Microbiological Surveillance and State of the Art Technological Strategies for the Prevention of Dialysis Water Pollution

Bolasco, Piergiorgio; Contu, A.; Meloni, P; Vacca, Dorio; Galfré, Andrea

doi:10.3390/ijerph9082758

Cited by 10 publications

(9 citation statements)

References 16 publications

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“…All 19 participating Centers made use of ultrapure, sterile and pyrogen-free dialysis solutions checked once monthly by cultural and endotoxins confirmation. Dialysate fluids were produced by a bi-osmosis and purified by daily nocturnal thermal disinfection of the piping (≥90 °C) [ 32 – 34 ].…”

Section: Methodsmentioning

confidence: 99%

Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra

Palleschi

Ghezzi²,

Palladino³

et al. 2016

BMC Nephrol

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BackgroundHemodiafiltration with on-line endogenous reinfusion (HFR) is an extracorporeal dialytic method that combines diffusion, convection and adsorption. HFR-Supra (HFR-S) is a second-generation system with increased convective permeability and adsorption capability. Previous studies suggested that HFR reduces oxidative stress compared to standard haemodialysis. The principal aim of the present study was to compare antioxidant vitamins behavior and oxidative status of hemodialysis patients treated with HFR and HFR-S.MethodsThe study was designed as a multicenter, randomized, crossover trial. Forty-one patients were recruited from 19 dialysis centers and after a 4-month washout stabilization period in on-line hemodiafiltration (ol-HDF), each patient was randomized to a sequence of treatments (HFR-S followed by HFR or viceversa) with each treatment applied over 6 months. Plasma levels of Advanced Oxidation Protein Products, Total Antioxidant Status, vitamins C, A and E and their ligands (Retinol Binding Protein and total lipids) were measured at baseline and at the end of each treatment period.ResultsResults show that the higher convective permeability of HFR-S with respect to HFR did not produce additional beneficial effects on the patients’ oxidative status, a slight decrease of both Vitamin A and Retinol Binding Protein being the only difference registered in the long-term. However, as compared to ol-HDF, both the re-infusive techniques allowed to reduce the intradialytic loss of Vitamin C and, in the long-term, improve the patients’ oxidative status and increase Retinol Binding Protein plasma values. No significant differences were found between the Vitamin C concentration of pre- and post cartridge UF neither in HFR-S nor in HFR showing that the sorbent resin does not adsorb Vitamin C.ConclusionHFR-S and HFR are almost equivalent in term of impact on antioxidant vitamins and oxidative status of hemodialysis patients. Nonetheless, as compared to ol-HDF, both treatments produced a sensible sparing of Vitamin C and may represent a new approach for reducing oxidative stress and related complications in dialysis patients. Long-term effects of re-infusive treatments on patients’ cardiovascular morbidity and mortality need to be evaluated.Trial registrationClinicalTrials.gov Identifier NCT01492491, retrospectively registered in 10 December 2011.

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Section: Methodsmentioning

confidence: 99%

Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra

Palleschi

Ghezzi²,

Palladino³

et al. 2016

BMC Nephrol

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“…Condizione indispensabile è la motivazione e la buona aderenza alla terapia nutrizionale prescritta. Inoltre anche l’uso di membrane meno bio-incompatibili 15 e la buona qualità dell’acqua di dialisi 16 assicurano oggi minore microinfiammazione e pro-ossidazione intra-sessione.…”

Section: Cenni Metodologici Introduttiviunclassified

Percorsi pratici per intraprendere un programma di dialisi monosettimanale combinato con una nutrizione ipoproteica personalizzata

Bolasco

Murtas²,

Concas³

et al. 2018

Giornale di Tecniche Nefrologiche e Dialitiche

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Practical paths to undertake a one-week dialysis program combined with a nutrition personalized hypoproteicsThe aim of this article is to provide detailed information to nephrologists on how to apply the combined diet dialysis program (CDDP) in selected patients. Patients are evaluated by urea nitrogen appearance, which allows the sustainability and compliance of patients on 0.6 g/kg per day low-protein diet to be verified by calculating the protein catabolic rate at a metabolic steady state. The combined action of nutrition and less frequent hemodialysis may preserve residual renal function with a further chance of achieving greater excretion of the protein-bound uremic toxins, thereby obtaining a positive phosphate balance. This paper describes all fundamental steps and calculations, although a greater clinical commitment is required to achieve a tailored therapeutic protocol such as Combined Diet Dialysis Program (CDDP).

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“…Condizione indispensabile è la motivazione e la buona aderenza alla terapia nutrizionale prescritta. Inoltre anche l'uso di membrane meno bioincompatibili 15 e la buona qualità dell'acqua di dialisi 16 assicurano oggi minore microinfiammazione e proossidazione intra-sessione.…”

Section: Cenni Metodologici Introduttiviunclassified

Percorsi pratici per intraprendere un programma di dialisi monosettimanale combinato con una nutrizione ipoproteica personalizzata

Bolasco

Murtas²,

Concas³

et al. 2018

G Clin Nefrol Dial

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Microbiological Surveillance and State of the Art Technological Strategies for the Prevention of Dialysis Water Pollution

Cited by 10 publications

References 16 publications

Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra

Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra

Percorsi pratici per intraprendere un programma di dialisi monosettimanale combinato con una nutrizione ipoproteica personalizzata

Percorsi pratici per intraprendere un programma di dialisi monosettimanale combinato con una nutrizione ipoproteica personalizzata

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