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 ...

OBJECTIVE Patients on continuous ambulatory peritoneal dialysis are frequently referred for radiologic evaluation of complications related to the dialysis. We studied the value of CT peritoneography in evaluating these complications. CT peritoneography is a technique in which CT scans are obtained after dialysis fluid containing iodinated contrast material is infused into the peritoneal cavity ...

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...

Universal lower dialysate [Na+] is often advocated as a means of improving the dire cardiovascular plight of our dialysis patients. However, there is evidence associating lower dialysate [Na+] and increased morbidity and mortality especially in frailer patients, probably as a result of more frequent intra-dialytic hypotension. In this editorial, we summarize arguments for and against lower dial...