Show simple item record

dc.contributor.advisorCastellanos de la Hoz, Juan Camilo 
dc.contributor.advisorZuñiga, Eduardo A 
dc.contributor.advisorMolano Triviño, Alejandra Patricia 
dc.contributor.advisorSanabria, Mauricio 
dc.contributor.advisorVesga Gualdron, Jasmin 
dc.creatorRamos Galvis, Leidy Carolina 
dc.creatorGutiérrez Castilla, Juan Felipe 
dc.date.accessioned2020-02-12T19:07:26Z
dc.date.available2020-02-12T19:07:26Z
dc.date.created2020-01-29
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/20859
dc.descriptionIntroducción: Actualmente se dispone de dializadores con membranas cuyos poros han expandido la capacidad de aclaramiento de moléculas medianas, permitiendo desarrollar un nuevo concepto de terapia: “Hemodiálisis Expandida”. Se ha demostrado además, que el flujo de dializado(Qd) tiene poco valor en la remoción de moléculas en hemodiálisis convencional, por lo que el objetivo de este estudio es evaluar la efectividad de diálisis teniendo en cuenta la tasa de reducción de moléculas medianas en pacientes con peso menor o igual a 70Kg comparando un flujo de dializado de Qd400ml/min vs un Qd500ml/min en hemodiálisis expandida con filtro TheranovaMR. Metódos y Resultados: Estudio observacional analítico de cohorte retrospectiva. 23 pacientes cumplieron criterios de inclusión, 11(47%) con Qd 400ml/min y 12(52.1%) con Qd 500ml/min. La tasa de reducción no fue estadísticamente significativa, excepto en las cadenas kappa, la cual fue de 0,71 y 0,64 con Qd400ml/min y Qd500ml/min respectivamente con una P 0.043. Además el consumo de agua fue menor en el grupo de Qd de 400ml/min con un ahorro promedio de 24 litros por paciente y 13.824 litros en 12 semanas. Conclusión: Utilizar un Qd de 400ml/min en hemodiálisis expandida comparado con Qd de 500 ml/min no influyó en la efectividad de diálisis en cuanto a tasa de reducción, al tiempo que se obtienen ahorros de agua sustanciales. Sin embargo, no existen estudios previos de estas características, por lo cual se considera un estudio Piloto y se requiere una muestra mayor para estudios posteriores.
dc.description.abstractIntroduction: Dialyzers with special kind of membranes are currently available with pores that have expanded the lightening capacity of medium molecules, allowing the development of a therapy concept: “Expanded Hemodialysis”. It has also been shown that the flow of dialysate (Qd) has little value in the removal of molecules in conventional hemodialysis, so the objective of this study is to evaluate the effectiveness of dialysis taking into account the rate of reduction of medium molecules in patients weighing less than or equal to 70Kg comparing a dialysate flow of Qd400ml / min vs a Qd500ml / min in expanded hemodialysis with TheranovaMR filter. Methods and Results: Retrospective analytical observational cohort study. 23 patients met inclusion criteria, 11 (47%) with Qd 400ml / min and 12 (52.1%) with Qd 500ml / min. The reduction rate was not statistically significant, except in the kappa chains, which was 0.71 and 0.64 with Qd400ml / min and Qd500ml / min respectively with a P 0.043. In addition, water consumption was lower in the Qd group of 400ml / min with an average saving of 24 liters per patient and 13,824 liters in 12 weeks. Conclusion: Using a Qd of 400ml / min in expanded hemodialysis compared to Qd of 500ml / min did not influence the effectiveness of dialysis in terms of reduction rate, while obtaining substantial water savings. However, there are no previous studies of these characteristics, so it is considered a pilot study and a larger sample is required for further studies.
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourcereponame:Repositorio Institucional EdocUR
dc.sourceinstname:Universidad del Rosario
dc.subjectHemodiálisis expandida
dc.subjectEemodiálisis expandida
dc.subjectFlujo de dializado (Qd)
dc.subject.ddcFarmacología & terapéutica 
dc.subject.lembNefrología
dc.subject.lembHemodiálisis-Investigaciones
dc.subject.lembDiálisis-Aparatos e instrumentos
dc.titleReducción de moléculas medianas con hemodiálisis expandida a diferentes flujos de dializado
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Nefrología
dc.publisher.programEspecialización en Nefrología
dc.publisher.departmentFacultad de Medicina
dc.subject.keywordExpanded hemodialysis
dc.subject.keywordDalysate flow (Qd)
dc.subject.keywordEffectiveness of dialysis
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.source.bibliographicCitationKashiwagi T, Sato K, Kawakami S, Kiyomoto M, Enomoto M, Suzuki T, et al. Effects of reduced dialysis fluid flow in hemodialysis. J Nippon Med Sch [Internet]. 2013 [cited 2018 Sep 26];80(2):119–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23657065
dc.source.bibliographicCitationTarrass F, Benjelloun M, Benjelloun O. Recycling Wastewater After Hemodialysis: An Environmental Analysis for Alternative Water Sources in Arid Regions. Am J Kidney Dis. 2008;52(1):154–8.
dc.source.bibliographicCitationJha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. Lancet [Internet]. 2013 Jul 20 [cited 2018 Sep 26];382(9888):260–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23727169
dc.source.bibliographicCitationPrasad N, Jha V. Hemodialysis in Asia. Kidney Dis (Basel, Switzerland) [Internet]. 2015 Dec [cited 2018 Sep 26];1(3):165–77. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27536677
dc.source.bibliographicCitationHoenich NA, Levin R, Ronco C. Water for haemodialysis and related therapies: recent standards and emerging issues. Blood Purif. 2010;29(2):81–5.
dc.source.bibliographicCitationAgar JWM. Reusing dialysis wastewater: the elephant in the room. Vol. 52, American journal of kidney diseases : the official journal of the National Kidney Foundation. United States; 2008. p. 10–2.
dc.source.bibliographicCitationDAUGIRDAS JT. Prescribing and monitoring hemodialysis in a 3-4 × /week setting. Hemodial Int [Internet]. 2008 Apr [cited 2018 Sep 26];12(2):215–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18394053
dc.source.bibliographicCitationRonco C, La Manna G. Expanded Hemodialysis: A New Therapy for a New Class of Membranes. In: Contributions to nephrology [Internet]. 2017 [cited 2018 Sep 26]. p. 124–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28535525
dc.source.bibliographicCitationDucuara D, Martínez A, Molano A, Wancjer B, Tovar JR. Effect of flow adjustment dialysate (Qd) hemodialysis on effectiveness of underweight patients. [cited 2018 Sep 26]; Available from: https://www.ingentaconnect.com/content/doaj/16927273/2013/00000011/00000002/art00003#Refs
dc.source.bibliographicCitationMolano Triviño A, Wancjer Meid B, Guzman G, Yunez Luqueta A, Beltrán J, Romero G, et al. SP491EFFECTS OF DECREASING DIALYSIS FLUID FLOW RATE ON DIALYSIS EFFICACY AND INTERDIALYTIC WEIGHT GAIN IN CHRONIC PATIENTS WITH HEMODIALYSIS - FLUGAIN Study. Nephrol Dial Transplant [Internet]. 2018 May 1 [cited 2018 Sep 26];33(suppl_1):i514–5. Available from: https://academic.oup.com/ndt/article/33/suppl_1/i514/4998454
dc.source.bibliographicCitationLeypoldt JK, Prichard S, Chertow GM, Alvarez L. Differential Molecular Modeling Predictions of Mid and Conventional Dialysate Flows. Blood Purif. 2019;47(4):369–76.
dc.source.bibliographicCitationMolano Trivino A, Galván Á, Wancjer Meid B, Vesga J, Suárez A, Sanabria RM, et al. SAT-342 LONG TERM OUTCOMES OF LOWERING DIALYSATE FLOW (QD) IN A POPULATION OF CHRONIC HEMODIALYSIS IN RTS COLOMBIA. Kidney Int Reports [Internet]. 2019 Jul 1;4(7):S151–2. Available from: https://doi.org/10.1016/j.ekir.2019.05.390
dc.source.bibliographicCitationLowrie EG, Laird NM, Parker TF, Sargent JA. Effect of the Hemodialysis Prescription on Patient Morbidity. N Engl J Med [Internet]. 1981 Nov 12 [cited 2018 Sep 26];305(20):1176–81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7027040
dc.source.bibliographicCitationHarter HR. Review of significant findings from the National Cooperative Dialysis Study and recommendations. Kidney Int Suppl [Internet]. 1983 Apr [cited 2018 Sep 26];(13):S107-12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6345891
dc.source.bibliographicCitationVanholder R, Schepers E, Pletinck A, Nagler E V., Glorieux G. The Uremic Toxicity of Indoxyl Sulfate and p-Cresyl Sulfate: A Systematic Review. J Am Soc Nephrol [Internet]. 2014 Sep 1 [cited 2018 Sep 26];25(9):1897–907. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24812165
dc.source.bibliographicCitationLocatelli F, Martin-Malo A, Hannedouche T, Loureiro A, Papadimitriou M, Wizemann V, et al. Effect of Membrane Permeability on Survival of Hemodialysis Patients. J Am Soc Nephrol [Internet]. 2009 Feb 25 [cited 2018 Sep 26];20(3):645–54. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19092122
dc.source.bibliographicCitationHakim P discussant: RM. Assessing the adequacy of dialysis. Kidney Int [Internet]. 1990 Feb 1;37(2):822–32. Available from: https://doi.org/10.1038/ki.1990.52
dc.source.bibliographicCitationHemodialysis Adequacy 2006 Work Group. Clinical Practice Guidelines for Hemodialysis Adequacy, Update 2006. Am J Kidney Dis [Internet]. 2006 Jul [cited 2018 Sep 26];48:S2–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16813990
dc.source.bibliographicCitationGoldstein SL, Brem A, Warady BA, Fivush B, Frankenfield D. Comparison of single-pool and equilibrated Kt/V values for pediatric hemodialysis prescription management: analysis from the Centers for Medicare & Medicaid Services Clinical Performance Measures Project. Pediatr Nephrol. 2006 Aug;21(8):1161–6.
dc.source.bibliographicCitationHimmelfarb J, Ikizler TA. Hemodialysis. N Engl J Med [Internet]. 2010 Nov 3;363(19):1833–45. Available from: https://doi.org/10.1056/NEJMra0902710
dc.source.bibliographicCitationDaugirdas JT, Depner TA. A nomogram approach to hemodialysis urea modeling. Am J Kidney Dis [Internet]. 1994 Jan [cited 2018 Sep 26];23(1):33–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8285195
dc.source.bibliographicCitationDaugirdas JT. Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol [Internet]. 1993 Nov [cited 2018 Sep 26];4(5):1205–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8305648
dc.source.bibliographicCitationBesarab A, Sherman R. The relationship of recirculation to access blood flow. Am J Kidney Dis [Internet]. 1997 Feb [cited 2018 Sep 26];29(2):223–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9016893
dc.source.bibliographicCitationEloot S, Van Biesen W, Vanholder R. A Sad but Forgotten Truth: The Story of Slow-Moving Solutes in Fast Hemodialysis. Semin Dial [Internet]. 2012 Sep 1 [cited 2018 Sep 26];25(5):505–9. Available from: http://doi.wiley.com/10.1111/j.1525-139X.2012.01107.x
dc.source.bibliographicCitationEuropean Best Practice Guidelines Expert Group on Hemodialysis, European Renal Association. Section II. Haemodialysis adequacy. Nephrol Dial Transplant [Internet]. 2002 [cited 2018 Sep 26];17 Suppl 7:16–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12386211
dc.source.bibliographicCitationGlorieux G, Tattersall J. Uraemic toxins and new methods to control their accumulation: game changers for the concept of dialysis adequacy. Clin Kidney J [Internet]. 2015 Aug [cited 2018 Sep 26];8(4):353–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26251699
dc.source.bibliographicCitationVanholder R, Glorieux G, Eloot S. Once upon a time in dialysis: the last days of Kt/V? Kidney Int [Internet]. 2015 Sep [cited 2018 Sep 26];88(3):460–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26061543
dc.source.bibliographicCitationPowers KM, Wilkowski MJ, Helmandollar AW, Koenig KG, Bolton WK. Improved urea reduction ratio and Kt/V in large hemodialysis patients using two dialyzers in parallel. Am J Kidney Dis [Internet]. 2000 Feb [cited 2018 Sep 26];35(2):266–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10676726
dc.source.bibliographicCitationel Akrout M, Jadoul M. [Methodology and practical use in hemodialysis of the percentage of urea reduction (PUR)]. Nephrologie [Internet]. 1995 [cited 2018 Sep 26];16(6):413–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8524448
dc.source.bibliographicCitationOwen WF, Lew NL, Liu Y, Lowrie EG, Lazarus JM. The Urea Reduction Ratio and Serum Albumin Concentration as Predictors of Mortality in Patients Undergoing Hemodialysis. N Engl J Med [Internet]. 1993 Sep 30 [cited 2018 Sep 26];329(14):1001–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8366899
dc.source.bibliographicCitationHeld PJ, Port FK, Wolfe RA, Stannard DC, Carroll CE, Daugirdas JT, et al. The dose of hemodialysis and patient mortality. Kidney Int [Internet]. 1996 Aug [cited 2018 Sep 26];50(2):550–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8840285
dc.source.bibliographicCitationSehgal AR, Snow RJ, Singer ME, Amini SB, DeOreo PB, Silver MR, et al. Barriers to adequate delivery of hemodialysis. Am J Kidney Dis [Internet]. 1998 Apr [cited 2018 Sep 26];31(4):593–601. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9531174
dc.source.bibliographicCitationIfudu O, Mayers JD, Matthew JJ, Fowler AM, Homel P, Friedman EA. Standardized Hemodialysis Prescriptions Promote Inadequate Treatment in Patients with Large Body Mass. Ann Intern Med [Internet]. 1998 Mar 15 [cited 2018 Sep 26];128(6):451. Available from: http://annals.org/article.aspx?doi=10.7326/0003-4819-128-6-199803150-00005
dc.source.bibliographicCitationAlayoud A, Benyahia M, Montassir D, Hamzi A, Zajjari Y, Bahadi A, et al. A Model to Predict Optimal Dialysate Flow. Ther Apher Dial [Internet]. 2012 Apr [cited 2018 Sep 26];16(2):152–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22458394
dc.source.bibliographicCitationBhimani JP, Ouseph R, Ward RA. Effect of increasing dialysate flow rate on diffusive mass transfer of urea, phosphate and 2-microglobulin during clinical haemodialysis. Nephrol Dial Transplant [Internet]. 2010 Dec 1 [cited 2018 Sep 26];25(12):3990–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20543211
dc.source.bibliographicCitationYamamoto K-I, Matsukawa H, Yakushiji T, Fukuda M, Hiyoshi T, Sakai K. Technical Evaluation of Dialysate Flow in a Newly Designed Dialyzer. ASAIO J [Internet]. 2007 Jan [cited 2018 Sep 26];53(1):36–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17237647
dc.source.bibliographicCitationVanholder R, De Smet R, Glorieux G, Argiles A, Baurmeister U, Brunet P, et al. Review on uremic toxins: classification, concentration, and interindividual variability. Kidney Int. 2003 May;63(5):1934–43.
dc.source.bibliographicCitationRonco C. The Rise of Expanded Hemodialysis. Vol. 44, Blood purification. Switzerland; 2017. p. I–VIII.
dc.source.bibliographicCitationCuenta de alto costo. Situación de la enfermedad renal crónica, la hipertensión arterial y la diabetes mellitus. Cuenta alto costo [Internet]. 2017;280. Available from: https://cuentadealtocosto.org/site/images/Publicaciones/2018/Libro_Situacion_ERC_en_Colombia_2017.pdf
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.
dc.type.documentTrabajo de grado
dc.creator.degreetypeFull time
dc.title.TranslatedTitleReduction of medium molecules with expanded hemodialysis at different dialysate flows


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record

Atribución-NoComercial-SinDerivadas 2.5 Colombia
Except where otherwise noted, this item's license is described as Atribución-NoComercial-SinDerivadas 2.5 Colombia