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1. HAEMODIALYSIS TECHNIQUES AND ADEQUACY 2

Author

P. Chamney, U. Moissl, P. Wabel, C. Amato, S. Stuard, M. Menzer, C. Vollmeier, G. Williams, R. Shrivastava, J. Chess, E. Catling, C. Brown, E. Baker, R. Ashcroft, A. Mikhail, L. Djukanovic, Z. Djuric, V. Knezevic, T. Lazarevic, S. Ljubenovic, R. Markovic, V. Rabrenovic, J. Marinkovic, N. Dimkovic, L. Lebourg, C. Ridel, H. De Preneuf, F. Le Roy, T. Petitclerc, M. Wester, F. Simonis, J. P. Kooman, W. H. Boer, K. G. F. Gerritsen, J. A. Joles, K.-i. Yamamoto, K. Eguchi, S. Hirakawa, J. Murakami, T. Akiba, M. Mineshima, D. Stamopoulos, N. Mpakirtzi, A. Lavranos, M. Panagiotou, D. Barbarousi, C. Matsouka, E. Grapsa, S. R. Abbas, F. Zhu, G. A. Kaysen, P. Kotanko, N. W. Levin, A. Vasilevsky, G. Konoplev, O. Stepanova, A. Rubinsky, A. Zemchenkov, R. Gerasimchuk, A. Frorip, T. Abe, K.-I. Yamamoto, I. Ishimori, M. Kusztal, T. Go Biowski, K. Letachowicz, P. Koni Ski, G. Witkowski, P. Pozna Ski, W. Weyde, M. Klinger, M. Ito, S. Ito, M. Suzuki, I. Masakane, D. Navarro, C. Goncalves, A. C. Ferreira, C. Jorge, C. Gil, I. Aires, P. Matias, M. Mendes, A. Azevedo, F. Gomes, A. Ferreira, C. Perazzini, L. Scutiero, L. Brighenti, A. Surace, D. Steckiph, P. Rovatti, S. Severi, J. Soltysiak, A. Warzywoda, A. Musielak, D. Ostalska-Nowicka, J. Zachwieja, T. Goeksel, H. Garnier, M. Ritzerfeld, H. Mann, F. Babinet, B. Allard, V. Todorova, C. Hamont, R. Begri, M. Dekker, M. Taks, C. Konings, V. Scharnhorst, J. Borawski, J. Gozdzikiewicz-Lapinska, B. Naumnik, C. A. Lodi, E. Grandi, E. Mancini, A. Santoro, L. Sereni, M. Caiazzo, L. Corazza, M. Atti, G. Palladino, K. Sakurai, T. Saito, H. Hosoya, F. Yamauchi, T. Kurihara, Y. Tanibayashi, N. Ikebe, M. Antonic, J. Gubensek, A. Drozg, E. Vannier, E. Mattio, A. Ragon, P. Brunet, W. Klimm, K. Pleskacz, B. Pietrzak, S. Niemczyk, J. K. Leypoldt, A. Bernardo, M. Muller, T. C. Marbury, B. F. Culleton, A. A. Zeraati, R. Hekmat, H. R. Reyhani, F. Sharifipoor, P. Bolasco, I. Sitzia, A. Monni, M. C. Mereu, A. M. Pinna, F. Logias, T. Ghisu, M. Passaghe, L. Gazzanelli, M. Ganadu, A. Piras, M. Cossu, B. Contu, S. Palleschi, B. Rossi, P. M. Ghezzi, S. Kron, D. Schneditz, T. Leimbach, S. Aign, J. Kron, A. Seker Kockara, M. Kayatas, C. Huzmeli, F. Candan, M. B. Yilmaz, B. A. Ahmed, C. N. Bejosano, S. A. Samra Abouchacra, S. Z. Al Falahi, K. M. Abdul Moniem, H. Dastoor, S. Kim, J. Oh, Y. Sin, J. Kim, and J. Lee

Subjects
03 medical and health sciences, Transplantation, medicine.medical_specialty, 0302 clinical medicine, Nephrology, business.industry, 030232 urology & nephrology, Medicine, 030204 cardiovascular system & hematology, business, Intensive care medicine
Published
2014

2. Vascular access

Author

L. Coentrao, C. Ribeiro, C. Santos-Araujo, R. Neto, M. Pestana, E. Rahman, H. Rahman, D. Ahmed, D. Mousa, M. El Bishlawi, H. Shibahara, N. Shibahara, S. Takahashi, E. Dupuis, X. Duval, Q. Dornic, C. Bonnal, J.-C. Lucet, O. Cerceau, C. Randoux, C. Balde, F. Besson, F. Mentre, F. Vrtovsnik, G. Koutroubas, P. Malindretos, G. Zagotsis, P. Makri, C. Syrganis, E. Mambelli, E. Mancini, C. Elia, V. Guadagno, M. G. Facchini, A. Zucchelli, M. Grazia, L. Patregnani, A. Santoro, G. Stefan, S. Stancu, C. Capusa, O. R. Ailioaiei, G. Mircescu, S. Anwar, C. Little, R. Kingston, P. Diwakar, R. Kaikini, E. Nikolaou, G. Loukas, A. Sabry, K. Alsaran, S. Al Sherbeiny, M. Abdulkader, I. Kwak, S. Song, E. Seong, S. Lee, D. Lee, I. Kim, H. Rhee, F. Silva, J. Queiros, J. Malheiro, A. Cabrita, A. Rocha, P. Bamidis, C. Liaskos, I. Chryssogonidis, C. Frantzidis, A. Papagiannis, D. Vrochides, A. Lasaridis, P. Nikolaidis, S. Kotwal, C. Muir, C. Hawley, P. Snelling, M. Gallagher, M. Jardine, K. Shibata, Y. Toya, S. Umemura, T. Iwamoto, S. Ono, E. Ikeda, A. Kitazawa, T. Kuji, N. Koguchi, H. Satta, M. Nishihara, S. Kawata, T. Kaneda, Y. Yamada, T. Murakami, M. Yanagi, G. Yasuda, S. Mathieu, D. Yves, T. Jean-Michel, Q. Nicolas, C. Jean-Francois, M. Ibrahim, M. Abdel Salam, A. Awadalla, W. Bichari, S. Zaki, R. Roca-Tey, R. Samon, O. Ibrik, A. Roda, J. C. Gonzalez-Oliva, R. Martinez-Cercos, J. Viladoms, C.-C. Lin, W.-C. Yang, Y.-O. Kim, S.-A. Yoon, Y.-S. Yun, H.-C. Song, B.-S. Kim, M.-A. Cheong, T. Ogawa, T. Kiba, S. Okazaki, M. Hatano, M. Iwanaga, C. Noiri, A. Matsuda, H. Hasegawa, T. Mitarai, A. DI Napoli, D. DI Lallo, L. Tazza, C. De Cicco, M. F. Salvatori, S. Chicca, G. Guasticchi, S. Gelev, L. Trajceska, E. Srbinovska, S. Pavleska, A. Oncevski, P. Dejanov, V. Gerasomovska, G. Selim, A. Sikole, S. Wilson, T. Mayne, M. Krishnan, J. Holland, A. Volz, L. Good, A. Nissenson, A. Stavroulopoulos, V. Aresti, G. Maragkakis, S. Kyriakides, C. Rikker, E. Juhasz, L. Tornoci, S. Tovarosi, J. Greguschik, O. Mag, L. Rosivall, T. Golebiowski, E. Watorek, M. Kusztal, K. Letachowicz, W. Letachowicz, K. Madziarska, H. Augustyniak Bartosik, M. Krajewska, W. Weyde, M. Klinger, A. Capitanini, S. Lange, A. Cupisti, T. Schier, G. Gobel, C. Bosmuller, I. Gruber, M. Tiefenthaler, T. Shipley, J. Adam, D. Sweeney, S. Fenwick, H. Mansy, S. Ahmed, I. Moore, P. Vigeral, S. Saksi, M. Flamant, H. Boulanger, W.-D. Park, M. A. Cheong, M. Nikam, A. Tavakoli, E. Chemla, J. Evans, H. Malete, L. Matyas, I. Mogan, M. Lazarides, A. Ebner, Y. Shi, J. Zhang, J. Cheng, L. R. Frank, H. Melanie, B. Dominique, G. Michel, K. Ikeda, T. Yasuda, H. Yotueda, L. Ebah, A. Jayanti, D. Kanigicherla, A. Summers, G. Manley, G. Dutton, N. Chalmers, S. Mitra, I.-A. Checherita, A. Niculae, D. Radulescu, C. David, F. L. Turcu, A. Ciocalteu, V. Persic, J. Buturovic-Ponikvar, R. Ponikvar, M. Touam, V. Menoyo, T. Drueke, M. Rifaat, C. Muresan, M. Abtahi, Z. Koochakipour, D. Joly, J. Baharani, S. Rizvi, K. P. Ng, L. Buzzi, C. Sarcina, E. Alberghini, F. Ferrario, I. Baragetti, G. Santagostino, S. Furiani, E. Corghi, V. Terraneo, F. Rastelli, G. Bacchini, C. Pozzi, M. Adorati Menegato, R. Mortellaro, A. Locicero, A. Romano, P. P. Manzini, D. Steckiph, S. Shintaku, H. Kawanishi, M. Moriishi, M. Bansyodani, S. Nakamura, M. Saito, S. Tsuchiya, F. Barros, R. Vaz, B. Carvalho, P. Martins, E. Likaj, S. Seferi, M. Rroji, A. Idrizi, A. Duraku, M. Barbullushi, and N. Thereska

Subjects
Transplantation, Nephrology
Published
2013

3. Extracorporeal dialysis: techniques and adequacy - A

Author

D. Steckiph, G. Calabrese, A. Bertucci, A. Mazzotta, G. Vagelli, M. Gonella, D. Stamopoulos, E. Manios, N. Papachristos, E. Grapsa, G. Papageorgiou, V. Gogola, B. So, V. Dey, E. M. Spalding, C. Libetta, P. Esposito, E. Margiotta, P. Maffioli, A. Bonaventura, L. Bianchi, D. Romano, T. Rampino, G. De Rosa, A. Mauric, U. Haug, G. Enzinger, E. Kern-Derstvenscheg, A. Sluga, C. Ausserwinkler, W. Beck, A. R. Rosenkranz, V. Maheshwari, S. Haroon, Y. Loy, L. Samavedham, G. P. Rangaiah, T. Lau, N. Mpakirtzi, M. Panagiotou, D. Barbarousi, C. Matsouka, A. D. Bunani, M. Kowalczyk, P. Bartnicki, M. Banach, J. Rysz, P. Lentini, L. Zanoli, A. Granata, A. Contestabile, A. Basso, G. Berlingo, V. Pellanda, M. de Cal, V. Grazia, A. Clementi, M. Insalaco, R. Dell'Aquila, A. Karkar, M. Abdelrahman, A. R. Martins, L. Parreira, A. S. Duque, I. Rodrigues, A. B. Baffoun, M. A. Youssfi, A. Sayeh, M. Beji, R. Ben Khadra, J. Hmida, M. Akazawa, H. Horiuchi, Y. Hori, A. Yamada, H. Satou, S. Odamaki, S. Nakai, K. Satou, K. Aoki, I. Saito, Y. Kamijo, S. Ogata, Y. Ishibashi, F. Basso, M. Wojewodzka-Zelezniakowicz, D. Cruz, A. Giuliani, L. Blanca Martos, P. Piccinni, C. Ronco, J. Potier, G. Queffeulou, J. Bouet, A. Nilsson, J. Sternby, G. Grundstrom, M. Alquist, M. Ferraresi, M. C. Di Vico, F. N. Vigotti, M. Deagostini, S. Scognamiglio, V. Consiglio, R. Clari, I. Moro, E. Mongilardi, G. B. Piccoli, V. Hancock, S. Huang, K. Nilsson Ekdahl, C. Baldin, M. Petrarulo, D. Mancuso, P. Inguaggiato, G. Canepari, G. Gigliola, C. Ferrando, S. Meinero, C. Sicuso, A. Pacitti, N. Afentakis, T. Tomo, K. Matsuyama, T. Nakata, K. Ishida, T. Takeno, J.-i. Kadota, J. Minakuchi, J. Kastl, M. Merello, C. Boccato, G. Giordana, S. Mazzone, V. Moscardo, B. Reinhardt, R. Knaup, W. Kruger, D. Tovbin, S. Kim, L. Avnon, M. Zlotnik, S. Storch, K. Umimoto, Y. Shimamoto, M. Suyama, M. Miyata, E. Bosch Benitez-Parodi, E. E. Baamonde Laborda, G. Perez, J. I. Ramirez, A. Ramirez Puga, R. Guerra, C. Garcia Canton, M. M. Lago Alonso, A. Toledo, M. D. Checa Andres, F. E. Latif, Y. Mochida, K. Matsumoto, K. Morita, D. Tsutsumi, K. Ishioka, K. Maesato, M. Oka, H. Moriya, S. Hidaka, T. Ohtake, S. Kobayashi, A. Ficheux, N. Gayrard, F. Duranton, C. Guzman, I. Szwarc, J. Bismuth-Mondolfo, P. Brunet, M.-F. Servel, A. Argiles, N. Tsikliras, S. Mademtzoglou, E. Balaskas, M. Zeid, A. Mostafa, M. N. Mowafy, E. I. Abdo, O. M. Al Amin, A. Ksiazek, W. Zaluska, J. Waniewski, M. Debowska, A. Wojcik-Zaluska, M. Elias, H. Francois, E. Obada, H. K. Lorenzo, B. Charpentier, A. Durrbach, S. Beaudreuil, G. Imamovic, D. Marcelli, I. Bayh, R. Hrvacevic, S. Kapun, A. Grassmann, L. Scatizzi, J. Maslovaric, R. Daelemans, S. Mesens, E. A. Mohamed, A. Wafae, H. Kawtar, H. Mohamed Amine, K. Driss, and B. Mohammed

Subjects
Transplantation, medicine.medical_specialty, Extracorporeal Dialysis, Nephrology, business.industry, Medicine, business, Intensive care medicine
Published
2013

4. Contents Vol. 31, 2011

Author

James F. Winchester, F. Logias, Naobumi Mise, B. Contu, G. Romei Longhena, A. Serra, Druck Reinhardt Druck Basel, Hye Min Choi, Hui-Teng Cheng, Kanji Shishido, Ya-Jun Luo, Eungtaek Kang, Kuan-Yu Hung, L. Corazza, Takahiro Nishi, Tadao Akizawa, Dinna N. Cruz, Francesco Garzotto, Tao Wang, Jeong Chul Kim, M. Ganadu, Ching Yan Goh, Xin-Hong Lu, M. Mascia, U. Teatini, Hiroshi Nishi, G. Cogoni, R. Ferrara, Satz Mengensatzproduktion, D. Casu, Won Yong Cho, Hiroki Suzuki, Ha-Na Yang, Yu-Chung Lien, T. Ghisu, P.M. Ghezzi, Imari Mimura, Ji Hyun Kim, Nathan W. Levin, Tun-Jun Tsai, Noriyuki Kato, Claudio Ronco, Tetsuo Michihata, Myung Gyu Kim, M. Cossu, Stephan Thijssen, Hyoung Kyu Kim, Tokuichiro Sugimoto, M. Passaghe, Sang-Kyung Jo, Hirokazu Honda, Zachary Z. Brener, D. Steckiph, Feidhlim Woods, Hye Won Kim, Peter Kotanko, F. Cadinu, Chung-Jen Yen, Federico Nalesso, Keiko Takahashi, Martin K. Kuhlmann, S. Murtas, Michael Bergman, P.G. Bolasco, Chih-Kang Chiang, Hon-Yen Wu, Jenq-Wen Huang, and Hee Chan Kim

Subjects
Nephrology, Hematology, General Medicine
Published
2011

7. Principal component analysis of the t-wave for mortality Prediction in hemodialysis patients

Author

CORSI, CRISTIANA, SANTORO, ANTONIO, SEVERI, STEFANO, F. Grandi, D. Steckiph, A. CAPPELLO, T. D’ALESSIO, M. KNAFLITZ, F.M. MONTEVECCHI, C. Corsi, F. Grandi, D. Steckiph, A. Santoro, and S. Severi

Abstract

PRINCIPAL COMPONENT ANALYSIS OF THE T-WAVE FOR MORTALITY PREDICTION IN HEMODIALYSIS PATIENTS Patients undergoing hemodialysis (HD) therapy often experience alterations in cardiac excitability and have accounting for an estimated 3-year cumulative probability of cardiovascular death of 39.5% of total deaths [1]. Abnormalities in ventricular repolarization and its dispersion could be a cause of HD-induced arrhythmogenic effect. Nowadays, no ECG-derived parameter has been proven to predict the risk of cardiovascular death. QT dispersion (QTd) has been proposed, however, some concerns have been raised about uncertainty of the QT dispersion measurement and technical difficulties in measuring the QT interval. Principal component analysis (PCA) of the T-wave vector applied to 12-lead recordings has been proposed to obtain an ECG marker of vulnerability to ventricular arrhythmias and of cardiovascular mortality [2]. Several studies showed that the ratio of the second to first eigenvalues (PCA ratio) more accurately represents repolarization abnormalities than QTd in a large general population sample [3,4]. The aim of this study was to explore the predictive value of the PCA ratio parameter for all-cause and cardiac mortality in a retrospective study on HD patients. METHODS The selected subjects were 122 patients (46 women and 76 men, mean age 77±10) in whom digital ECG recordings were available for the analysis from previous clinical studies. Standard holter 12-lead recordings (H-12 Holter, Mortara Instrument Inc., Milwaukee, Wisconsin, USA) were collected starting with the dialysis session. ECGs were sampled at 180 Hz or 1kHz and stored to a PC hard disk for subsequent analysis. PCA is an established method for representing data and, when applied to T-wave, it describes features of repolarization in a manner that is less dependent on precise determination of T-wave offset. Singular value decomposition was applied to the covariance matrix of the raw ECG data corresponding to T-wave from the eight independent ECG leads. Then, the main eigenvectors of the spatial T-wave were computed. The first eigenvector accounts for most of the energy in repolarization when applied to the normal T-wave vector, whereas inhomogeneous repolarization, if present, is indicated by a relevant contribution of the second and third components. Thus, the ratio of the second to first eigenvalues of the spatial T-wave vector (PCA ratio) generated from the 12-lead digital ECG serves as a measure of T-wave complexity or heterogeneity of repolarization, with increasing values referring to higher amount of complexity. As shown in fig. 1 the PCA ratio provides information that can be visualized by analogy as the long and short axes of the three-dimensional T-wave loop and provides an estimate of the relative fatness of the T-wave loop relative to its peak amplitude, in which a fatter loop with a higher PCA ratio reflects more complex Twave morphology. A median value of PCA was computed for each patient throughout the whole ECG recording. Following the Strong Heart Study [3] a threshold for PCA ratio in men and women, independently of gender, was defined as 28%. Deaths were identified in an ongoing surveillance in each dialysis center and were verified through review of medical records. Deaths were classified as cardiac if caused by myocardial infarction, sudden death from CHD, or congestive heart failure by an independent review panel of physicians unaware of PCA ratio findings. After a maximum follow-up of 5 years, patients were censored as dead or alive considering the days from the date of the first ECG recording. Patients were then divided in two groups depending on the median PCA ratio value. Endpoints were all-cause mortality and cardiac mortality. Mortality rates were calculated and plotted according to the Kaplan-Meier analysis. P

Published
2010

9. Influence of plasma potassium changes on the myocardial cell repolarization during hemodialysis

Author

CAGNOLI, LEONARDO, GRANDI, ELEONORA, SEVERI, STEFANO, SANTORO, ANTONIO, G. London, L. Mercadal, H. Fessy, B. Perrone, D. Steckiph, M. TIMIO, V. WIZEMANN, S. VENANZI, L. Cagnoli, G. London, L. Mercadal, H. Fessy, B. Perrone, D. Steckiph, E. Grandi, S. Severi, and A. Santoro

Abstract

Dialysis therapy has a strong impact on cardiac excitability and the frequency of ectopic beats increases in the course of the session. Dispersion of ventricular repolarization could be a cause of the dialysis arrhythmogenic effect. In fact, QT dispersion increases during dialysis and this increase seems to be related to electrolyte, particularly potassium and calcium, concentration changes. However, some concerns have been raised about uncertainty of the QT dispersion measurement. Principal component analysis of the T wave applied to 12-lead ECG recording has been proposed as a novel approach to study the complexity of repolarization without having to determine the end of T-wave. The aim of this study was to assess and quantify the 24-hour changes in the complexity of ventricular repolarization in patients undergoing hemodialysis by means of principal components analysis. The effects of two dialysis protocols leading to different plasma potassium levels were also analyzed. Twelve patients were studied during Acetate Free Biofiltration with K+ profiling (AFBK). AFBK sessions were classified as Klow and Khigh on the basis of the dialyzate K+ concentration set at the start of the treatment. For each patient four sessions (2 Klow and 2 Khigh) were analysed. Holter 24-hour recordings were collected starting with the dialysis session. Principal components analysis was applied to the T wave automatically extracted from each beat and the repolarization complexity was quantified by the ratio of the second to the first eigenvalue (PCA ratio). Hemodialysis caused a significant increase in the PCA ratio (+50% at the end of the sessions). The PCA ratio recovered to the basal value during the first hour post-dialysis and kept stable during the subsequent 19 hours. When comparing Klow and Khigh sessions the PCA ratio increase was similar during the first two hours of dialysis but it was significantly higher in Klow sessions in the last two hours of dialysis, then the PCA ratio recovered to the same basal value. A difference in the occurrence of ventricular ectopic beats was also pointed out, being the number of premature ventricular contractions (PVCs) significantly higher in Klow sessions in the last three hours of treatment (p

Published
2008

11. Extracorporeal dialysis: techniques and adequacy

Author

C. Donadio, A. Kanaki, A. Martin-Gomez, S. Garcia, M. Palacios-Gomez, D. Calia, E. Colombini, F. DI Francesco, S. Ghimenti, M. Onor, D. Tognotti, R. Fuoco, E. Marka-Castro, M. I. Torres Zamora, J. Giron-Mino, M. A. Jaime-Solis, L. M. Arteaga, H. Romero, A. Akonur, K. Leypoldt, M. Asola, B. Culleton, S. Eloot, G. Glorieux, N. Nathalie, R. Vanholder, A. Perez de Jose, U. Verdalles Guzman, S. Abad Esttebanez, A. Vega Martinez, D. Barraca, C. Yuste, L. Bucalo, A. Rincon, J. M. Lopez-Gomez, P. Bataille, P. Celine, A. Raymond, G. Francois, L. Herve, D. Michel, R. Jean Louis, F. Zhu, P. Kotanko, S. Thijssen, N. W. Levin, N. Papamichail, M. Bougiakli, C. Gouva, S. Antoniou, S. Gianitsi, A. Vlachopanou, S. Chachalos, K. Naka, D. Kaarsavvidou, K. Katopodis, L. Michalis, K. Sasaki, K. Yasuda, M. Yamato, A. Surace, P. Rovatti, D. Steckiph, R. Bandini, S. Severi, A. Dellacasa Bellingegni, A. Santoro, M. Arias, A. Sentis, N. Perez, N. Fontsere, M. Vera, N. Rodriguez, C. Arcal, N. Ortega, F. Uriza, A. Cases, F. Maduell, S. R. Abbas, P. Georgianos, P. Sarafidis, P. Nikolaidis, A. Lasaridis, A. Ahmed, H. Kaoutar, B. Mohammed, O. Zouhir, P. Balter, N. Ginsberg, P. Taylor, T. Sullivan, L. A. Usvyat, P. Zabetakis, U. Moissl, M. Ferrario, F. Garzotto, P. Wabel, D. Cruz, C. Tetta, M. G. Signorini, S. Cerutti, A. Brendolan, C. Ronco, J. Heaf, M. Axelsen, R. S. Pedersen, H. Amine, Z. Oualim, A. L. Ammirati, N. K. Guimaraes de Souza, T. Nemoto Matsui, M. Luiz Vieira, W. A. Alves de Oliveira, C. H. Fischer, F. Dias Carneiro, I. J. Iizuka, M. Aparecida de Souza, A. C. Mallet, M. C. Cruz Andreoli, B. F. Cardoso Dos Santos, L. Rosales, Y. Dou, M. Carter, A. Testa, L. Sottini, B. Giacon, E. Prati, C. Loschiavo, M. Brognoli, C. Marseglia, A. Tommasi, L. Sereni, G. Palladino, S. Bove, G. Bosticardo, E. Schillaci, P. Detoma, R. Bergia, J. W. Park, S. J. Moon, H. Y. Choi, S. K. Ha, H.-C. Park, Y. Liao, L. Zhang, P. Fu, H. Igarashi, N. Suzuki, S. Esashi, I. Masakane, V. Panichi, G. De Ferrari, S. Saffiotti, A. Sidoti, M. Biagioli, S. Bianchi, P. Imperiali, C. Gabrielli, P. Conti, P. Patrone, G. Rombola, V. Falqui, C. Mura, A. Icardi, A. Rosati, F. Santori, A. Mannarino, A. Bertucci, J. Jeong, O. K. Kim, N. H. Kim, M. Bots, C. Den Hoedt, M. P. Grooteman, N. C. Van der Weerd, A. H. A. Mazairac, R. Levesque, P. M. Ter Wee, M. J. Nube, P. Blankestijn, M. A. Van den Dorpel, Y. Park, J. Jeon, N. Tessitore, V. Bedogna, D. Girelli, L. Corazza, P. Jacky, Q. Guillaume, B. Julien, W. Marcinkowski, M. Drozdz, A. Milkowski, T. Rydzynska, T. Prystacki, R. August, E. Benedyk-Lorens, K. Bladek, J. Cina, G. Janiszewska, A. Kaczmarek, T. Lewinska, M. Mendel, M. Paszkot, E. Trafidlo, M. Trzciniecka-Kloczkowska, A. Vasilevsky, G. Konoplev, O. Lopatenko, A. Komashnya, K. Visnevsky, R. Gerasimchuk, I. Neivelt, A. Frorip, M. Vostry, J. Racek, D. Rajdl, J. Eiselt, L. Malanova, U. Pechter, A. Selart, M. Ots-Rosenberg, D. H. Krieter, S. Seidel, K. Merget, H.-D. Lemke, C. Wanner, B. Canaud, A. Rodriguez, A. Morgenroth, K. Von Appen, G.-P. Dragoun, R. Fluck, D. Fouque, R. Lockridge, Y. Motomiya, Y. Uji, T. Hiramatsu, Y. Ando, M. Furuta, T. Kuragano, A. Kida, M. Yahiro, Y. Otaki, Y. Hasuike, H. Nonoguchi, T. Nakanishi, M. Sain, V. Kovacic, D. Ljutic, J. Radic, I. Jelicic, S. F. Yalin, S. Trabulus, A. S. Yalin, M. R. Altiparmak, K. Serdengecti, A. Ohtsuka, K. Fukami, K. Ishikawa, R. Ando, Y. Kaida, T. Adachi, K. Sugi, S. Okuda, O. B. Nesterova, E. D. Suglobova, R. V. Golubev, A. N. Vasiliev, V. A. Lazeba, A. V. Smirnov, K. Arita, E. Kihara, K. Maeda, H. Oda, S. Doi, T. Masaki, S. Hidaka, K. Ishioka, M. Oka, H. Moriya, T. Ohtake, S. Nomura, S. Kobayashi, S. Wagner, A. Gmerek, J. Wagner, V. Wizemann, N. Eftimovska - Otovic, K. Spaseska-Gjurovska, S. Bogdanovska, E. Babalj - Banskolieva, M. Milovanceva, R. Grozdanovski, A. Pisani, E. Riccio, A. Mancini, P. Ambuhl, S. Astrid, P. Ivana, H. Martin, K. Thomas, R. Hans-Rudolf, A. Daniel, K. Denes, M. Marco, R. P. Wuthrich, S. Andreas, S. Andrulli, P. Altieri, G. Sau, P. Bolasco, L. A. Pedrini, C. Basile, S. David, M. Feriani, P. E. Nebiolo, R. Ferrara, D. Casu, F. Logias, R. Tarchini, F. Cadinu, M. Passaghe, G. Fundoni, G. Villa, B. R. DI Iorio, C. Zoccali, F. Locatelli, M. Hamamoto, D.-Y. Lee, B. Kim, K. H. Moon, Z. LI, P. Ahrenholz, R. E. Winkler, G. Waitz, H. Wolf, G. Grundstrom, M. Alquist, M. Holmquist, A. Christensson, P. Bjork, M. Abdgawad, L. Ekholm, M. Segelmark, C. Corsi, J. De Bie, E. Mambelli, D. Mortara, D. Arroyo, N. Panizo, B. Quiroga, J. Reque, R. Melero, M. Rodriguez-Ferrero, P. Rodriguez-Benitez, F. Anaya, J. Luno, A. Ragon, A. James, P. Brunet, S. Ribeiro, M. S. Faria, S. Rocha, S. Rodrigues, C. Catarino, F. Reis, H. Nascimento, J. Fernandes, V. Miranda, A. Quintanilha, L. Belo, E. Costa, A. Santos-Silva, J. Arund, R. Tanner, I. Fridolin, M. Luman, C. Clajus, J. T. Kielstein, H. Haller, P. Libutti, P. Lisi, L. Vernaglione, F. Casucci, N. Losurdo, A. Teutonico, C. Lomonte, C. Krisp, D. A. Wolters, M. Matsuyama, T. Tomo, K. Ishida, K. Matsuyama, T. Nakata, J. Kadota, M. Caiazzo, E. Monari, A. Cuoghi, E. Bellei, S. Bergamini, A. Tomasi, T. Baranger, P. Seniuta, F. Berge, V. Drouillat, C. Frangie, E. Rosier, W. Labonia, A. Lescano, D. Rubio, N. Von der Lippe, J. A. Jorgensen, T. B. Osthus, B. Waldum, I. Os, M. Bossola, E. DI Stasio, M. Antocicco, L. Tazza, I. Griveas, A. Karameris, P. Pasadakis, V. Savica, D. Santoro, S. Saitta, V. Tigano, G. Bellinghieri, S. Gangemi, R. Daniela, I. A. Checherita, A. Ciocalteu, I. A. Vacaroiu, A. Niculae, E. Stefaniak, I. Pietrzak, D. Krupa, L. Garred, E. Mancini, L. Corrazza, M. Atti, B. Afsar, D. Stamopoulos, N. Mpakirtzi, B. Gogola, M. Zeibekis, D. Stivarou, M. Panagiotou, E. Grapsa, O. Vega Vega, D. Barraca Nunez, M. Fernandez-Lucas, A. Gomis, J. L. Teruel, S. Elias, C. Quereda, L. Hignell, S. Humphrey, N. Pacy, and N. Afentakis

Subjects
Transplantation, medicine.medical_specialty, Extracorporeal Dialysis, Nephrology, business.industry, Uremic toxins, Medicine, Identification (biology), business, Intensive care medicine, Microbiology
Published
2011

12. Calcium profiling in hemodiafiltration: a new way to reduce the calcium overload risk without compromising cardiovascular stability

Author

Piergiorgio Bolasco, E. Mancini, Claudia Perazzini, Stefano Severi, Leonardo Cagnoli, Aurora Summa, Antonio Santoro, Gabriella Concas, Denis Steckiph, Fabio Badiali, S. Severi, P. Bolasco, F. Badiali, G. Conca, E. Mancini, A. Summa, C. Perazzini, D. Steckiph, L. Cagnoli, and A. Santoro

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Biomedical Engineering, Medicine (miscellaneous), Adynamic bone disease, chemistry.chemical_element, Bioengineering, Hemodiafiltration, Calcium, Cardiovascular, QT interval, CALCIUM, Biomaterials, Dialysis Solutions, Internal medicine, Heart rate, medicine, Humans, Prospective Studies, Calcium overload, Aged, Chemistry, General Medicine, Surgery, Blood pressure, Multicenter study, Hemodialysis, Cardiology, Kidney Failure, Chronic, Female, BLOOD PRESSURE
Abstract

Background Low and high dialysate calcium (Ca2+) content may have positive and harmful effects depending on the considered pathological aspect: hemodynamic instability, cardiac arrhythmias, parathormone release, adynamic bone disease, cardio-vascular calcifications. We hypothesized that a time-profiled Ca2+ concentration would keep the cardiovascular advantages of high Ca2+ but would reduce the risk of calcium overload. Methods A prospective, multicenter study using a particular hemodiafiltration technique that allows the profiling of electrolytes was designed. Patients (n = 22) underwent randomly a 3-week dialysis session with low and high constant dialysate Ca2+ (LdCa, 1.25 mM and HdCa, 2 mM) and profiled Ca2+ (PdCa), respectively. Plasma and spent dialysate Ca2+, systolic and diastolic arterial pressure (SAP, DAP) and QT interval corrected for heart rate (QTc) were analyzed. Results Plasma Ca2+ concentration decreased in LdCa, whereas it increased in HdCa and to a lesser extent, in PdCa. Total amount of Ca2+ given to the patient in PdCa (15.5 ± 1.0 mmol) was higher than in LdCa (4.3 ± 1.6 mmol) but lower than in HdCa (21.9 ± 3.3 mmol). SAP and DAP decreased in LdCa, whereas it was almost constant in both HdCa and PdCa. QTc significantly increased, up to critical values (>460 msec), only during LdCa. Conclusions PdCa seems to retain the advantages of high Ca2+ in terms of hemodynamic stability and modification of QTc while reducing the excessive positive calcium balance typical of dialysis with high Ca2+ content.

Published
2014

13. The dialysis staff workload and the blood volume tracking system during the hemodialysis sessions of hypotension-prone patients.

Author

Doria M, Genovesi S, Biagi F, Steckiph D, Mancini E, Stella A, and Santoro A

Subjects
Aged, Aged, 80 and over, Cross-Over Studies, Female, Humans, Hypotension diagnosis, Hypotension etiology, Hypotension physiopathology, Italy, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic physiopathology, Male, Predictive Value of Tests, Prospective Studies, Time Factors, Time and Motion Studies, Treatment Outcome, Blood Pressure, Blood Volume, Blood Volume Determination, Hypotension prevention & control, Kidney Failure, Chronic therapy, Personnel Staffing and Scheduling, Renal Dialysis adverse effects, Workload
Abstract

Purpose: Intradialytic hypotension (IDH) represents a common hemodialysis (HD) complication. Blood volume tracking (BVT) is a tool regulating the relative blood volume changes and potentially reducing the occurrence of IDH. The aim of this study was to evaluate the ability of BVT to reduce the staff workload associated to IDH., Methods: Ten hypotension-prone HD patients were treated each with 39 conventional HD (HD) sessions and then switched to 39 HD sessions with BVT (HD-BVT). The staff interventions related to IDH were monitored by a trained staff., Results: Dialysis sessions complicated by IDH and staff interventions were affected by BVT (HD: 102 and 127 vs. HD-BVT: 57 and 59, respectively, for both p<0.001). The time consumed by staff in IDH management was decreased by HD-BVT (1416 vs. 578 min, p<0.001)., Conclusions: The effectiveness of BVT to reduce the frequency of IDH leads to a reduction of the dialysis staff workload with fewer staff interventions, allowing for major work-time saving.

Published
2014
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14. Calcium profiling in hemodiafiltration: a new way to reduce the calcium overload risk without compromising cardiovascular stability.

Author

Severi S, Bolasco P, Badiali F, Concas G, Mancini E, Summa A, Perazzini C, Steckiph D, Cagnoli L, and Santoro A

Subjects
Aged, Female, Humans, Kidney Failure, Chronic blood, Male, Prospective Studies, Calcium blood, Dialysis Solutions, Hemodiafiltration methods, Kidney Failure, Chronic therapy
Abstract

Background: Low and high dialysate calcium (Ca²⁺) content may have positive and harmful effects depending on the considered pathological aspect: hemodynamic instability, cardiac arrhythmias, parathormone release, adynamic bone disease, cardio-vascular calcifications. We hypothesized that a time-profiled Ca²⁺ concentration would keep the cardiovascular advantages of high Ca²⁺ but would reduce the risk of calcium overload., Methods: A prospective, multicenter study using a particular hemodiafiltration technique that allows the profiling of electrolytes was designed. Patients (n = 22) underwent randomly a 3-week dialysis session with low and high constant dialysate Ca²⁺ (Ld(Ca,), 1.25 mM and Hd(Ca,), 2 mM) and profiled Ca²⁺ (Pd(Ca)), respectively. Plasma and spent dialysate Ca²⁺, systolic and diastolic arterial pressure (SAP, DAP) and QT interval corrected for heart rate (QTc) were analyzed., Results: Plasma Ca²⁺ concentration decreased in Ld(Ca), whereas it increased in Hd(Ca) and to a lesser extent, in Pd(Ca). Total amount of Ca²⁺ given to the patient in Pd(Ca) (15.5 ± 1.0 mmol) was higher than in Ld(Ca) (4.3 ± 1.6 mmol) but lower than in Hd(Ca) (21.9 ± 3.3 mmol). SAP and DAP decreased in Ld(Ca), whereas it was almost constant in both Hd(Ca) and Pd(Ca·). QTc significantly increased, up to critical values (>460 msec), only during Ld(Ca·)., Conclusions: Pd(Ca) seems to retain the advantages of high Ca²⁺ in terms of hemodynamic stability and modification of QTc while reducing the excessive positive calcium balance typical of dialysis with high Ca²⁺ content.

Published
2014
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15. Divert to ULTRA: differences in infused volumes and clearance in two on-line hemodiafiltration treatments.

Author

Panichi V, De Ferrari G, Saffioti S, Sidoti A, Biagioli M, Bianchi S, Imperiali P, Gabbrielli C, Conti P, Patrone P, Falqui V, Rombolà G, Mura C, Icardi A, Mulas D, Rosati A, Santori F, Mannarino A, Tomei V, Bertucci A, Steckiph D, and Palla R

Subjects
Adult, Aged, Anticoagulants therapeutic use, Automation, Biomarkers blood, Cross-Over Studies, Equipment Design, Feedback, Female, Hemodiafiltration instrumentation, Hemodiafiltration nursing, Humans, Italy, Kidney Failure, Chronic blood, Kidney Failure, Chronic nursing, Male, Membranes, Artificial, Middle Aged, Phosphates blood, Pressure, Prospective Studies, Time Factors, Treatment Outcome, Workload, beta 2-Microglobulin blood, Hemodiafiltration methods, Kidney Failure, Chronic therapy
Abstract

Background: Mixed diffusive-convective dialysis therapies offer greater removal capabilities than conventional dialysis. The aim of this study was to compare two different on-line, post-dilution hemodiafiltration (HDF) treatments with regard to achieved convective volume and middle-molecule dialysis efficiency: standard volume control (sOL-HDF) and automated control of the transmembrane pressure (TMP) (UC-HDF)., Methods: We enrolled 30 ESRD patients (55.9 ± 14.0 years, 20/10 M/F) in a randomized, prospective, cross-over study. The patients received a 3-month period of sOL-HDF followed by UC-HDF for a further 3 months, or vice versa, using the same dialysis machine. In sOL-HDF, fixed exchange volumes were set according to a filtration fraction greater than or equal to 25%. In UC-HDF therapy, the exchanged volume was driven by a biofeedback system controlling the TMP and its set point in a double loop. Patients maintained their treatment time, dialyzer, blood flow rate, and anticoagulant regimen unchanged throughout the study., Results: Greater convective volumes were achieved in UC-HDF than in sOL-HDF (23.8 ± 3.9 vs.19.8 ± 4.8 L; p<0.001) with high pre-dialysis Ht value (sOL-HDF 34.0 ± 4.5% and UC-HDF 34.0 ± 4.4%; p = 0.91). The average clearance values of ß2m and P were higher in UC-HDF than in sOL-HDF (respectively 123 ± 24 vs. 111 ± 22 ml/min, p<0.002 and 158 ± 26 vs. 152 ± 25 ml/min, p<0.05). Moreover, the UC-HDF mode led to a significantly increased rate of call-free sessions from 88% to 97% (p<0.0001)., Conclusions: This study showed that the biofeedback module, applied to the automatic control of TMP in on-line HDF, results in higher convective volumes and correspondingly higher ß2m and P clearances. By making the HDF treatment more automated and less complex to perform, it significantly reduced the staff workload.

Published
2012
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16. Evaluation of a new online hemodiafiltration mode with automated pressure control of convection.

Author

Teatini U, Steckiph D, and Romei Longhena G

Subjects
Aged, Hemodialysis Solutions therapeutic use, Humans, Kidney Failure, Chronic therapy, Middle Aged, Treatment Outcome, Convection, Hemodiafiltration methods, Hemodiafiltration standards, Pressure
Abstract

Background: Postdilution hemodiafiltration (HDF) still remains the gold standard for solute removal, but with high hemoglobin levels transmembrane pressure (TMP) may reach high levels, reducing filter performance. We compared three online postdilution HDF treatments without TMP alarms for convective volume and plasma changes following treatment., Methods: Twelve patients were enrolled in a trial with three online postdilution HDF treatments. In the volume-controlled mode (VOLc), we set the exchanged volume to obtain a filtration fraction close to 25% without TMP alarms. In the pressure-controlled mode (TMPc), we set the TMP at 100 mm Hg. In the ULTRAc mode (TMP scan combined with TMPc), the dialysis machine automatically selects the TMP with a scan. All treatments were performed with an AK200 ULTRA-S system., Results: Even with hemoglobin levels >12 g/dl, we found a 57% rise in ultrafiltration rate in TMPc versus VOLc and a 92% rise in ULTRAc versus VOLc. Phosphates and myoglobin levels were significantly affected by treatment type., Conclusions: ULTRAc may be a useful tool to achieve an excellent purification performance without the constraints associated with the risk of hemoconcentration., (Copyright © 2011 S. Karger AG, Basel.)

Published
2011
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17. Simple model of intra-extracellular potassium kinetics and removal applied to constant and potassium-profiled dialysis.

Author

Bolasco P, Concas G, Steckiph D, Grandi F, and Polacchini M

Subjects
Body Water physiology, Female, Hemodialysis Solutions analysis, Humans, Ion Transport, Male, Plethysmography, Impedance, Potassium analysis, Extracellular Fluid metabolism, Intracellular Fluid metabolism, Models, Biological, Potassium metabolism, Renal Dialysis
Abstract

Aim: The incidence rate for sudden death in hemodialysis patients ranges between 2% and 7%. This phenomenon is frequently due to cardiac arrhythmias. In particular, the process of potassium (K(+)) depuration performed during hemodialysis has been found to be related to arrhythmia onset. The main aim of this study was to introduce a simple double-pool mathematical model of K(+) kinetics to investigate the effects of dialysate K(+) concentration on intracellular and extracellular K(+) removal. The secondary aim was to evaluate the K(+) removed from the different body pools in 2 different types of K(+) dialysate: constant and profiled., Methods: Our model evaluated K(+) removal and body water in the intracellular and extracellular spaces using plasma, erythrocytes and spent dialysate K(+) concentration, and intracellular and extracellular volume (t=0) in 6 patients (4 females and 2 males). All patients were treated with acetate-free biofiltration with a constant K(+) dialysate concentration (AFB) and with a profiled one (AFB-K). Moreover, the electrolyte concentration (sodium, calcium and bicarbonate) and pH were analyzed in all sessions., Results: A similar total potassium removal was evaluated by the model, starting from a similar final K(+) plasma reduction. At 10 minutes, the model assessed a higher K(+) removal in the extracellular space during AFB (26.6% vs. 7.7%, p<0.001) involving a lower K(+) concentration (5.0 +/- 0.5 in AFB and 5.2 +/- 0.6 in AFB-K, p<0.05) and consequently a higher cell hyperpolarization (-73.4 +/- 3.9 mV vs. -72.1 +/- 2.4 mV, p=0.05). No differences in pH, intracellular and extracellular Na+ or plasma Ca(2+) were highlighted between AFB and AFB-K., Conclusions: The model we developed allows us to evaluate K(+) removal and body water in the intracellular and extracellular spaces during treatment. The assessment of this information may have a relevant role toward an understanding of the causes of the Nernst potential changes during hemodialysis that are often related to the onset of arrhythmias.

Published
2008

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