Therapeutic Apheresis and Dialysis最新文献

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Factors affecting clinical outcomes of continuous and intermittent plasmapheresis in patients with severe hypertriglyceridemia 影响严重高甘油三酯血症患者连续性和间歇性浆膜腔穿刺术临床疗效的因素

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-04-27 DOI: 10.1111/1744-9987.14134

Eiman A. Hussein

IntroductionAcute hypertriglyceridemia is considered a category III indication for plasmapheresis. The use of plasma as replacement fluid (RF) has been suggested to replace the consumed lipoprotein lipase. Heparin when used as an anticoagulant could possibly release lipoprotein lipase, thereby increasing triglyceride clearance.MethodsThe impact of RF (albumin vs fresh frozen plasma (FFP) and anticoagulant (ACD‐A vs. heparin) on triglycerides following plasmapheresis in 27 patients with severe hypertriglyceridemia (SHTG) was investigated. A paired study of four patients with recurrent SHTG was conducted, evaluating continuous (Optia) versus intermittent flow plasmapheresis (Haemonetics).ResultsShorter procedures positively impacted triglycerides (TG) drop post‐sessions p < 0.05. In albumin sessions, patients who used heparin demonstrated significantly greater drop in TG and required less sessions than did those with citrate p < 0.05. In heparin sessions, patients who used albumin demonstrated significantly greater drop in triglycerides and required less sessions than did those with FFP p < 0.05. Three of six patients who used FFP and heparin showed a triglyceride drop of 11.7% following three sessions and a 50% drop with one albumin session. Compared with Haemonetics, Optia removed comparable volumes of plasma in less time, processing smaller blood volumes and using less citrate p < 0.05. Patients demonstrated significantly lower drop in TG and required more sessions with Haemonetics than they did with Optia p < 0.05.ConclusionShorter procedure was the main predictor for effective TG clearance. This can be achieved by continuous apheresis technology, particularly when using albumin as RF. TG removal via Optia seems to be optimized by using heparin.

导言急性高甘油三酯血症被认为是血浆置换术的第三类适应症。有人建议使用血浆作为替代液（RF）来替代消耗掉的脂蛋白脂肪酶。方法研究了白蛋白与新鲜冰冻血浆（FFP）和抗凝剂（ACD-A 与肝素）对 27 例严重高甘油三酯血症（SHTG）患者浆膜清除术后甘油三酯的影响。对四名复发性高甘油三酯血症（SHTG）患者进行了配对研究，评估了持续性（Optia）和间歇性流动血浆置换术（Haemonetics）。在白蛋白疗程中，与使用枸橼酸盐的患者相比，使用肝素的患者甘油三酯下降幅度更大，所需疗程更短 p < 0.05。在肝素疗程中，与使用 FFP 的患者相比，使用白蛋白的患者甘油三酯下降幅度明显更大，所需疗程也更短 p <0.05。在使用 FFP 和肝素的六名患者中，有三名患者在三次治疗后甘油三酯下降了 11.7%，而在一次白蛋白治疗后甘油三酯下降了 50%。与 Haemonetics 相比，Optia 在更短的时间内清除了相当数量的血浆，处理的血量更少，使用的枸橼酸盐更少 p < 0.05。与使用 Optia 的患者相比，使用 Haemonetics 的患者 TG 降幅明显较低，需要的疗程也更多 p < 0.05。持续性血液净化技术可以实现这一目标，尤其是在使用白蛋白作为射频时。使用肝素似乎能优化 Optia 清除 TG 的效果。

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引用次数: 0

A scale development study: Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment 量表开发研究：接受血液透析治疗的患者主要护理者负担量表

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-04-27 DOI: 10.1111/1744-9987.14129

Cansu Kosar Sahin, Hatice Ceylan, Canan Demir Barutcu

IntroductionAs hemodialysis is a long‐term treatment method requiring significant self‐management skills, it affects both the patient and the caregiver in many ways. It is inevitable that changes in the burden perceived by the caregiver over time will not affect the patient's health care outcomes. The aim of this study was to develop an up‐to‐date scale by examining the psychometric properties of items created specifically for the care burden perceived by individuals who provide care for patients receiving hemodialysis treatment.MethodsThis study is a methodological study with the use of the COSMIN Checklist. The sample of the study included 404 individuals who were the primary caregivers of patients receiving hemodialysis treatment. Data were collected using descriptive characteristics form and the draft form of the Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment. Exploratory and confirmatory factor analysis and predictive validity were used to evaluate validity. The Cronbach's alpha reliability coefficient, item analysis, and test–retest method were employed to evaluate reliability.ResultsAccording to exploratory factor analysis, a scale structure with four subdimensions was determined, and goodness of fit was achieved using confirmatory factor analysis. The Cronbach's alpha coefficient of the final form of the scale consisting of 34 items was found to be 0.95 for the total scale, 0.93 for the self‐management support subscale, 0.91 for the psychological support subscale, 0.91 for the caregiver symptom subscale, and 0.93 for the caregiver individual coping subscale.ConclusionThe Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment, which was found to meet the validity and reliability criteria, has a four‐point Likert‐type scoring structure, 34 items, and four subdimensions. It is thought that the scale can make significant contributions to the international literature if its validity and reliability are established with nursing practices and research.

导言：由于血液透析是一种需要大量自我管理技能的长期治疗方法，它对患者和护理人员都有多方面的影响。随着时间的推移，护理人员所感受到的负担的变化不可避免地不会影响患者的医疗结果。本研究的目的是通过检查专为血液透析患者提供护理的个人所感知的护理负担而创建的项目的心理测量特性，来开发一个最新的量表。研究样本包括 404 名接受血液透析治疗患者的主要护理人员。数据收集采用描述性特征表和接受血液透析治疗患者主要照顾者负担量表草案。采用探索性和确认性因素分析及预测有效性来评估其有效性。结果根据探索性因子分析，确定了包含四个子维度的量表结构，并通过确认性因子分析实现了拟合度。由 34 个项目组成的最终量表的 Cronbach's alpha 系数为：总量表 0.95，自我管理支持分量表 0.93，心理支持分量表 0.91，照顾者症状分量表 0.91，照顾者个体应对分量表 0.93。结论接受血液透析治疗的主要照顾者负担量表符合效度和信度标准，具有四点 Likert 式评分结构、34 个条目和 4 个子维度。如果该量表的效度和信度能与护理实践和研究相结合，相信会对国际文献做出重大贡献。

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引用次数: 0

Post‐COVID anxiety, depression, and quality of life among Egyptian hemodialysis patients 埃及血液透析患者在 COVID 后的焦虑、抑郁和生活质量

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-04-17 DOI: 10.1111/1744-9987.14128

Rehab AlSayed Shaban, Ahmed E. Abdulgalil, Ahmed Bahie

IntroductionThis study examined the impact of Coronavirus disease 2019 on anxiety, depression, and health‐related quality of life (HRQOL) among Egyptian hemodialysis (HD) patients.MethodsThis multicenter cross‐sectional study was carried out in Egypt in the years 2021–2022, where 300 HD patients from four HD centers were allocated into two groups: post‐COVID and non‐COVID. The Hospital Anxiety and Depression Scale (HADS) and the Kidney Disease QOL‐36 questionnaire were used to assess anxiety, depression, and QOL of the included patients.ResultsIn the post‐COVID group, abnormal and borderline cases of anxiety and depression were detected in 38.6% and 62.5% of patients, respectively, with no statistically significant difference between both groups. The post‐COVID group showed higher work status and lower sexual and physical functioning, which correlated negatively with anxiety and depression scores.ConclusionPast‐COVID infection did not influence depression and anxiety symptoms in HD patients. Sexual and physical functioning were more affected among COVID‐survivors.

导言本研究探讨了2019年冠状病毒病对埃及血液透析（HD）患者焦虑、抑郁和健康相关生活质量（HRQOL）的影响。方法这项多中心横断面研究于2021-2022年在埃及开展，来自4个HD中心的300名HD患者被分为两组：COVID后和非COVID。研究采用医院焦虑抑郁量表（HADS）和肾脏病 QOL-36 问卷来评估纳入患者的焦虑、抑郁和 QOL。COVID后组患者的工作状态较高，性功能和身体功能较低，这与焦虑和抑郁评分呈负相关。COVID幸存者的性功能和身体功能受到的影响更大。

引用次数: 0

Effect of medium cut‐off membranes on Pentosidine and N‐(carboxymethyl) lysine levels in uncontrolled diabetic hemodialysis patients 介质截流膜对不受控制的糖尿病血液透析患者体内喷托苷和 N-（羧甲基）赖氨酸水平的影响

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-04-04 DOI: 10.1111/1744-9987.14126

Neriman Sıla Koç, Hasan Yeter, Tolga Yıldırım, Yunus Erdem, Rahmi Yılmaz

IntroductionPatients on hemodialysis, especially with diabetes, face elevated cardiovascular events. A major contributor to complications associated with diabetes is advanced glycation end products (AGEs). Removing these compounds is challenging in traditional hemodialysis. Medium‐cut‐off (MCO) membranes potentially remove toxins without significant albumin loss. This study explored how MCO membranes impact AGEs levels in uncontrolled diabetic patients undergoing hemodialysis.MethodsSixteen patients received MCO membrane dialysis, while others used high‐flux (HF) membranes. After 12 sessions, the dialyzers were switched, totaling 24 sessions. Blood samples at trial initiation (T0), session 12 (T1) and session 24 (T2) tested for CML, Pentosidine, laboratory parameters.ResultsSwitching dialyzers showed increased albumin with MCO‐to‐HF and decreased with HF‐to‐MCO, albeit nonsignificant (p = 0.5/p = 0.1). Patients on MCO had lower albumin levels than HF (p = 0.03/p = 0.6, respectively). Hemodialysis with MCO demonstrated lower levels of CML/Pentosidine compared to HF (p = 0.09/p = 0.9 for CML; p = 0.04/p = 0.3 for Pentosidine). Transitioning to HF led to elevated levels (p = 0.4/p = 0.09 for CML; p = 0.3/p = 0.07 for Pentosidine).ConclusionMCO dialysis in diabetic individuals notably reduces AGE levels.

导言血液透析患者，尤其是糖尿病患者，面临着心血管事件的增加。导致糖尿病并发症的一个主要因素是高级糖化终产物（AGEs）。在传统的血液透析中，清除这些化合物是一项挑战。中截留（MCO）膜有可能在不损失大量白蛋白的情况下清除毒素。本研究探讨了 MCO 膜如何影响接受血液透析的未控制糖尿病患者体内的 AGEs 水平。12次透析后，更换透析器，共进行了24次透析。在试验开始时（T0）、第 12 次（T1）和第 24 次（T2）采集的血样检测了 CML、喷托苷和实验室参数。MCO 患者的白蛋白水平低于 HF（分别为 p = 0.03/p = 0.6）。与高频透析相比，接受 MCO 血液透析的患者白蛋白/喷托西汀水平较低（白蛋白 p = 0.09/p = 0.9；喷托西汀 p = 0.04/p = 0.3）。转为高频透析后，AGE 水平升高（CML 的 p = 0.4/p = 0.09；喷托西啶的 p = 0.3/p = 0.07）。

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引用次数: 0

Active vitamin D analog and SARS-CoV-2 IgG after BNT162b2 vaccination in patients with hemodialysis 血液透析患者接种 BNT162b2 疫苗后的活性维生素 D 类似物和 SARS-CoV-2 IgG

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-03-19 DOI: 10.1111/1744-9987.14121

Akio Nakashima, Izumi Yamamoto, Arisa Kobayashi, Keita Kimura, Tatsuhiro Yaginuma, Shinichiro Nishio, Kazuhiko Kato, Rena Kawai, Tetsuya Horino, Ichiro Ohkido, Takashi Yokoo

Vaccination is the effective strategy for coronavirus disease 2019 (COVID-19). However, few studies have investigated the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (Ig)G and vitamin D.

接种疫苗是2019年冠状病毒疾病（COVID-19）的有效策略。然而，很少有研究调查了严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）免疫球蛋白（Ig）G与维生素D之间的关联。

引用次数: 0

Therapeutic Apheresis and Dialysis Forthcoming Events April 2024 治疗性血液透析 2024 年 4 月即将举办的活动

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-03-04 DOI: 10.1111/1744-9987.14009

引用次数: 0

Management of dialysis patients with hepatitis C virus in the era of direct-acting antiviral therapy. 直接作用抗病毒疗法时代的丙型肝炎透析患者管理。

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-02-01 Epub Date: 2023-09-04 DOI: 10.1111/1744-9987.14060

Michel Jadoul, Laura Labriola

引用次数: 0

The effect of double filtration plasmapheresis and corticosteroids on patients with anti-dipeptidyl-peptidase-like protein 6 encephalitis. 抗二肽基肽酶样蛋白 6 脑炎患者接受双滤过性浆细胞清除术和皮质类固醇的效果。

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-02-01 Epub Date: 2023-07-17 DOI: 10.1111/1744-9987.14039

Wenbin Wan, Yuanmei Pan, Ying Chen, Shuwei Bai, Xiaoying Yao, Yan Lin, Jun Wu, Liping Ni, Yufang Mei, Huiying Qiu, Yan Zhou, Yong Hao, Yangtai Guan

Introduction: Anti-dipeptidyl-peptidase-like protein 6 (DPPX) encephalitis is a rare condition with varied symptoms including gastrointestinal issues, weight loss, cognitive and mental dysfunction, and hyperexcitability of the central nervous system.

Methods: We studied five patients with anti-DPPX encephalitis who received immunotherapy, specifically DFPP, at our hospital. We analyzed their clinical symptoms, lab results, electrophysiological and imaging findings, and outcomes with immunotherapy.

Results: Patients presented with cognitive dysfunction, tremor, seizures, psychiatric disturbances, and cerebellar and brainstem dysfunction. Magnetic resonance imaging (MRI) showed brain abnormalities in one patient and elevated cerebrospinal fluid (CSF) protein levels in two patients. Antibodies against DPPX were detected in all patients and in CSF in two patients. One patient had antibodies against anti-CV2/contactin response mediator protein 5 (CRMP5). All patients responded well to DFPP and corticosteroids.

Conclusion: DFPP may be an effective treatment for anti-DPPX encephalitis. Further research is needed to understand disease progression and evaluate immunotherapy efficacy.

导言：抗二肽基肽酶样蛋白 6（DPPX）脑炎是一种罕见病，症状多样，包括胃肠道问题、体重减轻、认知和精神功能障碍以及中枢神经系统过度兴奋：我们研究了在本医院接受免疫疗法（特别是 DFPP）的五名抗DPPX脑炎患者。我们分析了他们的临床症状、实验室结果、电生理和影像学检查结果以及免疫治疗的效果：结果：患者出现认知功能障碍、震颤、癫痫发作、精神障碍以及小脑和脑干功能障碍。磁共振成像（MRI）显示一名患者脑部异常，两名患者脑脊液（CSF）蛋白水平升高。所有患者均检测到 DPPX 抗体，两名患者的脑脊液中检测到 DPPX 抗体。一名患者体内有抗CV2/接触素反应介质蛋白5（CRMP5）抗体。所有患者对 DFPP 和皮质类固醇反应良好：结论：DFPP可能是治疗抗DPPX脑炎的有效方法。结论：DFPP可能是治疗抗DPPX脑炎的有效方法，但还需要进一步研究，以了解疾病进展情况并评估免疫疗法的疗效。

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引用次数: 0

A nephrologist dream of peritoneal dialysis catheter with zero migration: A multicenter prospective study. 肾脏病学家梦寐以求的零移位腹膜透析导管：一项多中心前瞻性研究。

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-02-01 Epub Date: 2023-08-16 DOI: 10.1111/1744-9987.14045

Abdullah K Al-Hwiesh, Ibrahiem Saeed Abdul-Rahman, Jose Carolino Divino-Filho, Mohamed A Nasreldin, Amani A Al-Hwiesh, Nadia Al-Audah, Hatem H Althubaini, Moaz Abdulgalil, Ghassan A Salah, Mohammad Z Al-Baggal, Bassam A Abu-Oun, Nehad Al-Audah, Habib S Al-Ramadan, Kaltham Alfalah, Zahra Almarri, Ayat A Al-Awal

Introduction: PD catheter tip migration is a common complication and a significant cause of catheter malfunction. In this perspective, we present our experience with a new catheter and a new technique that involves the use of a new triple cuff PD catheter and a low entry site in an attempt to prevent PD catheter migration.

Methods: A total of 503 incident PD patients have been studied in more than one PD center over a period of 5 years.

Results: During the 5-year follow up we recorded zero percent catheter migration. Other technical complications were poor drainage in 3.4%, omental wrap in 2.8%, early leakage in 3.4%, and catheter replacement in 2.4%. By the end of the study, the one-year PD catheter survival was 97.6%.

Conclusion: Our new triple cuff PD catheter and our low-entry approach seem to be effective in preventing PD catheter migration and minimizing other mechanical complications.

导言：PD导管尖端移位是一种常见的并发症，也是导管故障的一个重要原因。在这篇论文中，我们介绍了使用新型导管和新技术的经验，其中包括使用新型三层袖带 PD 导管和低入口部位，试图防止 PD 导管移位：方法：我们在一个以上的PD中心对503名PD患者进行了为期5年的研究：结果：在5年的随访中，导管移位率为零。其他技术并发症包括引流不畅（3.4%）、网膜包裹（2.8%）、早期渗漏（3.4%）和导管更换（2.4%）。研究结束时，PD 导管的一年存活率为 97.6%：结论：我们的新型三层袖带腹腔穿刺导管和低入口方法似乎能有效防止腹腔穿刺导管移位，并将其他机械并发症降至最低。

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引用次数: 0

The addition of Cytosorb in patients on VA-ECMO improves urinary output and ICU survival. 在使用 VA-ECMO 的患者中添加 Cytosorb，可提高尿量和重症监护室存活率。

IF 1.9 4区医学 Q3 Medicine

Therapeutic Apheresis and Dialysis

Pub Date : 2024-02-01 Epub Date: 2023-09-11 DOI: 10.1111/1744-9987.14064

Daniel Lovrić, Marijan Pašalić, Stefan Križanac, Karla Kovačić, Boško Skorić, Hrvoje Jurin, Davor Miličić, Vedran Premužić

Introduction: The aim of this study was to analyze the efficiency of CytoSorb adsorber in patients presenting with cardiogenic shock and treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Methods: Sixteen patients put on VA ECMO due to cardiogenic shock were included, stratified according to the use of Cytosorb adsorber in the first 24 h and compared across different clinical outcomes.

Results: Significantly lower vasopressor doses were required among patients treated with Cytosorb at the initiation and before weaning from ECMO. Furthermore, these patients showed significantly higher urine output before weaning and lower lactate levels during the extracorporeal support. Finally, the mortality rate was lower among the Cytosorb therapy group (22.2% vs 57.1%).

Conclusion: While a decrease in vasopressor doses was already associated with CytoSorb use, this is the first study showing an increase in urinary output and a trend towards better survival among patients on VA ECMO treated with CytoSorb.

简介本研究旨在分析CytoSorb吸附剂在心源性休克并接受静脉体外膜氧合（VA-ECMO）治疗的患者中的应用效果：方法：纳入16例因心源性休克而接受体外膜肺氧合（VA-ECMO）治疗的患者，根据患者在最初24小时内使用Cytosorb吸附剂的情况进行分层，并比较不同的临床结果：结果：在开始使用和从 ECMO 断奶前使用 Cytosorb 吸附剂的患者所需的血管加压剂剂量明显较低。此外，这些患者在断奶前的尿量明显增加，体外支持期间的乳酸水平降低。最后，Cytosorb疗法组的死亡率较低（22.2% 对 57.1%）：结论：虽然使用 CytoSorb 已导致血管加压剂剂量减少，但这是首次有研究显示使用 CytoSorb 治疗的 VA ECMO 患者的尿量增加，存活率也呈上升趋势。

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