James F Winchester

..Extensive clinical studies are underway to demonstrate the clinical utility and safety of adding routinely a sorbent hemoperfusion device to hemodialysis...

..There seems to be a relative risk reduction in mortality when patients are treated with dialysis membranes that have a higher clearance of beta-2 microglobulin...

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..In the event of overwhelming illness and the patient's perception of the futility of continuation of dialysis, cessation of dialysis must be approached in a humane, considerate, and compassionate manner...

..Tables of drugs removed by both techniques are given for guidance. These tables will be updated regularly on the Advances in Renal Replacement Therapy website...

..Clinical application of hemoperfusion devices containing these sorbents is early in its development. Studies related to hemoperfusion in uremia are discussed in detail...

..Sorbent devices added to hemodialysis, or the use of such devices alone in inflammatory states, including sepsis, ARF, cardiopulmonary bypass, pre-explantation of donor organs and ESRD, are being studied...

..Few data are available on the impact of residual renal function (RRF) on mortality and hospitalization in hemodialysis (HD) patients. The objective of our study was to compare clinical outcomes for HD patients with and without RRF...

..The kidney injury caused the accumulation of metformin, leading to lactic acidosis and acute pancreatitis. Sodium bicarbonate hemodialysis not only improved the metabolic abnormalities but also hastened the removal of metformin...

..TESS data do not separate continuous renal replacement therapy from hemodialysis, and not all poisonings were reported in this system. Nonetheless, these trends are useful to the nephrology community...

..This article will discuss the principles of drug removal, the indications for dialysis, and give a brief outline of poisons amenable to dialysis...

..Little attention is paid to the potential for harm to patients, and to the profession of medicine, from the widespread use of guidelines...

..Potential applications include daily home dialysis, treatment of acute renal failure in the ICU, ultrafiltration of ascites, and the wearable artificial kidney...

..Hyperuricemia is associated with hypertension, coronary artery disease, and chronic kidney disease. However, there are no specific data on the relationship of uric acid to cardiovascular disease in the chronic hemodialysis setting...

..Factors influencing dialytic removal of LMWPs such as membrane characteristics, protein-membrane interactions, and solute removal mechanisms, as well as strategies to enhance clearance of these compounds are discussed...

..This all but guarantees many guidelines are obsolete by the time they are published. Guidelines are produced with industry support and recommendations often have a major impact on sales of industry products...

..Body size has changed in the US and Canada over the last few decades and there are similar changes worldwide. We suggest that the minimum targets for peritoneal dialysis be reinstituted at the previous standard Kt/V(urea) of 2.0...

..Sorbents assist the process of peritoneal dialysate regeneration and have the potential to improve the efficiency of continuous flow peritoneal dialysis...

..In the meantime, we must continue to use less than ideal evidence and our own experience in dealing with these controversial issues to guide our decision-making process...

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..However, these equations require complex calculations and several parameters. We derived an equation to estimate creatinine clearance (eCCr) rapidly...

..X-Sorb appears to be an effective sorbent for myoglobin and warrants a trial in vivo to determine whether it is equally effective and safe...

..This article will review the evidence supporting the importance of RRF on outcome and outline potential strategies that may better preserve RRF in patients on dialysis...

..Molecular structure and chemical modifications of the surface beads of this cartridge should prevent exposure of dense hydrophobic surface sites to proteins, and avoid the major drawbacks of previous polystyrene-type adsorbent materials...

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..CONCLUSION: The sorbent beads removed uremic solute(s) that prime monocytes to enhanced cytokine production. Removal of beta2M was efficient, and of native and AGE-modified middle molecules likely...

..The atypically low hospitalization and mortality rates for the conventional monitoring group suggest that these findings should be generalized to the US hemodialysis population with caution...

..This study seeks to define the relationship between IDWG and BP in prevalent hemodialysis subjects...