbonate salts. However, even at low concentrations that wouldn’t surpass the metabolic capacity of the Krebs tricarboxylic acid (TCA) cycle, other metabolic routes a...
Background/Objectives: Protein–energy wasting (PEW) is a common complication in patients with chronic kidney disease (CKD) receiving renal replacement therapy by dialyses. This condition is associated with higher morbidity, mortality, and poore...
Background: Although low magnesium levels have been associated with an increased mortality in dialysis patients, they are kept low by routinely-used dialysates containing 0.50 mmol/L magnesium. Thus, we investigated the impact of a higher dialysate m...
14 October 2022
Health-related quality of life (HRQoL) is an important health indicator in chronic diseases like kidney diseases. Health literacy (HL) may strongly affect HRQoL, but evidence is scarce. Therefore, we assessed the associations of HL with HRQoL in dial...
Polymeric reverse osmosis (RO) membranes are critical for producing ultrapure water for hemodialysis process, but once they reach their end-of-life (EoL) stage, mainly due to fouling, they are usually discarded—adding to the growing challenges...
The number of chronic renal disease patients has shown a significant increase in recent decades over the globe. Hemodialysis is the most commonly used treatment for renal replacement therapy (RRT) and dominates the global dialysis market. As one of t...
Oxidative stress is exacerbated in hemodialysis patients by several factors, including the uremic environment and the use of dialysis fluids (DFs). Since magnesium (Mg) plays a key role in modulating immune function and in reducing oxidative stress,...
6 January 2022
Health-related quality of life (HRQoL) is likely to deteriorate with the progression of chronic kidney disease (CKD). This change may be worsened by low health literacy (HL). We performed a longitudinal study at over 20 dialysis clinics in Slovakia (...
Of the many treatment parameters in hemodialysis care that could be individualised, the dialysate sodium concentration has been identified as a prime candidate for personalisation. Newer hemodialysis machines are equipped with controllers to manage t...
Maintenance hemodialysis induces water-soluble vitamins and trace elements losses, which is why recommendations regarding potential supplementation were provided, but mainly based on conventional hemodialysis. This study′s aim was to measure th...
Thermally reduced graphene oxide (TRGO) is a graphene-based nanomaterial that has been identified as promising for the development of amperometric biosensors. Urease, in combination with TRGO, allowed us to create a mediator-free amperometric biosens...
The aim of this work was to evaluate the contributions of the main chromophores to the total UV absorbance of the spent dialysate and to assess removal dynamics of these solutes during optical on-line dialysis dose monitoring. High performance chroma...
The current interpretation of the controversial and dynamic nature of the literature reports in this area leads me to lean towards the preference of a standard DNa+ in the upper range (138 mEq/L) of the current international utilization and preferenc...
The choice of dialysate sodium concentration remains amongst the most crucial and difficult to address challenges, in the care of hemodialysis (HD) patients. Our understanding of the determinants of sodium transport, as well as the consequences of ge...
The dialysis membrane based on a hydrophilic polymer (Hydrolink NV) was designed to enhance the movement of adsorbed water at the blood–membrane interface, aiming to achieve antithrombogenic and antifouling effects. This study aimed to assess t...
The principal aim of dialysis in relation to sodium is that dialysate sodium should not be low enough to cause intradialytic hypotension and cramps, and should not be high enough to cause interdialytic weight gain and hypertension. Dialysis sodium at...
Ocular complications are common among end-stage renal disease patients and some complications had been linked to increments of intraocular pressure (IOP) during hemodialysis. The changes of IOP during hemodiafiltration (HDF) have been scarcely invest...
The characteristic feature of chronic peritoneal damage in peritoneal dialysis (PD) is a decline in ultrafiltration capacity associated with pathological fibrosis and angiogenesis. The pathogenesis of peritoneal fibrosis is attributed to bioincompati...
Optical monitoring of spent dialysate has been used to estimate the removal of water-soluble low molecular weight as well as protein-bound uremic toxins from the blood of end stage kidney disease (ESKD) patients. The aim of this work was to develop a...
Modern hemodialysis employs weak acids as buffers to prevent bicarbonate precipitation with calcium or magnesium. Acetate, the most used acid, is linked to chronic inflammation and poor dialysis tolerance. Citrate has emerged as a potential alternati...
Liver failure is the 12th leading cause of death worldwide. Protein-bound toxins such as bilirubin are responsible for many complications of the disease. Binder dialysis systems use albumin or another binding molecule in dialysate and detoxifying sor...
One of the key goals of hemodialysis is to control sodium balance and volume status. The traditional view is that inter-dialytic sodium gains can be adequately controlled by ultrafiltration with the convective removal of sodium. However, dialyzing al...
The ever-increasing number of discarded end-of-life dialysate polyamide thin-film composite membranes (DEoLMs) from presents both environmental and economic challenges for health centers. Traditional thermo-chemical cleaning techniques have been depl...
Low sodium dialysate was commonly used in the early year of hemodialysis to enhance diffusive sodium removal beyond its convective removal by ultrafiltration. However, disequilibrium syndrome was common, particularly when dialysis sessions were reduc...
Adsorption of urea from dialysate is essential for wearable artificial kidneys (WRK). Molecularly imprinted microspheres with nanoporous and multilayered structures are prepared based on liquid–liquid phase separation (LLPS), which can selectiv...
It was shown earlier that the use of fast protein and metabolites liquid chromatography (FPMLC) and low-cost deep UV–LED-based optical chromatographic sensors with PD-10 desalting columns as a separation element can facilitate the monitoring of...
The best evidence available to guide a policy for prescribing the dialysate sodium concentration, [DNa], comes from large randomly selected observational studies, such as the Dialysis Outcomes and Practice Patterns Study (DOPPS). These show that, aft...
Optical online methods are used to monitor the haemodialysis treatment efficiency of end stage kidney disease (ESKD) patients. The aim of this study was to analyse the effect of the administration of UV-absorbing drugs, such as paracetamol (Par), on...
We developed Mixed Matrix Membrane Adsorbers (MMMAs) formed by cellulose acetate and various sorbent particles (activated carbon, zeolites ZSM-5 and clinoptilolite) for the removal of urea, creatinine and uric acid from aqueous solutions, to be used...
Microdialysis, a sampling method for pharmacokinetics–pharmacodynamics (PK–PD) modeling in preclinical and clinical studies, is a convenient in vivo sampling technique. Geniposide (GE), an iridoid glycoside compound, is the major active ingredient of...
Managing mineral bone disease (MBD) could reduce cardiovascular risk and improve the survival of dialysis patients. Our study focuses on the impact of calcium bath exposure in dialysis patients by comparing peritoneal dialysis patients (PD, intervent...
Background and Objectives: Kidneys play a key role in maintaining the acid–base balance. The aim of this study was to evaluate the effect of a 3-month oral sodium bicarbonate administration on arterial wall stiffness, arterial pressure and seru...
Extensive evidence supports an important role for soluble oligomers of the amyloid β-protein (Aβ) in Alzheimer’s Disease pathogenesis. In the present study we combined intracerebroventricular (icv) injections with brain microdialysis technology in th...
A portable urea sensor for use in fast flow conditions was fabricated using porous polytetrafluoroethylene (PTFE) membranes coated with amine-functionalized parylene, parylene-A, by vapor deposition. The urea-hydrolyzing enzyme urease was immobilized...
Peritoneal dialysis (PD) is limited by glucose-mediated peritoneal membrane (PM) fibrosis, angiogenesis, and ultrafiltration failure. Influencing PM integrity by pharmacologically targeting sodium-dependent glucose transporter (SGLT)-mediated glucose...
Peritoneal dialysis (PD) is a renal replacement therapy that removes solutes, electrolytes, and water via the infusion of dialysis fluid into the peritoneal cavity. However, the non-physiological composition of conventional PD fluids can cause perito...
13 April 2019
Unlike chyloperitoneum associated with clinical conditions including cancer, cirrhosis, and traumatic surgery, calcium channel blocker (CCB)-associated chyloperitoneum is rarely discussed in comprehensive studies on chyloperitoneum. We aimed to inves...
The growing demand for gluten-free products requires the study of alternatives to produce nutritionally and technologically favorable foods. The aim was to evaluate the content and antioxidant capacity of gluten-free bread enriched with whole flour o...
Objectives: Osteoprotegerin (OPG) is a member of the tumor necrosis factor receptor family involved in processes in many inflammatory states. OPG concentration is enhanced in the majority of chronic kidney disease (CKD) patients and those undergoing...
18 March 2021
Early in the coronavirus-2019 (COVID-19) containment strategy, people with end-stage renal disease (ESRD) were identified as extremely clinically vulnerable and subsequently asked to ‘shield’ at home where possible. The aim of this study was to inves...
Restoring sodium and fluid homeostasis in hemodialysis (HD) patients is a crucial aim to reduce cardiovascular burden and improve global outcome. This crucial target is achieved at maximum in one quarter of HD patients according to a recent study. So...
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