Effect of High-Cutoff Hemodialysis vs Conventional Hemodialysis on Hemodialysis Independence Among Patients With Myeloma Cast Nephropathy

Bridoux, Frank; Carron, Pierre-Louis; Pégourie, Brigitte; Alamartine, Éric; Augeul-Meunier, Karine; Karras, Alexandre; Joly, Bertrand; Péraldi, Marie-Noëlle; Arnulf, Bertrand; Vigneau, Cécile; Lamy, Thierry; Wynckel, Alain; Kolb, Brigitte; Royer, Bruno; Rabot, Nolwenn; Benboubker, Lotfi; Combe, Christian; Jaccard, Arnaud; Moulin, Anne‐Marie; Knebelmann, Bertrand; Chevret, Sylvie; Fermand, Jean‐Paul

doi:10.1001/jama.2017.17924

Cited by 134 publications

(160 citation statements)

References 38 publications

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“…6,7 A randomized controlled study, called MYRE, showed that FLCs removal with a HCO dialyzer improves patients' outcomes. 8 However, high cost, elevated protein leakage requiring albumin replacement after treatments reduce its utilization. 7 As a consequence dialyzers cheaper than HCO dialyzers, efficient in FLCs removal but without protein leakage are still wanted.…”

Section: Discussionmentioning

confidence: 99%

Early use of PEPA dialyzer for light chains removal and for the recovery from myeloma cast nephropathy: A case report

Donati¹,

Zappulo²,

Chiocchini³

et al. 2019

Hemodialysis International

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Section: Discussionmentioning

confidence: 99%

Early use of PEPA dialyzer for light chains removal and for the recovery from myeloma cast nephropathy: A case report

Donati¹,

Zappulo²,

Chiocchini³

et al. 2019

Hemodialysis International

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“…Cast nephropathy is generated by massive light chain secretion in the tubules and precipitated with reduction of tubular flow. There was an RCT comparing between intensive HD (eight 5-hour sessions over 10 days) with a HCO dialyzer (HCO-HD) and conventional HD among patients who were newly diagnosed with myeloma cast nephropathy and treated with a bortezomib-based chemotherapy regimen [44]. HCO-HD allowed higher clearance of both kappa (κ) and lambda (λ) light chains.…”

Section: Hdf and Myeloma Cast Nephropathymentioning

confidence: 99%

Hemodiafiltration in Acute Kidney Injury

Takkavatakarn¹,

Susantitaphong²,

SomchaiEiam-Ong³

2019

Aspects in Continuous Renal Replacement Therapy

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Acute kidney injury (AKI) is one of the most important complications during hospitalization, especially in critically ill patients. Recent data demonstrated that certain biomarkers including pro-inflammatory cytokines are associated with high morbidity and mortality. These biomarkers, most of which have middle molecular weight, and protein-bound uremic toxins are limitedly removed by diffusion mechanism in conventional hemodialysis. Hemodiafiltration (HDF), a new modality that combines convective clearance with diffusion, could effectively enhance removal of middle molecule and protein-bound solutes. Therefore, HDF is increasingly used in several AKI settings such as septic AKI, rhabdomyolysis-associated AKI, myeloma cast nephropathy, and contrast-induced AKI. This chapter summarizes the available HDF techniques including intermittent and continuous modes, and clinical data comprise the benefits of HDF on biomarkers and renal as well as cardiovascular outcomes. Additionally, the topic provides the proposed future directions of HDF in various AKI settings.

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“…High‐cut‐off membranes and the new generation medium cut‐off membranes may potentially have a role in the management of light nephropathy along with appropriate chemotherapy. However, the actual reported clinical outcomes using these high cut‐off membranes remain inconclusive …”

Section: Dialyzer Choice In Aki and In Critical Carementioning

confidence: 99%

“…However, the actual reported clinical outcomes using these high cut-off membranes remain inconclusive. 3,[82][83][84]…”

Section: S69mentioning

confidence: 99%

Choosing a dialyzer: What clinicians need to know

Haroon¹,

Davenport

2018

Hemodialysis International

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The objectives of hemodialysis have moved from the diffusive clearance of small molecular weight uremic toxins and achieving dialyzer urea adequacy targets to emphasis on improving clinical outcomes in end stage renal failure patients by increasing larger sized uremic toxin clearance. Clinical emphasis in the last few decades has focused on increasing middle molecule weight toxin clearance by hemodiafiltration. Although long‐term data is still lacking, short‐term outcomes appear promising. Advancements in nanotechnology have now introduction a new generation of medium cut‐off membrane dialyzers which allow diffusive clearance of similar middle molecular weight uremia toxin clearance as hemodiafiltration, without increased albumin losses. As these dialyzers have only recently been introduced into clinical practice, no long‐term outcomes are available to determine the relative benefits or advantages of this approach. As dialyzers are now designed to maximize diffusive or convective clearance, or provide a combination, then clinicians can now choose dialyzers tailored to the individual patient needs depending on clinical circumstances. We review the key important features in choosing a dialyzer for patients with end stage renal failure and acute kidney injury.

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Effect of High-Cutoff Hemodialysis vs Conventional Hemodialysis on Hemodialysis Independence Among Patients With Myeloma Cast Nephropathy

Abstract: clinicaltrials.gov Identifier: NCT01208818.

Cited by 134 publications

References 38 publications

Early use of PEPA dialyzer for light chains removal and for the recovery from myeloma cast nephropathy: A case report

Early use of PEPA dialyzer for light chains removal and for the recovery from myeloma cast nephropathy: A case report

Hemodiafiltration in Acute Kidney Injury

Choosing a dialyzer: What clinicians need to know

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