Effect of increased blood flow rate on renal anemia and hepcidin concentration in hemodialysis patients

Yamamoto, Miyako; Matsumoto, Tomio; Ohmori, Harunori; Takemoto, Masumi; Ikeda, Masanobu; Sumimoto, Ryo; Kobayashi, Tsuyoshi; Kato, Akihiko; Ohdan, Hideki

doi:10.1186/s12882-021-02426-7

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…For the first time, we identified dialysis adequacy (stdKt/ V) as a potential impact factor of CHF. Dialysis adequacy directly reflects the removal of uremic toxins and is associated with inflammation, anemia, and nutritional status [36], which might serve as risk factors of CVD. Studies have shown that dialysis dose or adequacy or even the blood flow rate were associated with mortality or cause-specific mortality [17,[37][38][39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes in Patients on Hemodialysis with Congestive Heart Failure

Zhao¹,

Gan²,

Niu³

et al. 2023

Kidney Dis

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Introduction: Congestive heart failure (CHF) is one of the common complications in patients with end-stage kidney disease. In the general population, CHF increases the risk of the death. However, there is no well-designed relevant study in the Chinese hemodialysis (HD) population addressing the risks associated with CHF. The aim of this study was to explore the impact of CHF on clinical outcomes in HD patients. Methods: Data from a prospective cohort study, the China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5 (2012-2015), were analyzed. Demographic data, comorbidities, lab data, and death records were extracted. CHF was defined by the diagnosis records upon study inclusion. Our primary outcome was all-cause and cardiovascular (CV) mortality; secondary outcomes were all-cause and cause-specific hospitalization risk. Associations between CHF and outcomes were evaluated using Cox regression models. Stepwise multivariate logistic regression was used to identify the related risk factors, and subgroup analyses were carried out. Results: Of 1411 patients without missing CHF history information, 24.1% (340) had CHF diagnosis at enrollment. The overall mortality rates were 21.8% vs. 12.0% (p <0.001) in patients with and without CHF during follow-up, respectively. CHF was associated with higher all-cause mortality (adjusted HR: 1.72, 95% CI: 1.17-2.53, p=0.006), and the association with CV death was of similar magnitude (HR: 1.60, 95% CI: 0.91-2.81, p=0.105). CHF patients had more episodes of hospitalization due to heart failure (HR 2.93, 95% CI: 1. 49- 5.76, P<0.01). However, compared with patients without CHF, the all-cause hospitalization risk was not much higher in CHF patients (HR 1.09, 95% CI: 0.90-1.33, P=0.39). Subgroup analysis found that the effect of CHF on all-cause mortality was stronger for male patients, patients with residual renal function, the elderly (≥60 years of age), patients with arteriovenous fistulae vascular accesses, non-diabetic patients, low-flux dialyzer users, and inadequately dialyzed patients (stdKt/V<2). Conclusion: In HD patients, CHF was found to be associated with a higher risk of all-cause mortality and cause-specific hospitalization risk. Further research is needed to identify opportunities to improve care for HD patients combined with CHF.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes in Patients on Hemodialysis with Congestive Heart Failure

Zhao¹,

Gan²,

Niu³

et al. 2023

Kidney Dis

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“…Low molecular weight heparin (bemiparin) was used in all patients in doses of 2,500 -3,500 IU/session, depending on their body weight. For all patients, the blood supply to the filter was 400 mL/min, with arterial aspiration pressure < 200 mm Hg [1] and the dialysate flow rate was 500 mL/min, as previously specified by others [2] (all HD machines used were the Nikkiso DBB EXA). The duration of the sessions for seven patients was 4 h, for two patients, it was 4 h and 15 min, and for one patient, it was 4 h and 45 min (Table 1).…”

Section: Methodsmentioning

confidence: 99%

Albumin Loss in Post-Dilution On-Line Hemodiafiltration Compared With Pre-Dilution On-Line Hemodiafiltration and Conventional Hemodialysis

Mavromatidis¹,

Kalogiannidou²,

Passadakis³

2023

World J Nephrol Urol

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Background:The purpose of the study was to investigate the amounts of albumin lost in the dialysate in a dialysis session using either a high-flux (on-line hemodiafiltration (HDF)) or a low-flux filter (conventional hemodialysis (HD)). Methods:The loss of albumin was studied in 10 hemodialyzed patients, with on-line HDF (pre-and post-dilution) and with conventional HD. We determined the albumin loss in the total ultrafiltrate for four different dialysis models. Results:No change was found in serum albumin levels when switching from conventional HD to on-line HDF. The loss of albumin in online HDF post-dilution, with a high-flux filter of 2.5 m 2 (group A) was marginally significantly greater than the loss with the same filter with a surface area of 2.1 m 2 (group B) (P = 0.05). However, there was no difference in albumin loss when comparing groups A and B with group C (conventional HD) (P = NS). Albumin loss was significantly less in group D (pre-dilution on-line HDF, with filter 2.5 m 2 surface area) compared to groups A (P < 0.01), B (P < 0.01) and C (P < 0.03). The urea reduction ratio in each case (groups A, B, C and D) was, on average, > 73.5%, but in group C, it was significantly lower than in groups A and B (P < 0.05). Transmembrane pressure in group D was clearly lower than in groups A and B. Conclusion:The polyethersulfone filters (polynephron) used in the on-line HDF lost very little albumin in a session (more with postdilution), but this increased when their surface area and the transmembrane pressure increased. The urea reduction ratio was above the desired target in each model of dialysis using this filter, including both surface areas.

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“…Measurement of immunoglobulin, complements, and cluster of differentiation (CD)4/CD8 was entrusted to Bio-Medical Laboratories, Inc. (Tokyo, Japan). Measurements of natural killer (NK) cell activity and soluble interleukin-2 receptor (sIL-2R) were obtained as previously reported [ 23 ]. Serum IL-6 was determined with a Quantikine ELISA kit (R&D Systems, Inc., Minneapolis, MO, USA).…”

Section: Methodsmentioning

confidence: 99%

<i>Clostridium butyricum</i> affects nutrition and immunology by modulating gut microbiota

Yamamoto

Ohmori

Takei

et al. 2022

Bioscience of Microbiota, Food and Health

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The gut microbiota has nutritional and protective functions. In patients with end-stage renal disease, changes in the gut microbiota disrupt their protective functions. Probiotics help maintain normal bowel function. However, their role in patients with end-stage renal disease is controversial. We investigated whether Clostridium butyricum affects the nutrition and immune function of patients with end-stage renal disease undergoing 3 maintenance dialysis between 2014 and 2015; thirty-seven patients were included. The patients were divided into two groups: one in which Clostridium butyricum was administered and one in which it was not. One tablet of MIYA-BM®, which contained 20 mg of Clostridium butyricum, was administered orally three times daily for 2 years in the Clostridium butyricum group. The 16S rRNA genes were sequenced from stool samples of 14 (37.8%) patients in the Clostridium butyricum group and 23 (62.2%) patients in the control group. The differences in the gut microbiota of the two groups were analyzed. The -diversity index indicated that the Clostridium butyricum group had significantly more operational taxonomic units and higher albumin and transferrin levels than the control group. The effector to target cell ratio was significantly higher in the Clostridium butyricum group. In addition, interleukin-6 levels were significantly lower in the Clostridium butyricum group, and inflammation was less severe in this group. The patients undergoing maintenance dialysis with Clostridium butyricum had abundant gut microbiota.They also had a good nutritional status, low systemic inflammation, and a good immunological status.

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Effect of increased blood flow rate on renal anemia and hepcidin concentration in hemodialysis patients

Cited by 7 publications

References 31 publications

Clinical Outcomes in Patients on Hemodialysis with Congestive Heart Failure

Clinical Outcomes in Patients on Hemodialysis with Congestive Heart Failure

Albumin Loss in Post-Dilution On-Line Hemodiafiltration Compared With Pre-Dilution On-Line Hemodiafiltration and Conventional Hemodialysis

<i>Clostridium butyricum</i> affects nutrition and immunology by modulating gut microbiota

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