During peritoneal dialysis solutes and water are transported across the peritoneum, a thin “membrane” lining the abdominal and pelvic cavities. Dialysis fluid containing an “osmotic agent”, usually glucose, is infused into the peritoneal space, and solutes and water pass from the blood into the dialysate (and vice versa). The complex physiological mechanisms of fluid and solute transport betwee...

The aim of the study was to explore the possibility of utilizing UV-absorbance measurements of spent dialysate to assess urea rebound. Ten patients on chronic three-times-a-week hemodialysis were included in the study. On-line UV-absorbance of spent dialysate was monitored. Urea rebound was calculated based on urea concentration in blood (Rb) and UV-absorbance in spent dialysate (Ra). Rb and Ra...

The long-term clinical effects of the use of a low calcium concentration in the dialysate are largely unknown. For this reason, the influence of low-calcium dialysate on parathyroid hormone (PTH) secretion in hemodialysis patients and its long-term effect on the severity of secondary hyperparathyroidism were studied. In 35 hemodialysis patients, the dialysate calcium concentration was lowered f...

Peritoneal dialysis can be considered a "wearable" dialysis therapy. However, patients typically require 3 or 4 daily exchanges, each taking 20-40 minutes and potentially increasing the risk of infection by repeated disconnection and reconnection. Although peritoneal dialysis cyclers allow patients to be "free" from their machine for 13-15 hours, they similarly need a supply of fresh dialysate....

BACKGROUND Protein-bound toxins such as indoxyl sulfate (IS) are not efficiently removed by conventional hemodialysis (HD). OBJECTIVES To improve the removal of IS, we performed an in vitro study to evaluate the effects of high dissolved hydrogen on the dissociation of IS from albumin using simulated HD. MATERIALS AND METHODS Wasted dialysate from peritoneal dialysis was concentrated a hund...

The optimal dialysate sodium concentration for chronic hemodialysis patients remains controversial. Conflicting data from small observational studies and large cohort study have not convinced nephrologists to choose either a high or low dialysate. Despite lack of evidence, I would prescribe individualized concentrations with risk hypertension volume overload, aligning the patients’ predialysis ...

When encountering unusually appearing dialysate effluent from a patient doing peritoneal dialysis, it is important to review the patient’s recent exposures. In the case of “black”-appearing dialysate effluent, consideration needs to be given to the possibility of someone having undergone a colonoscopy and having tattooing with India ink. Nephrology nurses are frequently the first to be notified...

BACKGROUND Recent dialyzer-related developments have concentrated upon the improvement of performance and biocompatibility. The focus of these developments was predominantly on the membrane itself. A newly developed high-flux dialyzer (FX60) with an advanced Fresenius Polysulfone) membrane (Helixone) overcomes this limitation and has several design-related advantages attributed to the redesign ...

A Best Practice Guideline about Dialysis fluid purity was developed under the leadership of the Spanish Society of Nephrology in 2004. The second edition revised Guideline considered new evidences and International Standard. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. This Guideline is based on ...

It has been suggested that hemodynamic instability and impaired vascular reactivity during combined ultrafiltration-hemodialysis are related to bioincompatibility factors such as dialysate-derived contaminants or the dialyzer. The study presented here investigated whether vascular reactivity could be improved by the use of sterile dialysate. Forearm vascular resistance and venous tone (measured...