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Hemodialysis - From Basic Research to Clinical Trials (Contributions to Nephrology) PDF

277 Pages·2008·2.8 MB·english
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Hemodialysis – From Basic Research to Clinical Trials Contributions to Nephrology Vol. 161 Series Editor Claudio Ronco Vicenza Hemodialysis – From Basic Research to Clinical Trials Volume Editors Claudio Ronco Vicenza Dinna N. Cruz Vicenza 35 figures, 2 in color, and 14 tables, 2008 Basel·Freiburg·Paris·London·New York·Bangalore· Bangkok·Shanghai·Singapore·Tokyo·Sydney Contributions to Nephrology (Founded 1975 by Geoffrey M. Berlyne) Claudio Ronco Dinna N. Cruz Department of Nephrology Department of Nephrology St. Bortolo Hospital St. Bortolo Hospital Viale Rodolfi 37 Viale Rodolfi 37 IT-36100 Vicenza (Italy) IT-36100 Vicenza (Italy) Library of Congress Cataloging-in-Publication Data Hemodialysis : from basic research to clinical trials / volume editors, Claudio Ronco, Dinna N. Cruz. p. ; cm. – (Contributions to nephrology, ISSN 0302-5144 ; v. 161) Includes bibliographical references and indexes. ISBN 978-3-8055-8566-8 (hard cover : alk. paper) 1. Hemodialysis. I. Ronco, C. (Claudio), 1951– II. Cruz, Dinna N. III. Series. [DNLM: 1. Renal Dialysis–trends. W1 CO778UN v.161 2008 / WJ 378 H4884 2008] RC901.7.H45H448 2008 617.4(cid:1)61059–dc22 2008015981 Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents®and Index Medicus. Disclaimer. The statements, options and data contained in this publication are solely those of the individ- ual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. © Copyright 2008 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland) www.karger.com Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel ISSN 0302–5144 ISBN 978–3–8055–8566–8 Contents IX Preface Ronco, C.; Cruz, D.N. (Vicenza) Dialysis Technology 1 Water Treatment for Dialysis: Technology and Clinical Implications Hoenich, N.A. (Newcastle upon Tyne); Levin, R. (New York, N.Y.) 7 Dialysate Composition Viganò, S.M.; Di Filippo, S.; Manzoni, C.; Locatelli, F. (Lecco) Vascular Access 12 Challenge for the Interventional Nephrologist: Monitoring the Arteriovenous Fistula Campos, R.; Riella, M.C. (Paraná) 23 Preoperative Hemodialysis Fistula Evaluation: Angiography, Ultrasonography and Other Studies, Are They Useful? Weitzel, W.F. (Ann Arbor, Mich.) 30 Endovascular Procedures Asif, A. (Miami, Fla.) 39 Optimal Management of Central Venous Catheters for Hemodialysis Canaud, B.; Chenine, L.; Henriet, D.; Leray, H. (Montpellier) V Epidemiology and Practice 48 Trends in Medication Use and Clinical Outcomes in Twelve Countries: Results form the Dialysis Outcomes and Practice Patterns Study (DOPPS) Tentori, F. (Ann Arbor, Mich.) 55 Epigenetics and the Uremic Phenotype: A Matter of Balance Stenvinkel, P.; Ekström, T.J. (Stockholm) 63 The Burden of Cardiovascular Disease in Patients with Chronic Kidney Disease and in End-Stage Renal Disease Zoccali, C. (Reggio Calabria) Inflammation 68 BNP and a Renal Patient: Emphasis on the Unique Characteristics of B-Type Natriuretic Peptide in End-Stage Kidney Disease Haapio, M. (Helsinki); Ronco, C. (Vicenza) 76 Potential Interplay between Nutrition and Inflammation in Dialysis Patients Kuhlmann, M.K. (Berlin); Levin, N.W. (New York, N.Y.) 83 Microinflammation and Endothelial Damage in Hemodialysis Merino, A.; Nogueras, S.; Buendía, P.; Ojeda, R.; Carracedo, J.; Ramirez-Chamond, R.; Martin-Malo, A.; Aljama, P. (Cordoba) 89 Oxidative Stress and Anemia in Chronic Hemodialysis: The Promise of Bioreactive Membranes Cruz, D.N.; de Cal, M.; Ronco, C. (Vicenza) Fluid Management 99 Consequences of Overhydration and the Need for Dry Weight Assessment Raimann, J.; Liu, L.; Ulloa, D.; Kotanko, P.; Levin, N.W. (New York City, N.Y.) 108 Body Composition and Outcomes in Chronic Hemodialysis Patients Hirachan, P.; Thijssen, S.; Levin, N.W.; Kotanko, P. (New York, N.Y.) 115 Whole-Body Spectroscopy (BCM) in the Assessment of Normovolemia in Hemodialysis Patients Wizemann, V.; Rode, C.; Wabel, P. (Bad Homburg) 119 Blood Volume Monitoring Winkler, R.E.; Pätow, W.; Ahrenholz, P. (Rostock) Contents VI Uremic Toxicity 125 From Uremic Toxin Retention to Removal by Convection: Do We Know Enough? Vanholder, R.; Meert, N.; Schepers, E.; Glorieux, G. (Gent) 132 Oxidative Stress in Hemodialysis Himmelfarb, J. (Portland, Me.) 138 Determinants of Insulin Resistance and Its Effects on Protein Metabolism in Patients with Advanced Chronic Kidney Disease Siew, E.D.; Ikizler, T.A. (Nashville, Tenn.) Treatment Efficacy 145 What Is Important in Dialysis? The Frequency of Treatment Sessions Lindsay, R.M. (London, Ont.) 154 Treatment Time Chazot, C.; Jean, G. (Tassin) 162 Membrane Characteristics Viganò, S.M.; Di Filippo, S.; Manzoni, C.; Locatelli, F. (Lecco) 168 What Is Important in Dialysis? Efficiency: Blood Flow, KoA and Kt/V? Gotch, F. (New York, N.Y.) 178 Cross-Membrane Flux Is a Major Factor Influencing Dialysis Patient Outcomes Canaud, B.; Chenine, L.; Henriet, D.; Leray, H. (Montpellier) Advanced Techniques 185 Inflammatory Pattern in Hemodiafiltration Panichi, V.; Paoletti, S.; Consani, C. (Pisa) 191 Online Hemodiafiltration: A Multipurpose Therapy for Improving Quality of Renal Replacement Therapy Canaud, B.; Chenine, L.; Henriet, D.; Leray, H. (Montpellier) 199 Biofeedback-Driven Dialysis: Where Are We? Santoro, A.; Ferramosca, E.; Mancini, E. (Bologna) Calcium/Phosphate Homeostasis 210 Calcium and Phosphorus Kinetics in Hemodialysis Therapy Gotch, F. (New York, N.Y.) Contents VII 215 Impact of Ca/P Disorders on Risks and Comorbidities Messa, P. (Milan) 222 Diagnostic Procedures and Rationale for Specific Therapies in Chronic Kidney Disease-Mineral and Bone Disorder Bover, J.; Canal, C.; Marco, H.; Fernandez-Llama, P.; Bosch, R.J.; Ballarín, J. (Barcelona) 234 Preventive Measures and New Pharmacological Approaches of Calcium and Phosphate Disorders Cozzolino, M.; Galassi, A.; Pasho, S., Fallabrino, G.; Gallieni, M.; Brancaccio, D. (Milan) Correction of Anemia 240 Insights in Anemia Management de Francisco, A.L.M.; Piñera, C. (Santander) 247 Red Blood Cell Lifespan, Erythropoiesis and Hemoglobin Control Kruse, A. (New York, N.Y.); Uehlinger, D.E., (Uppsala/Bern); Gotch, F.; Kotanko, P.; Levin, N.W. (New York, N.Y.) 255 New Erythropoiesis-Stimulating Agents: How Innovative Are They? Del Vecchio, L.; Locatelli, F. (Lecco) 261 Is the Advent of Biosimilars Affecting the Practice of Nephrology and the Safety of Patients? Ronco, C. (Vicenza) 271 Author Index 272 Subject Index Contents VIII Preface The 17th Annual International Vicenza Course on Hemodialysis has yet another exceptional group of speakers and we are excited that this volume of Contributions to Nephrologyis ready to guide attendees through the event and serve as a valuable tool for the future. All contributions have been collected and published in this volume as a result of the effort of all authors and the team of the Department of Nephrology at San Bortolo Hospital in Vicenza. Hemodialysis today moves towards innovative techniques, biomaterials and devices with an absolute need for solid evidence around every new treat- ment or technology. Based on this concept, the course and this book are focused on innovative technology and new therapies from bench to bedside. The continuous effort to improve patient care follows the complex pathway from basic research to clinical trials. We have devoted a good deal of time to the topic of uremic toxins with contributions dealing with this puzzling prob- lem from different points of view. Other emphasized areas include cardiovas- cular disease examined in its many facets and vascular access. As always, significant attention is placed on the physiological undertakings of treatments. Part of the program deals with practical questions in the dialysis unit. We are privileged to have such a superior group of speakers who can elaborate on these issues and discuss controversies that arise in the world of hemodialysis. Special attention has been placed on the problems of calcium and phosphate disorders, on the management of anemia, and finally on different biological disorders affecting the patients on dialysis. Once more, all these aspects are debated in light of international surveys, objective expert evaluation and recent clinical trials. IX

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