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Introduction: Catheter dysfunction is a concern when using double-lumen catheters in hemodialysis (HD). Reversing the connection mode results in higher blood flows, but also enhanced recirculation. We evaluated total solute removal (TSR) of different uremic retention solutes during a complete HD session, once with reversed (RL) and once with correctly connected lines (CL). Methods: Genius dialysis was performed in 22 HD patients at maximum blood flow (QB), once with CL and once with RL. TSR was determined for urea, creatinine, phosphate and ß2-microglobulin (ß2M). Using a kinetic model, we simulated TSR and reduction ratio (RR) for urea for different percentages of access recirculation and different QB during CL vs. RL. Results: RR and TSR of the tested solutes were not different in clinical practice between CL and RL. Mathematically, urea RR did not differ with CL or RL, but TSR decreased by 4.5%-23.3% when changing from CL to RL for a recirculation of 5%-25%, respectively. For a recirculation of 5%-25%, QB in RL should be increased by 6.7% and 52.0%, 8.5% and 72.0%, and 10.0% and 115.2%, respectively, for a blood flow in CL mode of 150, 200 or 250 ml/min. Conclusions: Connecting patients to double-lumen dialysis catheters in RL does not impair TSR in clinical practice. Mathematically, TSR during RL was dependent upon the obtained QB and degree of recirculation. A nomogram indicating the increase in QB needed in RL to obtain equal TSR as in the CL mode, at different degrees of recirculation, is provided.
Renal Division, Ghent University Hospital, Ghent - Belgium.
This article was published in the following journal.
Name: Journal of nephrology
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The association of Morse taper implant-abutment design with the use of a smaller abutment diameter (platform-switching) may improve dental implant success rate and prevent peri-implant bone loss. The ...
For a six-month period, all airway options used for non-emergent patients undergoing thoracic surgery requiring one-lung ventilation at a single institution were assessed after introduction of the Viv...
To compare the efficacy and safety of two different shaping methods for double-lumen endotracheal tube (DLT).DLT was shaped with the rod of a Shikani optical stylet (SOS) with the tracheal orifice ali...
One lung ventilation (OLV) has become a standard procedure for the vast majority of interventions in pulmonary surgery. It is used in both techniques: thoracotomy and videothoracoscopy (VA...
A technique not yet described in the literature and allowing anesthesiologists who do not regularly practice fibroscopy or who do not routinely have this type of apparatus for their proced...
The purpose of this study is to assessed the efficacy of a combined solution of ethanol (4%) and low molecular weight heparins LMWH in preventing tunnelled dialysis catheter infection in c...
The purpose of this study is to investigate whether cloxacillin lock is effective in prevention of double lumen infection.
The investigators sought to compare the time to intubation and success rate of the endotracheal intubation using standard double-lumen tube and video tube ETView DL in an adult cadaver mod...
Gene rearrangement of the B-lymphocyte which results in a substitution in the type of heavy-chain constant region that is expressed. This allows the effector response to change while the antigen binding specificity (variable region) remains the same. The majority of class switching occurs by a DNA recombination event but it also can take place at the level of RNA processing.
Discrete abnormal tissue masses that protrude into the lumen of the DIGESTIVE TRACT or the RESPIRATORY TRACT. Polyps can be spheroidal, hemispheroidal, or irregular mound-shaped structures attached to the MUCOUS MEMBRANE of the lumen wall either by a stalk, pedunculus, or by a broad base.
A prosthesis or restoration placed for a limited period, from several days to several months, which is designed to seal the tooth and maintain its position until a permanent restoration (DENTAL RESTORATION, PERMANENT) will replace it. (From Jablonski, Dictionary of Dentistry, 1992)
RNA consisting of two strands as opposed to the more prevalent single-stranded RNA. Most of the double-stranded segments are formed from transcription of DNA by intramolecular base-pairing of inverted complementary sequences separated by a single-stranded loop. Some double-stranded segments of RNA are normal in all organisms.
Congenital absence of the teeth; it may involve all (total anodontia) or only some of the teeth (partial anodontia, hypodontia), and both the deciduous and the permanent dentition, or only teeth of the permanent dentition. (Dorland, 27th ed)
Nephrology - kidney function
Nephrology is a specialty of medicine and pediatrics that concerns itself with the study of normal kidney function, kidney problems, the treatment of kidney problems and renal replacement therapy (dialysis and kidney transplantation). Systemic conditions...
Benign Prostatic Hyperplasia (BPH) Erectile Dysfunction Urology Urology is the branch of medicine concerned with the urinary tract and diseases that affect it. Examples include urethritis, urethrostenosis and incontinence. Urology is a su...
In medicine, dialysis is a process for removing waste and excess water from the blood, and is primarily used to provide an artificial replacement for lost kidney function in people with renal failure. Dialysis may be used for those with an acute disturba...