Artificial Dialysis Research Articles

Nutritional status and management of diary persons below 70 years at Ha Dong general hospital in 2022

Aims: To evaluate the nutritional status of patients with artificial dialysis, cyclic hemodialysis. Methods: A cross-sectional study of 110 patients under 70 years of age. Results : As the result of the body mass index (BMI) assessment, it was found that 31.8% of the patients experienced a lack of field energy and 4.5% of the patients had an overweight BMI according to who classification. The proportion of patients with low serum albumin levels (<35 g/ L ) was 24.5%. By the overall assessment method (SGA), 38.2% of patients had a slight nutritional risk and 1.8% were severely malnourished. Conclusion: Artificial kidney dialysis patients are at risk for malnutrition during hemodialysis. Therefore, it is necessary to observe, monitor, screen and evaluate the nutritional status of patients on artificial dialysis – periodic hemodialysis.

Thermal analysis for radiative flow of Darcy–Forchheimer nanomaterials subject to entropy generation

Abstract Background and objective Flow due to the Darcy–Forchheimer medium is an important perspective in various geophysics, industrial processes, geothermal energy, and thermodynamic processes. The importance of the Darcy–Forchheimer medium is noticed in technical, mechanical, industrial, and scientific fields including atomic waste archive, artificial dialysis, catalytic converters, gas turbine, improved oil recuperation, atherosclerosis, grain stockpiling, geo-energy production, and warm protection designing, etc. In view of such industrial and geothermal applications, the objective of this paper is to highlight the influence of entropy generation in chemical reactive MHD (magnetohydrodynamic) Darcy–Forchheimer nanoliquid flow with radiation. Flow by an exponentially stretching permeable sheet is taken. Thermal radiation, heat source, magnetic force, and dissipation impacts are considered in thermal expression. Additionally, Buongiorno’s model with random and thermophoresis diffusions is explained. Physical features of entropy are deliberated. The first-order isothermal reaction is discussed. Methodology Non-linear expressions are reduced to the dimensionless non-linear system through the implementation of non-similar transformations. The resultant non-linear systems are solved subject to local non-similarity via the ND-solve technique Results Graphical results for entropy rate, concentration, velocity, and thermal field versus emerging variables are studied. The reverse trend holds for entropy and velocity through the magnetic variable. A larger approximation of the Eckert number intensifies the thermal field. Conclusions A higher Forchheimer number reduces the fluid flow. A reverse impact for concentration and thermal field is seen through random motion variable. Similar behavior for thermal distribution is seen by thermophoresis and radiation effects. A larger porosity variable declines the entropy rate, while the reverse effect holds for the Brinkman number. A larger diffusion variable increases the entropy generation.

The scientific principles and technological determinants of haemodialysis membranes.

ABSTRACTIn most biological or industrial (including medical) separation processes, a membrane is a semipermeable barrier that allows or achieves selective transport between given compartments. In haemodialysis (HD), the semipermeable membrane is in a tubular geometry in the form of miniscule pipes (hollow fibres) and separation processes between compartments involve a complex array of scientific principles and factors that influence the quality of therapy a patient receives. Several conditions need to be met to accomplish the selective and desired removal of substances from blood in the inner cavity (lumen) of the hollow fibres and across the membrane wall into the larger open space surrounding each fibre. Current HD membranes have evolved and improved beyond measure from the experimental membranes available in the early developmental periods of dialysis. Today, the key functional determinants of dialysis membranes have been identified both in terms of their potential to remove uraemic retention solutes (termed ‘uraemic toxins’) as well subsidiary criteria they must additionally fulfill to avoid undesirable patient reactions or to ensure safety. The production of hundreds of millions of kilometres of hollow fibre membranes is truly a technological achievement to marvel, particularly in ensuring that the fibre dimensions of wall thickness and inner lumen diameter and controlled porosity—all so vital to core solute removal and detoxification functions of dialysis—are maintained for every centimetre length of the fragile fibres. Production of membranes will increase in parallel with the increase in the number of chronic kidney disease (CKD) patients expected to require HD therapies in the future. The provision of high-quality care entails detailed consideration of all aspects of dialysis membranes, as quality cannot in any way be compromised for the life-sustaining—like the natural membranes within all living organisms—function artificial dialysis membranes serve.

Studies of the Various Chronic Kidney Failure Rat Models and Hemodialysis Mini-pig Model for the Evaluation of Anti-hyperphosphatemia Drugs

Animal models of chronic kidney failure (CKF) have been developed for the pharmacodynamic evaluation of various phosphate binders that are used clinically to treat hyperphosphatemia in patients with chronic kidney disease. However, these models represent different disease states and severities, depending on the experimental conditions and are not clearly defined for pharmacological evaluation. In addition, experimental models have not yet been established for artificial dialysis. The purpose of this study was to confirm the utility of the various rat models of CKF and the mini-pig model of hemodialysis as models of hyperphosphatemia for pharmacodynamic evaluation. Various rat models of pre-dialysis CKF (oral adenine dosing, 5/6 resection, and ligation nephrectomy model) were evaluated through determinations of serum and urinary parameters (osmolality, creatinine, and phosphorus), pathological observations of kidney, and the phosphorus-absorbing properties of lanthanum carbonate (La) formulations. The rat and mini-pig models were compared based on each evaluation index. In the oral adenine dosing model, serum phosphorus increased markedly and the area under the serum phosphorus concentration-time curve (phosphorus AUC) decreased in a dose-dependent manner with the administration of La formulations. In contrast, a significant decrease in serum phosphorus AUC, a prolongation of the dialysis interval, and an improvement in dialysis efficiency were observed after administration of La formulations to the mini-pig hemodialysis model. Furthermore, the results of bioequivalence studies between two La formulations (Fosrenol and SW670, a generic formulation) suggested that the rat and mini-pig models are useful and precise as pre-dialysis and dialysis models, respectively.

Dementia May Reduce the Effectiveness of Low-Intensity Pulsed Ultrasound (LIPUS) Following Intramedullary Fixation for Trochanteric Fracture of the Femur

Objectives: Femoral trochanteric fracture often occurs in elderly females with bone fragility, and may accompany the complication of dementia, such as Alzheimer disease. In addition, comminuted fracture and unstable fracture are also confirmed in many cases, but low intensity pulsed ultrasound (LIPUS) is effective in promoting callus formation after osteosynthesis. However, there is a concern that LIPUS may not be effective when dementia develops as a concomitant complication in patients with femoral trochanteric fracture. In this study, we examined the effects of LIPUS to promote callus formation in subjects with and without decreased cognitive function. Subjects and Methods: The inclusion criteria included elderly females who underwent reduction with the use of intramedullary nails of the same type, began to receive load training with no limitation on the day following the surgery, and were followed from surgery to convalescent rehabilitation at our hospital. The exclusion criteria included those who received drugs to increase bone quantity, such as osteoporosis drugs (except for alfacalcidol) and AChEIs, routine steroid administration, or artificial dialysis. The subjects were divided into the decreased cognitive function group with HDS-R of 20 points or less and the non-decreased cognitive function group with 21 points or more. These groups were further divided into the LIPUS treated group and the non-treated group, respectively to compare the appearance of callus confirmed by plain X-ray examination. Results: In the non-decreased cognitive function group, callus formation was significantly promoted by LIPUS, but LIPUS showed no effect in the decreased cognitive function group. Discussions: Patients with dementia, such as Alzheimer disease, exhibit decreased parasympathetic nerve function and decreased bone mass caused by retroplasia of the hypothalamus, as well as protracted synostosis in hip fracture due to dementia. For femoral trochanteric fracture with the complication of decreased cognitive function, concomitant use of LIPUS and AChEIs, which inhibit the aggravation of dementia, may be effective.

Does Disease Management for Diabetes Reduce Medical Expenditures? Evidence Using a Three-Period Difference-in-Difference Analysis

Disease management (DM) is one of the most popular concepts among policymakers in OECD countries. Governments of these countries — including Germany, the United Kingdom, and the United States — not only implement pilot projects but also allocate substantial budgets toward DM programs. Nevertheless, evaluations about DM program on cost are still controversial. This study provides new evidence regarding DM program on cost. We focus on the DM program to prevent from renal dialysis for type 2 diabetic nephropathy patients (in the stage three and more). The DM program was implemented by a public health insurer (Kure City in Hiroshima Prefecture in Japan). We collate a unique database by linking medical claims data for the 2010–2012 fiscal years with intervention records by the DM program on both 2010 and 2011 fiscal years. We obtained unbalanced panel data for monthly medical costs in the form of several subtotals; for example, inpatient costs, outpatient costs, drug costs, and dialysis costs. There were 172 diabetic patients in our treatment group and 258 diabetic patients in our control group. To tackle with selection bias by non-randomized allocation of participants of the DM program, we adopted Fixed Effect Model of panel data analysis. We inserted individual constant term to absorb unobserved time irrelevant heterogeneity (i.e. motivation to control chronic illness) in the model. We also employ “Charlson Comorbidity Index” as explanatory variable in the model to control complexity of diabetic patient based on number of complications. We expanded Difference in Difference analysis from traditional two periods model to newly three periods model. Then, we can distinguish “rectification effect” on medical cost by case management in the DM program from “health improvement effect” on medical cost by preventing undergo artificial dialysis thanks to the DM program. Results indicate that dialysis cost was 51.33% lower in treatment group comparing with control group. The rectification effect was 33.63% and larger than the health improvement effect which was 25.84%. In case of all medical claim cost excluding the dialysis cost, there was only rectification effect and it was 8.52% lower than that of control group. The study concludes that the DM program focus on serious diabetic nephropathy patients would have significant cost containment effect on medical cost.

Application of ozone ultrafine bubble water for cleaning and sterilizing the dialysis circuit

The dialysis circuit was washed by the ultrafine bubble (UFB) water and ozone UFB water and sodium hypochlorite aqueous solution. The effect of washing time, ozone concentration of UFB water, influence of UFB water on artificial dialysis equipment, etc. were investigated. The cleaning and sterilizing effect of ozone UFB water passed through the filter for artificial dialysis was verified. It was confirmed that there were no colony bacteria in the circuit which was washed by the ozone UFB water for 1 hour. Ozone UFB water has the same bactericidal effect as sodium hypochlorite. As an alternative of sodium hypochlorite, we are expecting its application to the cleaning and sterilization of ozone UFB water for dialysis circuit.

Microbially reduced graphene oxide shows efficient electricity ecovery from artificial dialysis wastewater.

Anodes are crucial in determining the electricity recovery of microbial fuel cells (MFCs). In this study, graphene oxide (GO) was used as an anodic material for electricity recovery from artificial dialysis wastewater (ADWW). Anaerobic incubation of ADWW with GO for 21 days produced a hydrogel complex containing embedded microbial cells and microbially reduced GO (rGO). The rGO complex recovered 540 to 810 μA/cm3 of catalytic current from ADWW after 10 days of electrochemical cultivation at 200 mV (vs. Ag/AgCl), which was approximately thirty times higher than that recovered from graphite felt (GF), a representative anode in MFCs. High-throughput sequencing analysis of prokaryotic 16S rRNA genes revealed a predominance of the Geobacter genus (35% of all prokaryotic sequences identified), particularly in the rGO complex after 20 days of polarization. The superior electricity recovery of the rGO complex was attributable to enhanced direct electron transfer via a well-developed biofilm, while indirect electron transfer via an electron mediator occurred in culture using GF.

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Objectives In addition to blood pressure control, postpartum control of urine output is a major issue in hypertensive pregnancy, HELLP syndrome or placental abruption. Delayed diuresis after delivery may easily cause abdominal dropsy, pulmonary edema, or late-onset renal failure. We recently added a new medicine, carperitide (atrial natriuretic peptide, hANP®), in addition to standard diuretic, like furosemide, for diuresis in such severe postpartum conditions. The objective of this study was to reveal the clinical and cost effectiveness of use carperitide in postpartum intensive care after preeclampsia. Methods Medical records of the patients who were administered carperitide in Nara Medical University Hospital after delivery or cesarean section for severe preeclampsia, HELLP syndrome and placental abruption were reviewed. Six patients who used carperitide were compared with ten patients who did not. Duration between delivery or administration of carperitide and maternal massive diuresis were retrieved as well as background, maternal outcome, duration of stay in hospital and blood pressure. Results There have been no maternal deaths or the need for artificial dialysis after these diseases for recent five years. Use of carperitide significantly decreased maternal mean blood pressure after 48 h of operation and shortened the duration between delivery or cesarean section and massive diuresis. No adverse effect was defined. Conclusions Though it was not a randomized, controlled study, in the intensive care setting, use of carperitide in infusion-and-output control after preeclampsia and related severe diseases was associated with improved kidney protection, shortened duration of intensive care and hospitalization with fewer side effects. In difficulty of hydration control after preeclampsia, carperitide may be a useful medicine for intensive maternal care. Disclosures A. Shigemitsu: None. J. Akasaka: None. H. Shigetomi: None. T. Tsunemi: None. N. Koike: None. K. Iwai: None. K. Naruse: None. H. Kobayashi: None.

Role of Pharmacists during Serious Disasters and Peace Time<br/>—From the View of a Physician—

From April 9 to 16, 2011, I joined the first medical team at Ishinomaki as one of the supporting volunteers of Japan Primary Care Association for the 2011 East Japan Earthquake. I participated in launching the intensive care temporary clinic at Yugakukan. Yugakukan was one of the shelters set up right after the earthquake and tsunami on March 11, 2011. Later, it became the care unit for inpatients moved from Ishinomaki City General Hospital, which was crushed by the tsunami. Patients ranged in age and needs: from infant to elderly, and those needing internal and/or surgical medication or artificial dialysis. Under such conditions, we, as the first medical team members dispatched to the shelter, were concerned with the assessment of refugees and establishment of the management system of the shelter. Through the activities, I realized the utmost importance of "networking". In this paper, the role of pharmacists in disaster medicine, preparation for disaster medicine, and the role and function of pharmacists in community medicine under normal conditions will be demonstrated in relation to this keyword.

Tissue-Engineered Vascular Grafts: Autologous Off-the-Shelf Vascular Access?

Dialysis grafts have provided reliable access for millions of patients in need of renal replacement therapy. However, regardless of the material used for artificial dialysis grafts their mean patency remains generally poor and infection rates are greater than native arteriovenous fistulas. The need for superior alternatives to conventional synthetic materials used for vascular access has been an area of investigation for more than 25 years and recently there has been a great deal of progress in the field of tissue-engineered vascular grafts. Many of these technologies are either commercially available or are now entering early phases of clinical trials. This review briefly covers the history, potential advantages, and disadvantages of these technologies, which are likely to create an impact in the field of vascular access surgery.

Advance care planning needs, which is expected to end of life care teams in Japan

In Japan, which has the highest rate of aging worldwide, the study of advance care planning (ACP) requirements, which are expected of end-of-life care teams (EOLCT) for non-cancer patients, has...

Analytical Validation of Ameziniummetilsulfate by HPLC in Human Blood Plasma from Uremia Patient Treated by Dialysis

A high-performance liquid chromatography (HPLC) method using an internal standard is validated for the determination of 4-amino-6-methoxy-1-phenyl-pyridozinium methyl sulfate (ameziniummetilsulfate, AM) in a uremia patient treated by artificial dialysis. The method involves liquid-liquid extraction and ion-suppressed reverse-phase HPLC on an end-capped C-18 column. There is no interference by plasma components or AM metabolites in the HPLC analysis. Average recovery rate using liquid -liquid extraction was 88.7% and limit of determination (LOD) was 2 ng/ml. This concentration was sufficient to determine AM in human plasma. Accuracy and precision was < 5.6% and 16.2%, respectively, at 2 ng/ml, LOD.

Determination of the Endocrine Disrupter Bisphenoi-A in the Blood of Uremia Patients Treated by Dialysis

Automated solid-phase extraction (SPE) then high-performance liquid chromatography have been studied for determination of the endocrine disrupter bisphenoi-A (BPA) in blood. Electro chemical detection was used for selective and sensitive detection of BPA. Determination of BPA in the blood of uremia patients treated by dialysis has not yet been reported. Acidified blood and acidified SPE eluent were used to suppress the ionization of BPA and thus retain the compound on a C-18 column. Because artificial dialysis can be performed for periods longer than 40 years, for reasons of safety the amount of BPA migrating from the artificial dialyzer into the blood of a uremia patient was compared for different sterilization methods and for different artificial dialyzers manufactured from different materials.

On-line monitoring of urea using enzymatic field effect transistors

Silicon and polymer-based technologies were developed in order to reach the industrial fabrication of disposable, mass-fabricated microsensors for the urea detection in liquid phase. The detection principle is based on pH-sensitive chemical field effect transistor (pH-ChemFET) microdevices. In order to realize an urea-sensitive enzymatic field effect transistor (urea-EnFET), studies involve the integration of an urease-based enzymatic layer by ink jet printing techniques, the packaging into a specific flow cell compatible with the liquid phase measurement, and the development of urea-EnFET/pH-ChemFET differential analysis technique. Thus, the urea detection properties were studied in EDTA-based and dialysate solutions, evidencing good sensitivity in concentration ranges appropriate to human kidney failure. Finally, the whole analysis system was successfully tested for the continuous monitoring of urea in artificial dialysis conditions.

Posaconazole in intensive care patients I: invasive fungal infections in surgical intensive care and case presentation

Critically ill patients after extended surgical procedures are at high risk for postoperative infections. Fungal infections play a substantial role for immunocompromised patients, e.g. after solid organ transplantation or under chronic corticoid therapy. Posaconazole, a new broad-spectrum triazole effective against Aspergillus and Candida species as well as many fungi that are resistant to other antifungals, is well tolerated and can be used as an alternative in salvage therapy. Posaconazole can be administered via gavage so that antifungal therapy can be switched from an expensive intravenously applied antifungal to oral posaconazole at an early stage. Two case reports are presented, which show that posaconazole was efficacious and well tolerated following antifungal therapy with another azole. It was administered without difficulty via gavage to a patient receiving artificial respiration and dialysis.

人工透析の直接医療費とQOLに関する研究 : 透析非糖尿病, 透析糖尿病および非透析糖尿病患者間の比較

人工透析の直接医療費とQOLに関する研究 : 透析非糖尿病, 透析糖尿病および非透析糖尿病患者間の比較

Defining the role of sevelamer chloride as a therapeutic agent for management of phosphate in patient with hemodialysis

It has been about 18 months after the commercial release of sevelamer hydrochloride. I examined the phosphorus management in patient with hemodialysis with the use sevelamer hydrochloride. The phosphorus reduction of sevelamer hydrochloride was weaker than the precipitated calcium carbonate. Patients on artificial dialysis must undergo dietary therapy for the sevelamer hydrochloride to be effective. However, by switching from precipitated calcium carbonate to sevelamer hydrochloride, the calcium level dropped, and as a result the intact PTH rose. It was possible to subdue the rise of intact PTH with vitamin D. The usefulness of vitamin D dramatically increased with the decrease and the eventual cancellation of precipitated calcium carbonate. Furthermore, the calcium load lightened and the product of calcium and phosphorus decreased. At this point, I do not expect substantial phosphorus reduction from sevelamer hydrochloride. It must be recognized that the basis of phosphorus management is proper diet. Only with that can sevelamer hydrochloride be used to its fullest potential.

人工透析者の生き方・価値観の構造をとらえる一つの試み : 生活行動範囲との関連において

人工透析者の生き方・価値観の構造をとらえる一つの試み : 生活行動範囲との関連において

HPLC validation of ameziniummetilsulfate in human plasma from uremia patient treated by dialysis

A high-performance liquid chromatography (HPLC) method using an internal standard is validated for the determination of 4-amino-6-methoxy-1-phenyl-pyridazinium methyl sulfate (ameziniummetilsulfate, AM) in a uremia patient treated by artificial dialysis. The method involves liquid-liquid extraction and ion-supression, reverse-phase HPLC on an end-capped C-18 column. There is no interference by plasma components or AM metabolites in the HPLC analysis. Average recovery rate using liquid-liquid extraction was 88.7% and limit of determination was 2 ng mL−1. This concentration was sufficient to determine AM in human plasma. Accuracy and precision was <5.6% and 16.2%, respectively, at 2 ng mL−1, the limit of determination.