Reuse and Biocompatibility of Hemodialysis Membranes: Clinically Relevant?

Upadhyay, Ashish; Jaber, Bertrand L.

doi:10.1111/sdi.12574

Cited by 11 publications

(18 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In low-to-middle-income countries, the practice of dialyzer reuse is common [ 67 , 68 ]. However, multiple dialyzer reuse may contribute to negative outcomes [ 69 ] such as infection risks, biochemical and immunologic reactions, improper sterilization, increased membrane permeability [ 49 ], and loss of performance leading to inadequate dialysis adequacy.…”

Section: Iatrogenic Factors Of Malnutritionmentioning

confidence: 99%

“…However, multiple dialyzer reuse may contribute to negative outcomes [ 69 ] such as infection risks, biochemical and immunologic reactions, improper sterilization, increased membrane permeability [ 49 ], and loss of performance leading to inadequate dialysis adequacy. These issues are believed to arise from the reprocessing procedure involving sanitizing agents [ 67 , 70 ]. However, two studies have indicated that single, minimal (>6 times), or multiple dialyzer reuse carries no impact on dialysis adequacy, body weight, and serum albumin level [ 71 , 72 ].…”

Section: Iatrogenic Factors Of Malnutritionmentioning

confidence: 99%

See 1 more Smart Citation

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

et al. 2020

View full text Add to dashboard Cite

Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.

show abstract

Section: Iatrogenic Factors Of Malnutritionmentioning

confidence: 99%

Section: Iatrogenic Factors Of Malnutritionmentioning

confidence: 99%

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

et al. 2020

View full text Add to dashboard Cite

show abstract

“…15,16 In addition, although some studies show that the all-cause mortality in patients undergoing high flux dialysis may be lower compared to low flux hemodialysis, 15,17 this subject is still a matter of controversy. 18 The association of age and higher levels of bicarbonate had already been reported 3,18 and can be interpreted as a consequence of the lower acid generation in the dialysis interval due to the sarcopenia and reduced physical activity that can affect older hemodialysis patients. Although higher values for Kt/V 3,19 and duration of dialysis session 18 have been individually associated with higher levels of serum bicarbonate, we could not find studies addressing the role of the standard Kt/V in this regard.…”

Section: Discussionmentioning

confidence: 85%

Metabolic acidosis in hemodialysis: a neglected problem in Brazil

2020

View full text Add to dashboard Cite

Introduction: Metabolic acidosis is associated with the high mortality seen in hemodialysis patients. The panorama of metabolic acidosis in hemodialysis in Brazil is unclear since 1996 when the analysis of bicarbonate levels was no longer a compulsory exam. We aimed to establish the prevalence of metabolic acidosis in a hemodialysis population and analyze the factors associated with low bicarbonate levels. Methods: A cross-sectional study was carried out to assess the prevalence of metabolic acidosis in adults undergoing regular hemodialysis from January to April 2017, in four dialysis centers from Niteroi, Rio de Janeiro, Brazil, and surroundings. For blood gas analysis, samples of 2 mL were collected in heparinized syringes before a midweek dialysis session. Results: 384 patients with a mean age of 58.1 ± 15.8 years (54.5% men and 63.0%, non-white) were included. Approximately 30% had diabetes and 48%, hypertension. Nearly 88% used primary arteriovenous fistula as vascular access. The pre-dialysis mean serum tCO2 in the midweek session was 22.7 ± 3.0 mEq/L. The prevalence rate of serum bicarbonate below DOQI recommendation (22 mEq/L or higher) was 40.3%, and 6.5% had serum bicarbonate < 18 mEq/L. The dialyzer use count and the use of low-flux dialyzers were negatively associated whereas age and the standard Kt/V values were positively associated with the serum bicarbonate levels. Conclusion: The findings were in agreement with global data reported in previous studies. However, because the sample was relatively small and non-representative of the Brazilian population, a more comprehensive study, addressing national data is necessary to substantiate our findings.

show abstract

“…The low quality of the evidence in the available studies, acknowledged in the only systematic review we were able to retrieve, and the heterogeneity of the reuse modalities suggest that the time may be ripe for re-thinking this practice in the different context of ecological sustainability. In this regard, future studies should balance the advantages in reducing plastic waste with the need for using potentially toxic chemicals for membrane sterilization [94][95][96][97].…”

Section: Waste Management In Dialysismentioning

confidence: 99%

Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology

et al. 2020

View full text Add to dashboard Cite

High-technology medicine saves lives and produces waste; this is the case of dialysis. The increasing amounts of waste products can be biologically dangerous in different ways: some represent a direct infectious or toxic danger for other living creatures (potentially contaminated or hazardous waste), while others are harmful for the planet (plastic and non-recycled waste). With the aim of increasing awareness, proposing joint actions and coordinating industrial and social interactions, the Italian Society of Nephrology is presenting this position statement on ways in which the environmental impact of caring for patients with kidney diseases can be reduced. Due to the particular relevance in waste management of dialysis, which produces up to 2 kg of potentially contaminated waste per session and about the same weight of potentially recyclable materials, together with technological waste (dialysis machines), and involves high water and electricity consumption, the position statement mainly focuses on dialysis management, identifying ten first affordable actions: (1) reducing the burden of dialysis (whenever possible adopting an intent to delay strategy, with wide use of incremental schedules); (2) limiting drugs and favouring "natural" medicine focussing on lifestyle and diet; (3) encouraging the reuse of "household" hospital material; (4) recycling paper and glass; (5) recycling non-contaminated plastic; (6) reducing water consumption; (7) reducing energy consumption; (8) introducing environmental-impact criteria in checklists for evaluating dialysis machines and supplies; (9) encouraging well-planned triage of contaminated and non-contaminated materials; (10) demanding planet-friendly approaches in the building of new facilities.

show abstract

Reuse and Biocompatibility of Hemodialysis Membranes: Clinically Relevant?

Cited by 11 publications

References 33 publications

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Metabolic acidosis in hemodialysis: a neglected problem in Brazil

Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology

Contact Info

Product

Resources

About