Recombinant hirudin (lepirudin) is a potent direct thrombin inhibitor that is used particularly for treatment of immune-mediated heparin-induced thrombocytopenia. Because hirudin is almost exclusively eliminated by the kidneys, its half-life is markedly prolonged in patients with severe renal insufficiency. Therefore, these patients are at risk for bleeding, particularly because no antidote is ...

BACKGROUND To evaluate the benefits of dialyzer reuse for hemodialysis (HD) patients, including the cost of HD treatment and patient's survival, a comparison was made regarding the standard practice of single-use dialysis. METHODS From January 1, 2005, to December 31, 2005, a total of 128,232 successive HD treatments in 822 patients in Chang Gung Memorial Hospital-Kaohsiung Medical Center wer...

This study was designed to evaluate the pharmacokinetics of vancomycin during hemodialysis with cellulose triacetate (CT) high-flux dialyzers and to assess the influence of membrane surface area on intradialytic clearance. In a randomized crossover fashion, the pharmacokinetics of vancomycin were evaluated during dialysis with the CT 110 and CT 190 membranes. Six hemodialysis patients received ...

AIM We studied various hemodialysis strategies for the removal of protein-bound solutes, which are associated with cardiovascular damage. METHODS This study included 10 patients on standard (3 x 4 h/week) high-flux hemodialysis. Blood was collected at the dialyzer inlet and outlet at several time points during a midweek session. Total and free concentration of several protein-bound solutes wa...

BACKGROUND AND AIM Robust evidence about dialyzer reuse effects on mortality is not available. Our aim was to summarize the evidence for the effectiveness of dialyzer reuse compared to single use in patients with end-stage renal disease. METHODS We searched MEDLINE, Embase, CINAHL, SciELO, LILACS, USRDS ADR, universities' theses databases and annals of congress from major nephrology societies...

Stable PO2 during Hemofiltration in Spite of a Drop in Leucocytes K. Schaefer D. von Herrath M. Hüfler K. Schaefer, D. von Herrath, M.Hüfler, Medizinische Abteilung II, St. Joseph-Krankenhaus, D-1000 Berlin 42 Dear Sir, The pathogenesis of dialysis-induced hypoxemia is still not fully clarified [1]. Several mechanisms have been proposed, of which however only two deserve special attention. Crad...

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Patients receiving hemodialysis are prone to rapid changes in acid-base status with modern high-flux dialyzer membranes. These rarely consequential but may be problematic patients hypoventilation. We present a case of acute hypercapnic respiratory failure following initiation man oliguric kidney injury (AKI) and morb...