Haemodialysate: Long neglected, difficult to optimize, may modify hard outcomes
Entity
UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD)Publisher
Oxford University PressDate
2015-01-01Citation
10.1093/ckj/sfv088
Clinical Kidney Journal 8.5 (2015): 576-579
ISSN
2048-8505DOI
10.1093/ckj/sfv088Funded by
Grant support: ISCIII and FEDER funds PI13/00047, Sociedad Española de Nefrologia, ISCIII-RETIC REDinREN/RD012/0021, Comunidad de Madrid CIFRA S2010/BMD-2378. Salary support: Programa Intensificación Actividad Investigadora (ISCIII/Agencia Laín-Entralgo/CM) to A.O.Project
Comunidad de Madrid. S2010/BMD-2378/CIFRAEditor's Version
http://dx.doi.org/10.1093/ckj/sfv088Subjects
Ckd-mbd; End-stage kidney disease; Outcomes; Renal replacement therapy; Sudden death; MedicinaRights
The Author 2015Abstract
In two recent CKJ reviews, experts (Basile and Lomonte and Locatelli et al.) have reviewed haemodialysate composition. A longneglected
issue, observational studies have associated the composition of haemodialysate to adverse outcomes. However, the
scarcity of clinical trial-derived information results in limited guideline recommendations on the issue. Indeed, guidelines have
more frequently indicated what not to do rather than what to do. In this setting, expert opinion becomes invaluable. In
designing haemodialysate composition, a balance should be struck between the need to correct within a time frame of around 4
hours the electrolyte and water imbalances that take 48 to 72 h to build, with the need for gradual correction of these
imbalances. The issue is complicated further by the impact of individual variability in dietary habits, medications and
comorbidities. In this regard, a personalized medicine approach to individualization of haemodialysate composition offers the
best chance of improving patient outcomes. But how can haemodialysate individualization be achieved, and what clinical trial
design will best test the impact of such approaches on patient outcomes?
Files in this item
Google Scholar:Pérez-Gómez, María Vanessa
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Gonzalez-Parra, Emilio
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Ortiz Arduán, Alberto
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