Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy最新文献

Introduction: Patients with ovarian cancer often present with massive ascites, leading to significant protein loss during surgical procedures. Although cell-free concentrated ascites reinfusion therapy (CART) is used in palliative settings to mitigate protein loss, its application in intraoperative settings remains unexplored.

Methods: We retrospectively evaluated patients who underwent intraoperative CART for ovarian cancer treatment between March 2022 and 2025, compared two ascitic fluid collection methods (syringe and roller pumping), and analyzed operative parameter, fluid collection efficiency, albumin recovery, and adverse event-related data.

Results: Among the 12 patients included in this study, seven (58.3%) underwent CART using the roller pumping method, which significantly reduced the collection time compared with the syringe method (9 vs. 22 min, p < 0.05). The median collection speed was also significantly higher with the roller pumping method (404 vs. 140 mL/min, p < 0.05). Approximately 70% of the albumin in the collected ascitic fluid was successfully reinfused. Adverse events included transient hypotension (16.7%) and hypertension (25.0%), both of which resolved without intervention.

Conclusion: Intraoperative CART is a feasible and safe technique for protein loss management in patients undergoing surgery for ovarian cancer. The roller pumping method significantly shortened ascites collection time and reduced surgical burden.

Introduction: The efficacy of plasma exchange (PEx) in patients with anti-glomerular basement membrane antibody (anti-GBM Ab) disease requiring renal replacement therapy (RRT) at diagnosis remains unclear. This study aimed to investigate the outcomes and safety of patients with uremic anti-GBM Ab disease undergoing PEx.

Methods: We retrospectively analyzed nine patients confirmed by renal biopsy who received PEx using fresh frozen plasma or 5% human albumin solution and underwent hemodialysis (HD) concomitantly with standard immunosuppressive therapy. The outcome was determined as dialysis dependency, and safety was evaluated for adverse events.

Results: Two patients (22.2%) achieved dialysis independence at 10 and 11 months. Both patients had relatively preserved normal glomeruli (15.8%-37.2%) and achieved early remission. Retroperitoneal hemorrhage and recalcitrant anti-GBM Ab were noteworthy in other cases.

Conclusion: PEx can facilitate renal recovery in selected patients with anti-GBM disease requiring RRT. Pathological evaluation may be useful to determine the intensity and duration of treatment, including PEx.

We reviewed the study by Chen et al. on the association between blood cell indices, lipid levels, and mortality in hemodialysis patients. While the study provides valuable insights, several limitations affect its generalizability and validity. The data were limited to four centers within a single country, and key confounders-such as lifestyle, psychological factors, medication use, and nutritional status-were not addressed. Additionally, the findings are not applicable to patients on other dialysis modalities. We recommend future multicenter studies that incorporate broader populations, account for confounding variables, and include validated nutritional assessment tools to better understand mortality risks in this population.

Background: Post-transplant diabetes mellitus (PTDM) presents a growing global health challenge. Limited understanding of PTDM in Asians needs to be explored.

Objectives: This study aims to identify the cumulative incidence of PTDM and the associated risk factors in kidney transplant recipients.

Methods: This retrospective cohort was performed at the Kidney Transplant Center of Phramongkutklao Hospital (PMK-KT), Thailand, from January 1989 to January 2022. Demographic information, comorbid disorders, laboratory test results, pharmacological treatments, and drug concentrations were recorded. Utilizing multiple logistic regression analysis, we assessed the risk of PTDM.

Results: The total of 174 KT recipients was eligible for analysis. The cumulative incidence of PTDM was 16.7% (95% CI: 11.46%-23.05%). Multivariable logistic regression identified chronic hepatitis C, Everolimus usage, graft rejection, and post-transplant hypomagnesemia as predictors of PTDM. The overall mortality was 20.5% (95% CI: 14.62%-27.43%).

Conclusion: A slightly increased cumulative incidence of PTDM was observed. Several risk factors were identified.

This review systematically summarizes the current status of cognitive frailty in maintenance hemodialysis patients, including its prevalence, assessment and diagnostic criteria, associated risk factors, and the clinical application status and progress of related risk prediction models both domestically and internationally. The analysis aims to provide methodological references for future development and implementation of cognitive frailty risk prediction models tailored to this specific patient population.

Introduction: This pioneering study aimed to examine the effects of virtual reality (VR)-based videos on symptoms, vital signs, and comfort levels in hemodialysis patients, offering an innovative approach to improving their quality of life.

Methods: This randomized controlled pretest-posttest study included 54 hemodialysis patients treated at "X" Hospital between June 2024 and May 2025. Twenty-five patients were assigned to the intervention group, 25 to the control group, and 4 to a pilot group. Data were collected at baseline and after 8 weeks. Statistical analyses included t-tests, repeated measures ANOVA, Mann-Whitney U, and Friedman tests.

Results: In the intervention group, Dialysis Symptom Index (DSI) scores decreased significantly (p < 0.05), and comfort levels increased significantly (p < 0.05) across all subscales of the Hemodialysis Comfort Scale Version II. Vital signs remained within normal ranges before and after the intervention.

Conclusion: This study revealed that the use of virtual reality headsets significantly influenced dialysis symptom index scores and comfort levels. The intervention effectively reduced dialysis symptoms and significantly increased patient comfort. No significant differences were observed in vital signs.

Introduction: Iron-based phosphate binders (IBPBs) are used for the treatment of hyperphosphatemia. However, the erythropoiesis effects of IBPB treatment in peritoneal dialysis (PD) patients have not been fully investigated.

Methods: This retrospective, observational study included 75 PD patients. Various parameters were compared during the first 6 months of IBPB administration.

Results: While transferrin saturation, ferritin, hemoglobin (Hb), and mean corpuscular hemoglobin (MCH) increased significantly, red blood cell (RBC) count had no significant change and erythropoiesis-stimulating agent (ESA) doses decreased significantly after 6 months of IBPB administration. Furthermore, even in patients whose ESA dose had not changed by 2 months after starting IBPB administration, Hb, RBC count, and MCH were significantly increased at the second month.

Conclusion: Regardless of the type of IBPB, administration of IBPB resulted in significant iron supplementation and Hb elevation, and the mechanism behind this was not only the increase in MCH due to iron supplementation but also an increase in RBC counts.