C Ronco

..We undertook a prospective randomised study of the impact different ultrafiltration doses in continuous renal replacement therapy on survival...

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..The flow distribution is slightly affected by changes in flow rate and hematocrit showing an optimal utilization of the available surface for molecule adsorption...

..In particular, high-flux dialyzers with a reduced hollow fiber diameter are compared with standard dialyzers in terms of internal filtration and solute clearances...

..Several innovative features have been implemented by the manufacturer. These constructive approaches seem to have produced a positive effect on the dialyzer performance at the bedside...

..Such optimization might be due both to the improved dialyzer design at the level of the blood header and to the specific fiber undulation that prevents dialysate channeling...

..We undertook a prospective randomised study of the impact of different ultrafiltration doses in continuous renal replacement therapy on survival...

..No side effects occurred during treatment and we conclude that cellulose triacetate may be considered a good alternative to synthetic membranes in continuous renal replacement therapies...

..We concluded that the new Prismaflex is a well designed new machine for CRRT and can be safely and effectively utilized in the critical care nephrology setting...

..The data from this pilot study provide no evidence for a difference in hemodynamic effects between pulse HVHF and CPFA in patients with septic shock already receiving CRRT. A larger sample size is needed to adequately explore this issue...

..Continuous blood volume monitoring, blood pressure and heart rate variability inform clinical decision-making, but integrated use of multiple methodologies to achieve dry weight and understand patient factors has not yet been described...

..7%) or CVC (29.7%) or both (67.6%). After removal and replacement of CVCs and antibiotic therapy and the strict application of an infection management protocol, there were no more fever episodes or cultures positive for M. radiotolerans...

..Hypotension is caused by a drop in blood volume during ultrafiltration, followed by vasoconstriction and reduced perfusion in some regions of the body...

..SCT might represent an interesting option for the future especially in patients with hemodynamic instability and requirements for interventions during treatment...

..The results so far achieved seems to offer advantages in terms of high flows, minimal pressure regimes and negligible recirculation...

..The advent of automated machines has partially overcome this problem. Nevertheless, there are conditions and operation modes in which the potential for fluid balance errors is still present...

..Some of its features including a RIFLE class alert system, may help the treating physician to collect systematically AKI data in the ICU and possibly may guide specific decision on the institution of renal replacement therapy...

..Due to its lower implantation site this catheter demonstrates excellent wearability and good body image acceptance...

..In particular, we will focus on the importance of increased ultrafiltration volume and its impact on mortality in the general ICU population and in septic patients...

..These therapies could be able to reduce the peaks of the pro- and anti-inflammatory substances circulating during the syndrome, leading to a less severe degree of inflammation and immunodepression...

..Meanwhile, monitoring the drug serum concentration is still mandatory whenever clinically feasible...

..In conclusion, pro-apoptotic factors can be eliminated by dialytic membranes with the removal rate maximized by using super high flux dialysers which may represent a compromise between hemofiltration and plasmafiltration membranes...

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..This paper describes the rationale and potential of this technique. Reliability and tolerance of this technique and biological effects are described...

..To examine the ethical approach of clinicians to the continuous renal replacement therapy (CRRT)...

..The physiological stability provided by continuous therapies such as CVVH avoids this unwanted effect, and suggests that continuous renal replacement therapies should be a first choice in these patients...

..Although these approaches are still in the early stages of clinical testing, they are conceptually promising and might represent an important advance...

..Our aim was to evaluate the correlation between them and to compare the prevalence of each CKD stage using these two equations...

..The new radiological technique using the helical CT scanner allows detailed flow distribution analysis and has the potential for testing future modifications to dialyzer design...

..The experimental method utilized to analyze flow distribution seems to represent an important means to study the performance and design of this type of device...

..This paper describes the characterisation of the essential structure- and permeation-related parameters of the new membrane using a number of physical analytical techniques...

..Significant streaming of dialysate from port to port within the peritoneal cavity limited clearances. CFPD offers a potentially safe and effective alternative to daily or nightly home hemodialysis...

..The system could become an important complementary therapy for patients with congestive heart failure for whom classic methods of treatment have failed or simply are not available...

..The potential for a home-based application of these techniques represents a further stimulating concept to be investigated...

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..This is also crucial for renal recovery during acute renal failure...

..The apparent survival benefit among patients who have diabetes and are treated with high-flux membranes requires confirmation given the post hoc nature of our analysis...

..It is anticipated that treatment of plasma, as a device modular to conventional hemofiltration, may pave the way to innovative approaches to the extracorporeal treatment of septic patients...

..To study the approach of health care workers (HCW) to informed consent for therapy and research in the field of continuous renal replacement therapy (CRRT)...

..Pregnancy after kidney transplant has become possible thanks to the recent surgical and pharmacological breakthrough...

..The use of on-line blood volume monitors can be of further help in improving tolerance and the hemodynamic response...

..We hypothesized that increasing the filtration and backfiltration fluxes by modifying the structure of the dialyzer could enhance the convective transport of various solutes...

..The extracted plasma is then available for any type of treatment before being restituted to the patient via a second lumen in the same catheter...

..The mechanism of action is related to the wide antimicrobial spectrum and the rapid action of sodium hypochlorite possibly creating a protective barrier on the exit-site...

..The hardware and software of the newer continuous renal replacement therapies (CRRT) are certainly the key point in achieving these results and in safely performing such challenging techniques...

..In this regard, at least for CRRT, we anxiously await the results of the ongoing RCTs evaluating the effect of CRRT dose on patient outcome...

..The increasing use of computers and the evolution of the applied software will certainly help in reducing the costs and improving the performances of our newer dialysis devices...

..However, the lack of any meaningful outcome data for this therapy invalidates any claims of clinical "equivalence" to the other established modalities...

..The hardware and software of the newer CRRT systems are key in achieving these results and in safely performing such challenging techniques...

..The plasma bicarbonate level is determined by the dialytic base gain and the metabolic acid production. Bicarbonate buffered PD solution provides some advantages over the conventional lactate buffered PD solution...

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..In particular, urea clearances up to 48 ml/min and creatinine clearances up to 39 ml/min were obtained. No major complications were observed after one year of use of the catheter...

..The particularly low mortality of the center (6%/yr) may also be ascribed to a lower incidence of diabetes and other comorbidities...

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..This paper briefly reviews the most recent advances in the design and construction of haemodialyzers and points out the clinical impact of such innovations...

..4%. The study aims to investigate reasons for the high prevalence of ADPKD in our region and to describe the clinical profile and genetics of these patients...

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..The only variables are dialysate volume, flow, dwell time, and composition. Thanks to modification in these aspects of the dialysate, peritoneal dialysis techniques with different clearances and ultrafiltration rates can be accomplished...

..Recent developments in technology seem to have made CFPD easily feasible and well tolerated. A new era of PD is probably beginning and CFPD will definitely represent one of the key issues in the future of PD...

..In conclusion, the hemorheological variables change after dialysis in the direction which may impede the flow inside the microvessels...