Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration

Urabe, Shunichiro; Hosono, Takashi; Hyodo, Toru; Kikuchi, Makoto; Hida, Miho; Kurata, Yasuhisa; Kokubo, Kenichi

doi:10.1007/s10047-019-01100-y

Cited by 5 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7,30 A supporting evidence is that hemodialysis filtration and hemoperfusion can remove the middle-molecular-weight toxins and relieve the RLS symptoms. 31 Another 25 RLS patients in the current study presented the RLS symptoms prior to the initiation of hemodialysis, and three of them had a family history of RLS, suggesting that genetics may play a role in the development of RLS, especially the early-onset RLS.…”

Section: Discussionmentioning

confidence: 64%

“…27 The Hamilton Anxiety Scale 28 scale was used for anxiety evaluation, with scores ranging from 0 to 56, which grades anxiety severity as no anxiety (0-6), possible anxiety (7-13), mild anxiety (14)(15)(16)(17)(18)(19)(20), moderate anxiety (21)(22)(23)(24)(25)(26)(27)(28), and severe anxiety . The Hamilton Depression Scale 28 was used to evaluate depression, with scores ranging from 0 to 78, which grades depression severity as no depression (0-7), possible depression (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), mild and moderate depression (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), and severe depression (36-78).…”

Section: Sleep and Emotion Scalesmentioning

confidence: 99%

See 1 more Smart Citation

<p>Prevalence and Risk Factors of Restless Legs Syndrome in Hemodialysis Patients</p>

Zhang

Lin

et al. 2020

NSS

View full text Add to dashboard Cite

These authors contributed equally to this workObjective: The current study aimed to investigate the prevalence and risk factors of restless legs syndrome (RLS) in patients undergoing hemodialysis, as well as the mortality and risks of cardiovascular and cerebrovascular events. Methods: A total of 354 hemodialysis patients from four hospitals were enrolled. RLS was diagnosed using the International RLS Study Group (IRLSSG) criteria. The patients were evaluated face-to-face using the IRLSSG rating scale, Epworth Sleepiness Scale (ESS), Hamilton Anxiety Scale, Hamilton Depression Scale, and Pittsburgh Sleep Quality Index (PSQI). The patients were followed up for 9 months. Death was considered an endpoint event. The cardiovascular and cerebrovascular events were investigated. Results: The prevalence of RLS in hemodialysis patients was 40.7% and was associated with factors such as duration of hemodialysis, hypersensitive C-reactive protein, hyperparathyroidism, glycosylated serum protein, and erythropoietin treatment. The scores of the PSQI, ESS, and Hamilton Depression Scale in the RLS group were significantly higher than those in the non-RLS group (p < 0.05). During follow-ups, the incidence rate of cardiovascular diseases was 18.8% in the RLS group and 8.6% in the non-RLS group (p < 0.005). The IRLSSG rating scores were significantly higher in RLS patients with kidney transplantation failure compared with those without transplantation (p < 0.05). Conclusion: The prevalence of RLS was high in hemodialysis patients. The risk factors of RLS included duration of hemodialysis, hypersensitive C-reactive protein, hyperparathyroidism, glycosylated serum protein, and erythropoietin treatment. RLS affected sleep quality and emotion and increased the risk of cardiovascular diseases in hemodialysis patients. RLS was more severe in patients with kidney transplantation failure compared with those without transplantation.

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Sleep and Emotion Scalesmentioning

confidence: 99%

<p>Prevalence and Risk Factors of Restless Legs Syndrome in Hemodialysis Patients</p>

Zhang

Lin

et al. 2020

NSS

View full text Add to dashboard Cite

show abstract

“…Although dialysate albumin loss could be considered clinically tolerable in FDY treatments, it is important to note that, like MCO membranes, these dialyzers should only be used in HD mode to avoid increased albumin losses and decreasing serum levels, as demonstrated in a case report by Cuvelier et al with an MCO dialyzer in postdilution HDF. 20 In 2019, Uribe et al 21 published a case report of restless legs syndrome effectively treated with a PEPA dialyzer in predilution HDF; however, dialysate albumin losses were 12.1 g with 60 L predilution and 7.9 g with constant TMP predilution HDF, which raises concerns about medium-term safety.…”

Section: Discussionmentioning

confidence: 99%

“…with an MCO dialyzer in post‐dilution HDF 20 . In 2019, Uribe et al 21 . published a case report of restless legs syndrome effectively treated with a PEPA dialyzer in predilution HDF; however, dialysate albumin losses were 12.1 g with 60 L predilution and 7.9 g with constant TMP predilution HDF, which raises concerns about medium‐term safety.…”

Section: Discussionmentioning

confidence: 99%

Most recently developed polyester polymer alloy dialyzer: A new medium cut‐off membrane?

Maduell,

Rodríguez‐Espinosa,

Rodas

et al. 2024

Artificial Organs

View full text Add to dashboard Cite

BackgroundNew versions of the polyester polymer alloy (PEPA) membrane have appeared over the years, with increases in both the pore size and the amount of polyvinylpyrrolidone (PVP) to optimize hydrophilicity performance. This study aimed to assess the efficacy of the most recently developed PEPA dialyzer, the FDY series, in hemodialysis (HD) modality in terms of uremic toxin removal and albumin loss and to compare it with that of several high‐flux dialyzers currently used in HD and post‐dilution hemodiafiltration (HDF) treatments.MethodsA prospective study was carried out in 21 patients. All patients underwent six dialysis sessions with the same routine dialysis parameters; only the dialyzer and/or the dialysis modality varied: FX80 in HD, FDY 180 in HD, Clearum HS17 in HDF, Elisio 19H in HDF, Vitapes 180 in HDF, and FX80 in post‐dilution HDF. The reduction ratios (RR) of urea, creatinine, ß2‐microglobulin, myoglobin, κFLC, prolactin, α1‐microglobulin, α1‐acid glycoprotein, λFLC, and albumin were compared intraindividually. Dialysate albumin loss was also measured.ResultsBoth membranes FDY and FX80 are high‐flux dialyzers and are applied here in high‐flux HD. The average RR of β2‐microglobulin was slightly lower in the two HD treatments than in the HDF treatments. Comparison of dialysis treatments revealed that the PEPA FDY dialyzer in the HD modality was more effective than the FX80 dialyzer in high‐flux HD and was as effective as post‐dilution HDF, especially in terms of myoglobin, κFLC, prolactin, α1‐microglobulin, and λFLC RRs. The FDY treatments obtained similar albumin RR in blood and slightly higher dialysate albumin loss, although the values were clinically acceptable.ConclusionsThe most recently developed PEPA dialyzers in the HD modality were as effective as all treatments in the HDF modality and were clearly superior to high‐flux helixone HD treatment. These results confirm that this dialyzer should be categorized within the medium cut‐off (MCO) membrane classification.

show abstract

“…Retrospective small observational studies suggest that pre-dilution OL-HDF may ameliorate various uraemic symptoms, such as loss of appetite, resulting in an improved nutritional status and preserved muscle volume, relief of shoulder pain and lower prevalence of dialysis related amyloidosis, itching, insomnia and restless legs syndrome [ 15 , 16 ]. A study conducted by the Japanese Society for Haemodiafiltration (JSHDF) showed the non-inferiority of pre-dilution OL-HDF with regard to intradialytic haemodynamic stability compared with the post-dilution mode [ 8 ].…”

Section: Clinical Benefits Of Various Modes Of High-volume Ol-hdfmentioning

confidence: 99%

High-volume online haemodiafiltration treatment and outcome of end-stage renal disease patients: more than one mode

Schiffl

2020

Int Urol Nephrol

View full text Add to dashboard Cite

The reduction of the dismally high mortality of current end-stage renal disease patients maintained on conventional standard haemodialysis (HD) remains an unmet medical need. Online haemodiafiltration (HDF) modes with various sites of fluid substitution (post-, pre-, mixed-and mid-dilution) are increasingly used worldwide as promising alternatives to conventional HD. Large scale cohort studies, post hoc analyses of randomized trials, and individual participant meta-analyses suggest that post-dilution and pre-dilution, especially with high substitution volumes, improve outcomes compared with conventional standard HD. However, there is no definitive proof of a survival advantage of HDF over standard HD. The different modes of high-volume HDF should be considered a therapeutic platform allowing to personalize and tailor routine HDF treatment. The selection of the HDF mode should be made according to individual patient characteristics. Utilizing high retention onset membranes, expanded haemodialysis (HDx) can achieve the same solute removal performance as HDF. Subgroups of high-volume OL-HDF patients could benefit from HDx. Ongoing and future trials should provide definitive proof for the superiority of high-volume OL-HDF over conventional HD or HDx to give guidance for the most favourable mode of dialytic therapy for clinical use.

show abstract

Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration

Cited by 5 publications

References 9 publications

<p>Prevalence and Risk Factors of Restless Legs Syndrome in Hemodialysis Patients</p>

<p>Prevalence and Risk Factors of Restless Legs Syndrome in Hemodialysis Patients</p>

Most recently developed polyester polymer alloy dialyzer: A new medium cut‐off membrane?

High-volume online haemodiafiltration treatment and outcome of end-stage renal disease patients: more than one mode

Contact Info

Product

Resources

About