Advances and Advantages in Recent Central Dialysis Fluid Delivery System

Koda, Yutaka; Mineshima, Michio

doi:10.1159/000213494

Cited by 14 publications

(10 citation statements)

References 10 publications

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“…Accordingly, it has been suggested that DCa be individualized by CKD‐MBD status in each patient . However, in Japan, where a central dialysate fluid delivery system is common , it is more difficult to use individualized DCa baths. The results presented here show the effects of conversion of DCa from 3.0 to 2.75 mEq/L on mass dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L

et al. 2015

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Selection of a lower dialysate calcium concentration (DCa) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa can worsen mineral and bone disorders. This 1-year retrospective observational study evaluated 121 hemodialysis patients at Fukuoka Renal Clinic who underwent conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. The primary outcomes were changes in serum levels of calcium, phosphate, and parathyroid hormone (PTH). The effects of baseline serum calcium and PTH levels on changes in biochemical parameters were also determined. One year after DCa conversion, mean serum calcium level decreased, while serum phosphate, alkaline phosphatase, and PTH concentrations increased. The rate of achievement of target PTH was higher in patients with lower serum PTH level at baseline, while patients with higher baseline serum PTH level tended to exceed the upper limit of the PTH target range. Patients with higher baseline serum calcium concentration showed a greater decrease in serum calcium level and a greater increase in serum PTH level at 1 year. Patients with a lower baseline serum PTH level can benefit from optimal PTH control following conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. However, secondary hyperparathyroidism may be exacerbated in some patients with higher baseline serum calcium (Ca) and PTH levels. These results indicate that an individualized approach can maximize the benefits of Ca unloading after conversion to lower DCa.

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Section: Discussionmentioning

confidence: 99%

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L

et al. 2015

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“…Although the ability to supply a large amount of dialysis fluid is only temporary in CDDS, it is possible to use many patient monitors [12,13].…”

Section: Dialysis Fluid Delivery Systemsmentioning

confidence: 99%

The central dialysis fluid delivery system (CDDS): is it specialty in Japan?

Kawanishi

Moriishi²,

Takahashi³

et al. 2016

Ren Replace Ther

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The central dialysis fluid delivery system (CDDS) simplifies the maintenance and supervision involved by enabling the combined management of dialysis fluid for multiple persons, preparation of cleaning and antiseptic solutions, and delivery of these to each patient monitor. The CDDS has been used exclusively in Japan since 1960s. Approximately 88 % of dialysis machines are patient monitors with CDDS. It is a cost-effective, laborsaving, time-tested system with good microbial safety, which has been used for 45 years. In many countries, especially in Asia, the number of end-stage renal disease (ESRD) patients is increasing. The CDDS will contribute to such emerging situations with its easy handling and economic advantages.

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“…Standard reverse osmosis discharges more water than it actually produces for dialysis; the recovery ratio, i.e. the percentage of depurated water used for dialysis, can be over 80%, if the newer systems are employed; these are more expensive and the lifespan of the reverse osmosis membranes is often considerably shorter, especially when reverse osmosis is not coupled with a water softener system [9,19,27,31,[52][53][54][55][56][57].…”

mentioning

confidence: 99%

“…Centralised water preparation systems, available since the late 1970s, and particularly diffused in Japan, are The circular "cradle to cradle" model: technical waste should nourish the technical cycle, similar to organic waste, nourishing plants and being continously recycled in the biosphere increasingly being used: they combine water treatment with dialysis fluid preparation, both for haemodialysis and for haemodiafiltration [53][54][55][56][57]. This partly compensates for the higher costs of HDF and the avoidance of plastic bags for reinfusion is of obvious interest not only for reducing waste, but also as for water consumption.…”

mentioning

confidence: 99%

Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology

et al. 2020

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High-technology medicine saves lives and produces waste; this is the case of dialysis. The increasing amounts of waste products can be biologically dangerous in different ways: some represent a direct infectious or toxic danger for other living creatures (potentially contaminated or hazardous waste), while others are harmful for the planet (plastic and non-recycled waste). With the aim of increasing awareness, proposing joint actions and coordinating industrial and social interactions, the Italian Society of Nephrology is presenting this position statement on ways in which the environmental impact of caring for patients with kidney diseases can be reduced. Due to the particular relevance in waste management of dialysis, which produces up to 2 kg of potentially contaminated waste per session and about the same weight of potentially recyclable materials, together with technological waste (dialysis machines), and involves high water and electricity consumption, the position statement mainly focuses on dialysis management, identifying ten first affordable actions: (1) reducing the burden of dialysis (whenever possible adopting an intent to delay strategy, with wide use of incremental schedules); (2) limiting drugs and favouring "natural" medicine focussing on lifestyle and diet; (3) encouraging the reuse of "household" hospital material; (4) recycling paper and glass; (5) recycling non-contaminated plastic; (6) reducing water consumption; (7) reducing energy consumption; (8) introducing environmental-impact criteria in checklists for evaluating dialysis machines and supplies; (9) encouraging well-planned triage of contaminated and non-contaminated materials; (10) demanding planet-friendly approaches in the building of new facilities.

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Advances and Advantages in Recent Central Dialysis Fluid Delivery System

Cited by 14 publications

References 10 publications

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L

The central dialysis fluid delivery system (CDDS): is it specialty in Japan?

Green nephrology and eco-dialysis: a position statement by the Italian Society of Nephrology

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