Hemodialysis coupled with rheopheresis in calciphylaxis: A winning combination

Bennani, Hamza Naciri; Jouve, Thomas; Boudjemaa, Soufiane; Gil, H.A.; Rostaing, Lionel

doi:10.1002/jca.21736

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…28 Other case studies are confirming the positive effects of Rh in this extremely severe clinical condition. 29 –31 A randomized trial is scheduled to study Rh as an adjuvant therapy for calciphylaxis is under way (RHEO-CAL). 39…”

Section: Calciphylaxismentioning

confidence: 99%

Rheopheresis: A narrative review

Kosmadakis

2022

Int J Artif Organs

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Introduction: Rheopheresis is an extracorporal selective double-filtration procedure with an initial separation of plasma from the whole blood and a further filtration of the plasma through a second filter in order to eliminate a certain number of high molecular weight proteins such LDL, Lp(a), fibrinogen, α2-macroglobulin, Factor von Willebrand, and IgM Immunoglobulin. Methods: In this narrative review we discuss the available data on the effects of Rheopheresis in various clinical conditions. Results: Rheopheresis is considerd to exert a rapid effect on clinical conditions associated with seriously affected microcirculation and rheologic parameters such as, the dry age-related macular degeneration (AMD), sudden sensorineural hearing loss (SSHS), peripheral artery disease (PAD), calciphylaxis, systemic sclerosis and diabetic foot. Conclusions: Rheopheresis is a promising technique for conditions associated with affected microcirculatory rheologic parameters

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Section: Calciphylaxismentioning

confidence: 99%

Rheopheresis: A narrative review

Kosmadakis

2022

Int J Artif Organs

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“…While there are even fewer evidence-based studies on albumin infusion in dialysis patients, the few available ones suggest, as is logical to expect, that albumin infusion may have a favorable effect on intradialytic hypotension and a low risk of side effects. However, the advantages in the management of hypotension compared to saline infusion are not clear and probably cannot be generalized [135][136][137][138][139][140]. The high costs, the potential side effects, and, in particular, the risk of allergic reactions, need to be underlined.…”

Section: Albumin (And Blood Transfusions)mentioning

confidence: 99%

Intradialytic Nutrition and Hemodialysis Prescriptions: A Personalized Stepwise Approach

et al. 2020

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Dialysis and nutrition are two sides of the same coin—dialysis depurates metabolic waste that is typically produced by food intake. Hence, dietetic restrictions are commonly imposed in order to limit potassium and phosphate and avoid fluid overload. Conversely, malnutrition is a major challenge and, albeit to differing degrees, all nutritional markers are associated with survival. Dialysis-related malnutrition has a multifactorial origin related to uremic syndrome and comorbidities but also to dialysis treatment. Both an insufficient dialysis dose and excessive removal are contributing factors. It is thus not surprising that dialysis alone, without proper nutritional management, often fails to be effective in combatting malnutrition. While composite indexes can be used to identify patients with poor prognosis, none is fully satisfactory, and the definitions of malnutrition and protein energy wasting are still controversial. Furthermore, most nutritional markers and interventions were assessed in hemodialysis patients, while hemodiafiltration and peritoneal dialysis have been less extensively studied. The significant loss of albumin in these two dialysis modalities makes it extremely difficult to interpret common markers and scores. Despite these problems, hemodialysis sessions represent a valuable opportunity to monitor nutritional status and prescribe nutritional interventions, and several approaches have been tried. In this concept paper, we review the current evidence on intradialytic nutrition and propose an algorithm for adapting nutritional interventions to individual patients.

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