Predilution haemofiltration—the Second Sardinian Multicentre Study: comparisons between haemofiltration and haemodialysis during identical Kt/V and session times in a long‐term cross‐over study

Altieri, Paolo; Sorba, Giambattista; Bolasco, Piergiorgio; Asproni, Emilio; Ledebo, Ingrid; Cossu, Maria Vittoria; Ferrara, Rocco; Ganadu, Marino; Cadinu, Franco; Serra, G; Cabiddu, Gianfranca; Sau, Giovanna; Casu, Domenica; Passaghe, Mario; Bolasco, F; Pistis, Raffaele; Ghisu, Tonina

doi:10.1093/ndt/16.6.1207

Cited by 68 publications

(51 citation statements)

References 17 publications

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“…Lopes et al 24 were the first to prospectively test the effects of minimizing pulse pressure variation (< 10%) during surgery, and they observed a significant reduction in postoperative complications and hospital length of stay. In agreement with our results, Altieri et al 1 noted a significant reduction in the frequency of hypotensive episodes during hemofiltration compared with hemodialysis.…”

Section: Hemodynamicssupporting

confidence: 94%

“…1 Our serial hemodynamic studies showed that, for the rate of fluid removed, SLED elicited an appropriate increase in SVV, whereas CVVH failed to do so. Stroke volume variation reflects the dialysis-induced changes in the left ventricle stroke output and may serve as a variable continuously assesses the adequacy of fluid responsiveness as preload.…”

Section: Hemodynamicsmentioning

confidence: 70%

See 1 more Smart Citation

The hemodynamic effects during sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for uremic patients with brain hemorrhage: a crossover study

Wu¹,

Huang²,

Shiao

et al. 2013

JNS

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Object Hemodynamic instability occurs frequently during dialysis treatment and remains a significant cause of patient morbidity and mortality, especially in patients with brain hemorrhage. This study aims to compare the effects of hemodynamic parameters and intracranial pressure (ICP) between sustained low-efficiency dialysis (SLED) and continuous veno-venous hemofiltration (CVVH) in dialysis patients with brain hemorrhage. Methods End-stage renal disease (ESRD) patients with brain hemorrhage undergoing ICP monitoring were enrolled. Patients were randomized to receive CVVH or SLED on the 1st day and were changed to the other modality on the 2nd day. The ultrafiltration rate was set at between 1.0 kg/8 hrs and 1.5 kg/8 hrs according to the patient's fluid status. The primary study end point was the change in hemodynamics and ICP during the dialytic periods. The secondary end point was the difference between cardiovascular peptides and oxidative and inflammatory assays. Results Ten patients (6 women; mean age 59.9 ± 3.6 years) were analyzed. The stroke volume variation was higher with SLED than CVVH (generalized estimating equations method, p = 0.031). The ICP level increased after both SLED and CVVH (time effect, p = 0.003) without significant difference between modalities. The dialysis dose quantification after 8-hour dialysis was higher in SLED than CVVH (equivalent urea clearance by convection, 62.7 ± 4.4 vs 50.2 ± 3.9 ml/min; p = 0.002). Additionally, the endothelin-1 level increased after CVVH treatment (p = 0.019) but not SLED therapy. Conclusions With this controlled crossover study, the authors provide the pilot evidence that both SLED and CVVH display identical acute hemodynamic effects and increased ICP after dialysis in brain hemorrhage patients. Clinical trial registration no.: NCT01781585 (ClinicalTrials.gov).

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Section: Hemodynamicssupporting

confidence: 94%

Section: Hemodynamicsmentioning

confidence: 70%

The hemodynamic effects during sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for uremic patients with brain hemorrhage: a crossover study

Wu¹,

Huang²,

Shiao

et al. 2013

JNS

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“…However, a single recent report in 15 subjects studied in a prospective 6-month crossover format with predilution hemofiltration and high flux hemodialysis showed a significantly higher ambulatory mean arterial blood pressure during the bracketing hemofiltration periods than during high flux hemodialysis. As noted above, this result would be compatible with the postulated pathophysiology of the observed reverse "J" shaped curve of blood pressure and mortality noted above if the broader spectrum of solutes cleared by hemofiltration and the prolonged treatment prescriptions bear an etiologic relationship to improved survival (20).…”

Section: Editorialsupporting

confidence: 78%

Therapeutic use of the Dialysis Prescription for Improvement in Blood Pressure Control

Henderson

Owen

2002

Int J Artif Organs

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“…Although these studies were designed to evaluate outcomes of arterial blood pressure and intrasession symptoms, no differences were observed in presession P levels, and no superiority of HF compared to HDF was observed. 19,20 Since the end of the 1990s, a new hemodialytic method was introduced that employed three types of depuration: convection; adsorption by resins; and diffusion. 21 An ultrafiltrate is formed by the plasma water leaving the convective filter, and it is conveyed into a cartridge containing adsorbents (polystyrenic resin), which retain various high molecular-weight toxic substances.…”

Section: Convective Hemodialysis Techniquesmentioning

confidence: 99%

Phosphate control in dialysis

Cupisti¹,

Gallieni²,

Rizzo³

et al. 2013

IJNRD

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Prevention and correction of hyperphosphatemia is a major goal of chronic kidney disease-mineral and bone disorder (CKD-MBD) management, achievable through avoidance of a positive phosphate balance. To this aim, optimal dialysis removal, careful use of phosphate binders, and dietary phosphate control are needed to optimize the control of phosphate balance in well-nourished patients on a standard three-times-a-week hemodialysis schedule. Using a mixed diffusive-convective hemodialysis tecniques, and increasing the number and/or the duration of dialysis tecniques are all measures able to enhance phosphorus (P) mass removal through dialysis. However, dialytic removal does not equal the high P intake linked to the high dietary protein requirement of dialysis patients; hence, the use of intestinal P binders is mandatory to reduce P net intestinal absorption. Unfortunately, even a large dose of P binders is able to bind approximately 200-300 mg of P on a daily basis, so it is evident that their efficacy is limited in the case of an uncontrolled dietary P load. Hence, limitation of dietary P intake is needed to reach the goal of neutral phosphate balance in dialysis, coupled to an adequate protein intake. To this aim, patients should be informed and educated to avoid foods that are naturally rich in phosphate and also processed food with P-containing preservatives. In addition, patients should preferentially choose food with a low P-to-protein ratio. For example, patients could choose egg white or protein from a vegetable source. Finally, boiling should be the preferred cooking procedure, because it induces food demineralization, including phosphate loss. The integrated approach outlined in this article should be actively adapted as a therapeutic alliance by clinicians, dieticians, and patients for an effective control of phosphate balance in dialysis patients.

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Predilution haemofiltration—the Second Sardinian Multicentre Study: comparisons between haemofiltration and haemodialysis during identical Kt/V and session times in a long‐term cross‐over study

Cited by 68 publications

References 17 publications

The hemodynamic effects during sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for uremic patients with brain hemorrhage: a crossover study

The hemodynamic effects during sustained low-efficiency dialysis versus continuous veno-venous hemofiltration for uremic patients with brain hemorrhage: a crossover study

Therapeutic use of the Dialysis Prescription for Improvement in Blood Pressure Control

Phosphate control in dialysis

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