Comparison of the hemodynamic tolerance and the biological parameters of four acetate-free hemodialysis methods

Kosmadakis, George; Correia, Enrique Da Costa; Albaret, Julie; Somda, Frédéric; Aguilera, Didier

doi:10.1016/j.nephro.2017.03.002

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…73 The potassium modulation in the dialysate could be personalized, defining a profiled exchange during the treatment, obtaining both a gradual and safe reduction of serum potassium. 74 The fast reduction of serum potassium levels during the first hour of the dialysis has been closely related to higher prevalence of hypotensive episodes, 75 whereas a reduced incidence of risk of intra-and inter-dialysis arrhythmias, as well as an improvement in QTc dispersion, is described with potassium profiling. 76…”

Section: Acetate-free Biofiltration (Afb)mentioning

confidence: 99%

Updates on hemodialysis techniques with a common denominator: The personalization of the dialytic therapy

Monardo

Lacquaniti

Campo

et al. 2021

Seminars in Dialysis

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Morbidity and mortality marginally decreased over the last three decades in hemodialyzed (HD) patients, despite the introduction of multiple pharmacological and technological advancement. 1 Several randomized controlled studies failed to demonstrate the superiority of one procedure, schedule, or pharmacological interventions on survival and, consequently, weak level of recommendations has been revealed by best practice guidelines. [2][3][4][5] These negative results are closely related to the complexity of uremia, characterized by several metabolic disorders, as well as hyperparathyroidism, metabolic acidosis, Lcarnitine deficiency, and risk factors, influencing all-cause mortality. [6][7][8] General dialysis-dependent population is in fact elderly and affected by multiple co-morbid conditions, while hemodialysis (HD) represents just one component of the overall outcome-based risk profile. In particular, diabetes as well as obesity, due to their increasing incidence, are directly involved in kidney disease onset and progression. 9 Moreover, global patient heterogeneity, related to genetic, environmental, and demographic factors, needs to be evaluated as a risk factor for renal disease. Large-scale meta-analyses of genome-wide association studies have identified a number of loci significantly associated with systolic and/or diastolic blood pressure, apolipoproteins, or polymorphisms of vitamin D receptor, closely involved in the development of kidney disease. [10][11][12] Other obstacle to apply personalized dialysis is the lack of resources in the current sanitary systems, considering that, due to the combination of high costs and widespread need, renal replacement therapy is one of the most expensive treatments. 13,14 The actual costs of dialysis are not uniformly defined, with significant differences between highly resourced countries, where the most important item is the cost of nursing and medical care, and emerging countries, where the cost of dialysis supplies represents the most relevant item. 15 Moreover, ecologic implication is closely related with each HD session, analyzing water, energy, and waste

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Section: Acetate-free Biofiltration (Afb)mentioning

confidence: 99%

Updates on hemodialysis techniques with a common denominator: The personalization of the dialytic therapy

Monardo

Lacquaniti

Campo

et al. 2021

Seminars in Dialysis

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“…Studies using AFB have reported greater SBP stability compared to standard bicarbonate dialysate 51,52 . One study compared acetate‐free dialysis methods; acetate‐free biofiltration with a variable potassium to conventional hemodialysis, on‐line hemodiafiltration and on‐line hemofiltration all using a citrate dialysate, and reported that AFB was associated with less IDH and significantly higher SBP 53 …”

Section: Dialysate Acetate/citratementioning

confidence: 99%

Reducing the risk of intradialytic hypotension by altering the composition of the dialysate

Vareesangthip

Davenport

2020

Hemodialysis International

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Hypotension is the most common complication of outpatient hemodialysis sessions, with a reported prevalence of 4% to 31%, depending on which definition has been used and whether patients are symptomatic and nursing interventions were required. Dialysis centers which mix the dialysate in the dialysis machine have the opportunity to individualize the composition of the dialysate for patients. This permits a choice of dialysate sodium, potassium, calcium, magnesium, bicarbonate, acetate, and citrate concentrations and temperature. Studies have reported a higher intradialytic systolic blood pressure and fewer episodes of intradialytic hypotension when using a higher dialysate sodium, calcium, magnesium concentrations and lower temperature, but no clinical advantage for changing the potassium, bicarbonate, or citrate for acetate concentrations. The introduction of newer technology allowing real time measurements of plasma electrolyte concentrations will potentially allow changing the dialysate composition to reduce the risk of intradialytic hypotension without increasing the risk of positive electrolyte balances.

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Why is Intradialytic Hypotension the Commonest Complication of Outpatient Dialysis Treatments?

Davenport

2023

Kidney International Reports

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Comparison of the hemodynamic tolerance and the biological parameters of four acetate-free hemodialysis methods

Cited by 5 publications

References 17 publications

Updates on hemodialysis techniques with a common denominator: The personalization of the dialytic therapy

Updates on hemodialysis techniques with a common denominator: The personalization of the dialytic therapy

Reducing the risk of intradialytic hypotension by altering the composition of the dialysate

Why is Intradialytic Hypotension the Commonest Complication of Outpatient Dialysis Treatments?

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