المؤلفون: Maduell, Francisco, Broseta, José J, Rodríguez-Espinosa, Diana, Casals, Joaquim, Escudero, Victor, Gomez, Miquel, Rodas, Lida M, Arias-Guillén, Marta, Vera, Manel, Fontseré, Néstor

المصدر: Clinical Kidney Journal ; volume 16, issue 5, page 859-867 ; ISSN 2048-8505 2048-8513

الوصف: Background A key feature of dialysis treatment is the prescription of dialysate sodium (Na). This study aimed to describe the practical implementation of a new automated dialysate Na control biosensor and to assess its tolerance and the beneficial clinical effects of isonatraemic dialysis. Methods A prospective study was carried out in 86 patients who, along with their usual parameters, received the following five consecutive phases of treatment for 3 weeks each: phase 0: baseline 5008 machine; phases 1 and 2: 6008 machine without activation of the Na control biosensor and the same fixed individualized Na dialysate prescription or adjusted to obtain similar conductivity to phase 0; phases 3 and 4: activated Na control to isonatraemic dialysis (Na dialysate margins 135–141 or 134–142 mmol/L). Results When the Na control was activated, the few episodes of cramps or hypotension disappeared when the lower dialysate Na margin was increased by 1 or 2 mmol/L. The activated Na control module showed significant differences compared with baseline and the non-activated Na module in final serum Na values, diffusive Na balance, and changes in pre- to postdialysis plasma Na values. The mean predialysis systolic blood pressure value was significantly lower in phase 4 than in phase 1. There were no significant differences in total Na balance in the four 6008 phases evaluated. Conclusions The implementation of the automated dialysate Na control module is a useful new tool, which reduced the diffusive load of Na with good tolerance. The module had the advantages of reducing thirst, interdialytic weight gain and intradialytic plasma Na changes.

الإتاحة: https://doi.org/10.1093/ckj/sfad013Test
https://academic.oup.com/ckj/article-pdf/16/5/859/56811880/sfad013.pdfTest

المؤلفون: Casals, Joaquim, Broseta, José Jesús, Fernández, Rosa María, Rodriguez-Espinosa, Diana, del Risco, Jimena, Gómez, Miquel, Rodas, Lida M., Arias-Guillén, Marta, Vera, Manel, Fontseré, Néstor, Rico, Naira, Maduell, Francisco

المصدر: Nefrología ; ISSN 0211-6995

مصطلحات موضوعية: Nephrology

الإتاحة: https://doi.org/10.1016/j.nefro.2023.09.004Test
https://api.elsevier.com/content/article/PII:S0211699523001455?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0211699523001455?httpAccept=text/plainTest

المؤلفون: Maduell, Francisco, Broseta, José Jesús, Casals, Joaquim, Gómez, Miquel, Rodas, Lida M., Arias-Guillén, Marta, Vera, Manel, Fontseré, Néstor

المصدر: Nefrología (English Edition) ; volume 43, issue 6, page 750-756 ; ISSN 2013-2514

مصطلحات موضوعية: Nephrology

الإتاحة: https://doi.org/10.1016/j.nefroe.2024.01.006Test
https://api.elsevier.com/content/article/PII:S2013251424000087?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2013251424000087?httpAccept=text/plainTest

المؤلفون: Maduell, Francisco, Broseta, José Jesús, Casals, Joaquim, Gómez, Miquel, Rodas, Lida M., Arias-Guillén, Marta, Vera, Manel, Fontseré, Néstor

المصدر: Nefrología ; volume 43, issue 6, page 750-756 ; ISSN 0211-6995

مصطلحات موضوعية: Nephrology

الإتاحة: https://doi.org/10.1016/j.nefro.2022.08.001Test
https://api.elsevier.com/content/article/PII:S021169952200128X?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S021169952200128X?httpAccept=text/plainTest

العنوان البديل: Contrast-induced encephalopathy in patients with advanced chronic kidney disease: What the nephrologist needs to know. (English)

المؤلفون: Escudero-Saiz, Víctor Joaquín, Romani, Nathalie Melissa, Rodríguez, Pastora, Morantes, Laura, Risco-Zevallos, Jimena Del, Casals, Joaquim, Xipell, Marc, Guillén, Elena, Piñeiro, Gastón J., Blasco, Miguel, Rodas, Lida M., Quintana, Luis F., Poch, Esteban, Santana, Daniel, Andújar, Alicia Molina

المصدر: Nefrologia; May/Jun2024, Vol. 44 Issue 3, p317-322, 6p

الملخص (بالإنجليزية): Contrast-induced encephalopathy is a neurological complication related to contrast used in endovascular procedures or computed tomography (CT). The main risk factors are arterial hypertension, diabetes mellitus, chronic kidney disease (CKD), hyperosmolar contrasts, the amount of infused contrast and its direct infusion in the posterior cerebral territory, or pathologies with blood-brain barrier damage. Symptomatology is non-specific and may present as altered level of consciousness, neurological focality or seizures. Diagnosis is done by exclusion after ischemic or hemorrhagic stroke has been ruled out; CT or MRI are useful for differentiation. Generally, it appears shortly after exposure and the symptoms lasts 48-72 h with complete recovery, although cases with persistence of symptoms or longer duration have been described. Treatment consists of monitoring, supportive measures and renal replacement therapy (RRT) with hemodialysis (HD) in patients in chronic RRT program. It is important for the nephrologist to be aware of this entity given the susceptibility of the patient on HD as well as its potential therapeutic role in these patients. [ABSTRACT FROM AUTHOR]

Abstract (Spanish): La encefalopatía por contraste es una complicación neurológica relacionada con el contraste utilizado en procedimientos endovasculares o tomografía computarizada (TC). Los principales factores de riesgo son la hipertensión arterial, la diabetes mellitus, la enfermedad renal crónica (ERC), contrastes hiperosmolares, cantidad de contraste infundida y su infusión directa en el territorio cerebral posterior, o patologías que cursen con daño de barrera hematoencefálica. La sintomatologia es inespecífica y puede presentarse como alteración del nivel de conciencia, focalidad neurológica o crisis comiciales. El diagnóstico es de exclusión tras haber descartado los accidentes cerebrovasculares (ACV) isquémicos o hemorrágicos; el TC o la resonancia magnética (RM) son de utilidad para su diferenciación. Generalmente aparece poco tiempo tras la exposición y la sintomatologia dura 48-72 h con recuperación completa, aunque se han descrito casos con persistencia de los síntomas o mayor duración. El tratamiento es la monitorización con medidas de soporte y la terapia de sustitución renal con hemodiálisis (HD) en aquellos pacientes en programa crónico. Es importante que el nefrólogo conozca esta entidad, dada la susceptibilidad del paciente en HD, asi como su potencial papel terapéutico en estos pacientes. [ABSTRACT FROM AUTHOR]

: Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

العنوان البديل: Correlation of plasmatic sodium determined by the laboratory and that determined by the dialysis machine. (English)

المؤلفون: Casals, Joaquim, Broseta, José Jesús, Fernández, Rosa María, Rodriguez-Espinosa, Diana, Risco, Jimena del, Gómez, Miquel, Rodas, Lida M., Arias-Guillén, Marta, Vera, Manel, Fontseré, Néstor, Rico, Naira, Maduell, Francisco

المصدر: Nefrologia; May/Jun2024, Vol. 44 Issue 3, p417-422, 6p

الملخص (بالإنجليزية): Introduction: Changes in plasma sodium concentration (pNa, expressed in mEq/l) are common in hemodialysis (HD) patients. Hemodialysis monitors can estimate pNa by using an internal algorithm based on ionic dialysance measurements. The present study studies the accuracy of the correlation between the pNa estimated by the dialysis monitor and that measured by the biochemistry laboratory at our center. Material and methods: A single-centre prospective observational study in patients on a chronic HD program with the 6008 CAREsystem monitor and standard sodium (138 mEq/l) and bicarbonate (32mmol/l) prescriptions. Venous blood samples were drawn from each patient before and after each HD session to ensure inter- and intra-individual validity. The pNa was measured in the biochemistry laboratory using indirect potentiometry and simultaneously the estimated pNa by the HD monitor was recorded at the beginning and at the end of the HD session. For statistical analysis, a scatter plot was made, and Spearman's correlation quotient was calculated. In addition, the differences between both methods were represented as Bland-Altman diagrams. Results: The pre-dialysis pNa measured in the laboratory was 137.49 ±3.3, and that of the monitor, 137.96 ±2.91, with a correlation with R² value of 0.683 (P<.001). The post-dialysis pNa measured in the laboratory was 137.08 ± 2.23, and that of the monitor was 138.87 ± 1.88, with an R² of 0.442 (P<.001). On the Bland-Altman plots, the pre-dialysis pNa has a systematic error of 0.49, in favor of the monitor-estimated pNa, with a 95% confidence interval (CI) of (-3.24 to a 4.22). In the post-dialysis pNa, a systematic error of 1.79 with a 95% CI of (-1.64 to 5.22) was obtained. Conclusion: The correlation between the pNa estimated by Fresnius 6008 CAREsystem HD monitor and that measured by the laboratory is good, especially pre-dialysis measurements. Further studies should verify the external validity of these results. [ABSTRACT FROM AUTHOR]

Abstract (Spanish): Introducción: Las alteraciones de la concentración plasmática de sodio (Nap, expresado en mEq/l) son frecuentes en los pacientes en hemodiálisis (HD). Los monitores de HD tienen la capacidad de estimar la Nap mediante un algoritmo interno a partir de las medidas de la dialisancia iónica. En el presente trabajo se estudia la correlación entre la Nap estimada por el monitor de diálisis y la medida en el laboratorio de bioquímica de nuestro centro. Material y métodos: Estudio observacional prospectivo y unicéntrico en los pacientes en programa crónico de HD con el monitor 6008 CAREsystem y prescripción estándar de sodio (138 mEq/l) y bicarbonato (32mmol/l). De cada paciente se extrajeron muestras de sangre venosa antes y después de la sesión para asegurar validez inter e intraindividual. Se analizó la Nap en el laboratorio mediante potenciometría indirecta y simultáneamente se registraba la estimada por el monitor de HD al inicio y al terminar la sesión. Para el análisis estadístico se realizó un diagrama de dispersión y se calculó el cociente de correlación de Spearman. Además, se representaron las diferencias entre métodos mediante diagramas de Bland-Altman. Resultados: La Nap prediálisis medida en el laboratorio fue de 137,49 ±3,3, y la del monitor 137,96 ±2,91, con una correlación con valor de R² de 0,683 (p < 0,001). La Nap posdiálisis medida en el laboratorio fue de 137,08 ±2,23 y la del monitor de 138,87 ±1,88, con una R² de 0,442 (p <0,001). En los diagramas de Bland-Altman, la Nap prediálisis obtuvo un error sistemático de 0,49 mEq/l a favor de la Nap estimada por el monitor, con un intervalo de confianza (IC) al 95% de: -3,24-4,22. En cuanto a la Nap posdiálisis, se obtuvo un error sistemático de 1,79 mEq/l con un IC al 95% de: -1,64-5,22. Conclusión: La correlación entre la Nap estimada por el monitor de HD 6008 CAREsystem de Fresenius y la medida por el laboratorio es buena, siendo mejor en las mediciones prediálisis. Nuevos estudios deberán comprobar la validez externa de estos resultados. [ABSTRACT FROM AUTHOR]

: Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Escudero-Saiz, Víctor Joaquín, Romani, Nathalie Melissa, Rodríguez, Pastora, Morantes, Laura, Del Risco-Zevallos, Jimena, Casals, Joaquim, Xipell, Marc, Guillén, Elena, Piñeiro, Gastón J, Blasco, Miguel, Rodas, Lida M, Quintana, Luis F, Poch, Esteban, Santana, Daniel, Molina Andújar, Alicia

المصدر: Nefrologia (Engl Ed) ; ISSN:2013-2514

مصطلحات موضوعية: Advanced chronic kidney disease, Contraste yodado, Encefalopatía, Encephalopathy, Enfermedad renal crónica avanzada, Iodinated contrast

الوصف: Contrast-induced encephalopathy is a neurological complication related to contrast used in endovascular procedures or computed tomography (CT). The main risk factors are arterial hypertension, diabetes mellitus, chronic kidney disease (CKD), hyperosmolar contrasts, the amount of infused contrast and its direct infusion in the posterior cerebral territory, or pathologies with blood-brain barrier damage. Symptomatology is non-specific and may present as altered level of consciousness, neurological focality or seizures. Diagnosis is done by exclusion after ischemic or hemorrhagic stroke has been ruled out; CT or MRI are useful for differentiation. Generally, it appears shortly after exposure and the symptoms lasts 48-72h with complete recovery, although cases with persistence of symptoms or longer duration have been described. Treatment consists of monitoring, supportive measures and kidney replacement therapy (KRT) with hemodialysis (HD) in patients in chronic KRT program. It is important for the nephrologist to be aware of this entity given the susceptibility of the patient on HD as well as its potential therapeutic role in these patients.

العلاقة: https://doi.org/10.1016/j.nefroe.2023.05.018Test; https://pubmed.ncbi.nlm.nih.gov/38871560Test

الإتاحة: https://doi.org/10.1016/j.nefroe.2023.05.018Test
https://pubmed.ncbi.nlm.nih.gov/38871560Test

المؤلفون: Rodríguez Espinosa, Diana, Montagud Marrahi, Enrique, Cacho, Judit, Arana, Carolt, Taurizano, Natalia, Hermida, Evelyn, Del Risco Zevallos, Jimena, Casals Urquiza, Joaquim, Rosario, Anney, Cuadrado Payán, Elena, Molina Andújar, Alícia, Rodríguez, Néstor, Vilella i Morató, Anna, Bodro, Marta, Ventura Aguiar, Pedro, Revuelta, Ignacio, Cofán Pujol, Federico, Poch, Esteban, Oppenheimer Salinas, Federico, Vera, Manel, Rodas, Lida M., Cases, Aleix, Bayés, Beatriu, Diekmann, Fritz, Maduell, Francisco, Broseta, José Jesús, Cucchiari, David

المصدر: Articles publicats en revistes (Medicina)

مصطلحات موضوعية: COVID-19, Trasplantament renal, Hemodiàlisi, Vacunació, SARS-CoV-2, Kidney transplantation, Hemodialysis, Vaccination

الوصف: Introduction: Given the increased COVID-19 observed in kidney transplant recipients (KTRs) and haemodialysis patients, several studies have tried to establish the efficacy of mRNA vaccines in these populations by evaluating their humoral and cellular responses. However, there is currently no information on clinical protection (deaths and hospitalizations), a gap that this study aims to fill. Methods: Observational prospective study involving 1,336 KTRs and haemodialysis patients from three dialysis units affiliated to Hospital Clínic of Barcelona, Spain, vaccinated with two doses of mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 mRNA vaccines. The outcomes measured were SARS-CoV-2 infection diagnosed by a positive RT-PCR fourteen days after the second vaccine dose, hospital admissions derived from infection, and a severe COVID-19 composite outcome, defined as either ICU admission, invasive and non-invasive mechanical ventilation, or death. Results: Six per cent (18/302) of patients on haemodialysis were infected, of whom four required hospital admission (1.3%), only one (0.3%) had severe COVID-19, and none of them died. In contrast, 4.3% (44/1034) of KTRs were infected, and presented more hospital admissions (26 patients, 2.5%), severe COVID-19 (11 patients, 1.1%) or death (4 patients, 0.4%). KTRs had a significantly higher risk of hospital admission than HD patients, and this risk increased with age and male sex (HR 3.37 and 4.74, respectively). Conclusions: The study highlights the need for booster doses in KTRs. In contrast, the haemodialysis population appears to have an adequate clinical response to vaccination, at least up to four months from its administration.

وصف الملف: 10 p.; application/pdf

العلاقة: Reproducció del document publicat a: https://doi.org/10.1007/s40620-022-01257-5Test; Journal of Nephrology, 2022, vol. 35, num.3, p. 769-778; https://doi.org/10.1007/s40620-022-01257-5Test; http://hdl.handle.net/2445/213982Test; 721878

الإتاحة: https://doi.org/10.1007/s40620-022-01257-5Test
http://hdl.handle.net/2445/213982Test

المؤلفون: Rodríguez-Espinosa, Diana, Montagud-Marrahi, Enrique, Cacho, Judit, Arana, Carolt, Taurizano, Natalia, Hermida, Evelyn, Del Risco-Zevallos, Jimena, Casals, Joaquim, Rosario, Anney, Cuadrado-Payán, Elena, Molina-Andújar, Alicia, Rodríguez, Néstor, Vilella, Anna, Bodro, Marta, Ventura-Aguiar, Pedro, Revuelta, Ignacio, Cofàn, Frederic, Poch, Esteban, Oppenheimer, Frederic, Vera, Manel, Rodas, Lida M., Cases, Aleix, Bayés, Beatriu, Diekmann, Fritz, Maduell, Francisco, Broseta, José Jesús, Cucchiari, David

المصدر: Journal of Nephrology ; volume 35, issue 3, page 769-778 ; ISSN 1724-6059

مصطلحات موضوعية: Nephrology

الإتاحة: https://doi.org/10.1007/s40620-022-01257-5Test

المؤلفون: Maduell, Francisco, Broseta, José Jesús, Rodríguez-Espinosa, Diana, Del Risco-Zevallos, Jimena, Gómez, Miquel, Rodas, Lida M., Arias-Guillén, Marta, Vera, Manel, Fontseré, Néstor, Salgado, Maria del Carmen, Rico, Nayra

المصدر: Blood Purification ; volume 52, issue 1, page 68-74 ; ISSN 0253-5068 1421-9735

مصطلحات موضوعية: Nephrology, Hematology, General Medicine

الوصف: Introduction: The medium cut-off Elisio HX dialyzer by Nipro became commercially available in Europe in 2021, but there are still no reports of in vivo data. This study aimed to evaluate the safety and efficacy of it compared with previously evaluated hemodialysis (HD), expanded HD (HDx), and postdilution hemodiafiltration (HDF) treatments. Methods: A prospective study was carried out on 18 patients who underwent 5 dialysis sessions: FX80 Cordiax in HD, Elisio H19 in HD, Elisio HX19 in HDx, Theranova 400 in HDx, and FX80 Cordiax in HDF. The reduction ratios of urea, creatinine, ß2-microglobulin, myoglobin, kappa FLC, prolactin, α1-microglobulin, α1-acid glycoprotein, lambda FLC, and albumin were compared. Dialysate albumin loss was measured. Results: The comparison between the different dialysis modalities revealed no difference for small molecules, but HDx and HDF were significantly more efficient than HD for medium and large molecule removal. The efficacy of Elisio HX19 dialyzer in HDx was similar to the Theranova 400, superior to both dialyzers in HD, and slightly lower than HDF. Albumin losses in dialysate with HD dialyzers were less than 1 g, but between 1.5 and 2.5 g in HDx and HDF. The global removal score (GRS) values with HDx treatments were statistically significantly higher than those with HD. The highest GRS was obtained with the helixone dialyzer in HDF. Conclusions: The new MCO dialyzer, Elisio HX, performs with excellent behavior and tolerance. It represents an upgrade compared to their predecessor and is very close to the removal capacity of HDF treatment.

الإتاحة: https://doi.org/10.1159/000524644Test
https://karger.com/bpu/article-pdf/52/1/68/3961281/000524644.pdfTest