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  • 1
    In: Renal Replacement Therapy, Springer Science and Business Media LLC, Vol. 7, No. 1 ( 2021-12)
    Abstract: This article is a duplicated publication from the Japanese version of “2019 JSDT Guidelines for Peritoneal Dialysis” with permission from the Japanese Society for Dialysis Therapy (JSDT). This clinical practice guideline (CPG) was developed primarily by the Working Group on Revision of Peritoneal Dialysis (PD) Guidelines of the Japanese Society for Dialysis Therapy. Recently, the definition and creation process for CPGs have become far more rigorous; traditional methods and formats no longer adhere to current standards. To improve the reliability of international transmission of our findings, CPGs are created in compliance with the methodologies developed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) working group. Part 2 of this PD guideline is the first CPG developed by our society that conforms to the GRADE approach. Methods Detailed processes were created in accordance with the Cochrane handbook and the GRADE approach developed by the GRADE working group. Results Clinical question (CQ)1: Is the use of renin-angiotensin system inhibitors (RAS inhibitors), such as angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB ) , effective in PD patients? Recommendation: We suggest the usage of RAS inhibitors (ACEI and ARB) in PD patients (GRADE 2C). CQ2: Icodextrin or glucose solution: which is more useful as a dialysate among patients with PD? Recommendation: We suggest using icodextrin when managing body fluids in PD patients (GRADE 2C). CQ3: Is it better to apply or not apply mupirocin/gentamicin ointment to the exit site? Recommendation: We suggest not applying mupirocin/gentamicin ointment to the exit sites of PD patients (GRADE 2C). CQ4: Which surgical approach is more desirable when a PD catheter is placed, open surgery or laparoscopic surgery? No recommendation. CQ5: Which administration route of antibiotics is better in PD patients with peritonitis, intravenous or intraperitoneal? Recommendation: We suggest intraperitoneal administration of antibiotics in PD patients with peritonitis (GRADE 2C). Note: The National Insurance does not currently cover intraperitoneal administration. CQ6: Is peritoneal dialysis or hemodialysis better as the first renal replacement therapy in diabetic patients? No recommendation. Conclusions In the future, we suggest that society members construct their own evidence to answer CQs not brought up in this guideline, and thereby show the achievements of Japan worldwide.
    Type of Medium: Online Resource
    ISSN: 2059-1381
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2866852-2
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  • 2
    Online Resource
    Online Resource
    Wiley ; 2010
    In:  Hemodialysis International Vol. 14, No. s1 ( 2010-10)
    In: Hemodialysis International, Wiley, Vol. 14, No. s1 ( 2010-10)
    Abstract: Selecting dialyzers is more important for blood purification in critical care because other therapeutic options (especially amount of dialysate) are usually limited. Adsorption is a major mechanism of removing toxic substances from patients in these treatments. Several commercial dialyzers designed for acute blood purification therapy were investigated by performing aqueous ultrafiltration experiments to demonstrate the adsorptive importance of membrane materials. Polymethylmethacrylate showed strong adsorptive characteristics to α‐chymotripsinogen A (MW 25,000) but showed much less adsorptive characteristics to cytochrome C (MW 12,400). On the contrary, polyacrylonitrile showed relatively lower affinity and polysulfone showed essentially no affinity to these proteins. Time‐dependent and concentration‐dependent characteristics of clearance for these solutes were also demonstrated in polymethylmethacrylate. Adsorption found in polymethylmethacrylate may be due to the occlusion of protein molecules into pores of the membrane. Choosing membrane materials is, therefore, important not only in removing inflammatory cytokines but also for accounting for the loss of albumin in acute and chronic treatments.
    Type of Medium: Online Resource
    ISSN: 1492-7535 , 1542-4758
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2010
    detail.hit.zdb_id: 2103570-2
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  • 3
    Online Resource
    Online Resource
    Wiley ; 2011
    In:  Hemodialysis International Vol. 15, No. S1 ( 2011-10)
    In: Hemodialysis International, Wiley, Vol. 15, No. S1 ( 2011-10)
    Abstract: It is known that β 2 ‐microglobulin (β 2 ‐ MG ) concentration in peritoneal dialysis ( PD ) patients is inversely correlated to the residual renal function ( RRF ). With decreasing RRF , some PD patients may necessarily be treated with hemodialysis ( HD ) once a week, not only for removing excess water and small solutes, but also for removing much larger solutes such as β 2 ‐ MG . In this study, a kinetic model allowed us to show what is good about PD + HD combined therapy in long‐term PD patients. A mathematical model was established based on a classic compartment theory for clinical use. Model validations were made by comparing calculated results with clinical data in order to specify what was good about PD + HD combined therapy (5‐day PD  + 1‐ HD /week). Time‐averaged concentration ( TAC ) for urea and creatinine decreased by 20% on the average by introducing PD + HD combined therapy no matter which dialyzers were used. TAC for β 2 ‐ MG in PD + HD combined therapy, however, was strongly dependent upon the dialyzer clearance, and when a low flux dialyzer (clearance for β 2 ‐ MG  = 10 mL/min under Q B  = 200, Q D  = 500 mL/min) was used, pre‐dialysis β 2 ‐ MG concentration may increase. Use of super high‐flux dialyzers (clearance for β 2 ‐ MG  = 60 mL/min under the same conditions) should greatly reduce the β 2 ‐ MG concentration from 30 to 8 mg/L in 4‐hr treatment. Then, when PD + HD combined therapy is introduced to a PD patient with diminishing RRF , use of super high‐flux dialyzers may be strongly recommended in order not to increase concentrations of pre‐dialysis β 2 ‐ MG and/or even greater solutes. Use of super high‐flux dialyzers is a key to the success of PD + HD combined therapy that could prevent concentrations of large solutes from increasing.
    Type of Medium: Online Resource
    ISSN: 1492-7535 , 1542-4758
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 2103570-2
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2004
    In:  Hemodialysis International Vol. 8, No. 4 ( 2004-10), p. 368-371
    In: Hemodialysis International, Wiley, Vol. 8, No. 4 ( 2004-10), p. 368-371
    Type of Medium: Online Resource
    ISSN: 1492-7535 , 1542-4758
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2004
    detail.hit.zdb_id: 2103570-2
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  • 5
    Online Resource
    Online Resource
    Wiley ; 2015
    In:  Hemodialysis International Vol. 19, No. S3 ( 2015-10)
    In: Hemodialysis International, Wiley, Vol. 19, No. S3 ( 2015-10)
    Abstract: Vitamin E (vit E ) is coated on polysulfone ( PS ) dialysis membrane for antioxidative purpose. The membrane, however, has not yet been evaluated from the mass transfer point of view. We investigated this PS membrane with and without vit E coating in vitro ultrafiltration experiments to identify whether or not the coating influences the mass transfer. Dialyzers that included PS membrane with and without vit E coating were investigated. Aqueous test solution of various solutes including vitamin B 12 ( VB 12 , MW 1355), chymotrypsin (chymo, MW 25000), and albumin (alb, MW 66000) was prepared, and normal ultrafiltration experiments were performed at 310  K . Reverse ultrafiltration experiments in which test solution was filtered from outside to inside the hollow fiber were also performed. Sieving coefficients ( SC ) were computed for evaluation. SC for VB 12 was the same regardless of vit E coating; however, chymo was 0.82 ± 0.01 and 0.86 ± 0.01, respectively, for the membrane with and without vit E. Thus, it would be understood that vit E coating reduces the pore size of the membrane, resulting the reduced transport of larger solutes. Like other PS membrane, SC for alb was decreased over time regardless of vit E coating. More importantly, although the steady‐state SC for alb was almost identical in two membranes, PS without vit E showed much greater decrease for the first 2 h, while that with vit E showed very little decrease over time, which suggested the reduced fouling effect due to vit E coating. All the SC values found in reverse ultrafiltration were higher than those found in normal ultrafiltration; moreover, the degree of increase with chymo was approximately 5%, whereas that with alb was approximately 430%, which may be explained by a new model in which wedge effect is taken into consideration for the membrane transport. Vit E coating not only has antioxidative effect but also reduces the fouling that is usually caused by various proteins.
    Type of Medium: Online Resource
    ISSN: 1492-7535 , 1542-4758
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2103570-2
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  • 6
    Online Resource
    Online Resource
    S. Karger AG ; 2004
    In:  Blood Purification Vol. 22, No. Suppl. 2 ( 2004), p. 14-19
    In: Blood Purification, S. Karger AG, Vol. 22, No. Suppl. 2 ( 2004), p. 14-19
    Abstract: Daily hemofiltration (D-HF) is a new treatment modality that shows unique solute removal characteristics and possibly provides high quality of life for patients with end-stage renal disease. We evaluated solute removal characteristics of D-HF for 5 patients by kinetic modeling analysis. Five patients treated with normal 4-hour × 3 times/week hemodialysis (HD) were switched to D-HF (2-hour × 6 times/week). Ultrafiltration rates 〈 i 〉 (Q 〈 sub 〉 F 〈 /sub 〉 ) 〈 /i 〉 or small solute clearances ranged from 63 to 106 ml/min. All the pertinent kinetic parameters were determined from patients’ physical data and the HD portion of the clinical measurements. The two-compartment kinetic model predicted the concentration changes after switching from normal HD to D-HF. In all 5 patients, concentrations of small solutes such as urea-nitrogen (UN) increased whereas that of β 〈 sub 〉 2 〈 /sub 〉 -microglobulin (β 〈 sub 〉 2 〈 /sub 〉 -MG) decreased after switching from normal HD to D-HF. Predicted solute concentrations and clinical measurements for UN and β 〈 sub 〉 2 〈 /sub 〉 -MG were in good agreement with average error less than 10%. The model predicted that 〈 i 〉 Q 〈 sub 〉 F 〈 /sub 〉 〈 /i 〉 = 155 ml/min may be necessary for the time-averaged concentration 〈 i 〉 (TAC) 〈 /i 〉 of UN to be unchanged. The model also predicted that the 7 times/week D-HF should not increase the pretreatment concentration of UN, expecting even much lower β 〈 sub 〉 2 〈 /sub 〉 -MG concentration after switching from normal HD to D-HF. D-HF is superior to normal HD for removing larger solutes but may increase the 〈 i 〉 TAC 〈 /i 〉 of small solutes. A 7-day treatment (7 times/week) D-HF may improve the solute removal capacity of small solutes.
    Type of Medium: Online Resource
    ISSN: 0253-5068 , 1421-9735
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2004
    detail.hit.zdb_id: 1482025-0
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2008
    In:  Journal of Artificial Organs Vol. 11, No. 4 ( 2008-12), p. 212-215
    In: Journal of Artificial Organs, Springer Science and Business Media LLC, Vol. 11, No. 4 ( 2008-12), p. 212-215
    Type of Medium: Online Resource
    ISSN: 1434-7229 , 1619-0904
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2008
    detail.hit.zdb_id: 2077361-4
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  Journal of Artificial Organs Vol. 25, No. 4 ( 2022-12), p. 329-335
    In: Journal of Artificial Organs, Springer Science and Business Media LLC, Vol. 25, No. 4 ( 2022-12), p. 329-335
    Type of Medium: Online Resource
    ISSN: 1434-7229 , 1619-0904
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2077361-4
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  • 9
    Online Resource
    Online Resource
    Wiley ; 2020
    In:  Therapeutic Apheresis and Dialysis Vol. 24, No. 1 ( 2020-02), p. 26-33
    In: Therapeutic Apheresis and Dialysis, Wiley, Vol. 24, No. 1 ( 2020-02), p. 26-33
    Abstract: Because hemofilters used for continuous renal replacement therapy contact with blood over a prolonged period during treatments, platelet activation may occur stronger. The purpose of this study is to clarify the blood compatibility in three hemofilters mostly used in Japan. We compared the blood compatibility of the two polysulfone (AEF: Asahi Kasei Medical Co., Tokyo, Japan and SHG: Toray Medical Co., Ltd., Tokyo, Japan) and one polymethylmethacrylate membranes (CH: Toray Medical Co., Ltd.). First, test blood was collected from healthy volunteers. Subsequently, the blood was circulated by a roller pump at the rate of 100 mL/min. We measured the platelet counts and platelet factor 4 (PF4). The platelet counts at 48 h in polymethylmethacrylate membrane were significantly less than that in polysulfone membranes. Levels of the PF4 after the circulation were 978.5 ± 200.0 ng/dL with AEF, 863.0 ± 233.9 ng/dL with SHG and 1780.0 ± 465.1 ng/dL with CH, respectively. Hemofilters with polysulfone membranes showed less platelet activation. It was inferred that the amount of PVP, the smoothness of the membrane surface, and the inner diameter of the hollow fiber affect the blood compatibility in the hemofilter.
    Type of Medium: Online Resource
    ISSN: 1744-9979 , 1744-9987
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2010864-3
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  • 10
    Online Resource
    Online Resource
    Wiley ; 2022
    In:  Therapeutic Apheresis and Dialysis Vol. 26, No. 6 ( 2022-12), p. 1193-1201
    In: Therapeutic Apheresis and Dialysis, Wiley, Vol. 26, No. 6 ( 2022-12), p. 1193-1201
    Abstract: There is no standard for insoluble particulate matters in dialysate. We evaluated the insoluble particulate matters in online prepared substitution fluid. Methods We evaluated particle diameters and constituent elements of particles in online prepared substitution fluid and the final endotoxin retentive filter (ETRF). Results The measurement results with particles in the online prepared substitution fluid and particles attached to the final ETRF revealed that Ca‐containing particles accounted for 11 particles and Si‐containing particles accounted for 19 particles of 30 particles detected in the online prepared substitution fluid and the final ETRF. Conclusion We presume that insoluble particulates in online prepared substitution fluid were Ca and Mg precipitated from dialysate and Si precipitated from dialysis water. Even if two ETRFs were connected in series, these particles were formed in the final ETRF.
    Type of Medium: Online Resource
    ISSN: 1744-9979 , 1744-9987
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2010864-3
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