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Article ; Online: Dialyzer reprocessing: Considerations and pitfalls for effective and safe hemodialysis.

Thongsricome, Thana / Eiam-Ong, Somchai / Tiranathanagul, Khajohn

2023

Abstract: Background: Dialyzer reprocessing for dialyzer reuse in the same patient has been developed since the early time in hemodialysis history to save cost and time related to reassembling the new dialyzer during that time. The procedure can reduce the first- ... ...

Abstract	Background: Dialyzer reprocessing for dialyzer reuse in the same patient has been developed since the early time in hemodialysis history to save cost and time related to reassembling the new dialyzer during that time. The procedure can reduce the first-use and allergic reactions from using incompatible cellulosic dialyzer membrane by altering some manufacturing chemicals. Methods: All of established literatures regarding recent dialyzer reprocessing methods and considerations were extensively reviewed and summarized. Results: Dialyzer reprocessing can be performed by multiple protocols but involves common steps including bedside rinsing after use, cleaning, dialyzer testing to prevent excessive drop in dialyzer clearance and membrane integrity, high-level disinfection or sterilization either by chemicals or heat, storage, and preparation for subsequent dialysis session by adequate rinsing to reduce the residual reprocessing chemical to the safe level. Compared with the single-use strategy, evidence is conflicting for the mortality advantages or disadvantages of dialyzer reuse, with some showing increased mortality in patients receiving peracetic acid sterilization. Keys for the effective and safe dialyzer reuse involve strict adherence to specific manufacturer's protocol, adequate dialysis water quality complied with the Association for the Advancement of Medical Instrumentation standard, measurement of the total cell volume to prevent inadequate hemodialysis, and infectious control consideration. In the present era, single-use strategy is increasingly adopted due to the decreased cost for dialyzer manufacturing. Environmental concerns of higher solid waste from dialyzer disposal in single-use dialysis should be compared with the liquid waste from reprocessing chemicals along with plastic waste and cardboard in reuse dialysis. Conclusion: Dialyzer reprocessing with adequate regulation is considered as an acceptable option for cost-effective hemodialysis, compared with the single-use strategy.
Language	English
Publishing date	2023-06-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028193-9
ISSN	1525-139X ; 0894-0959
ISSN (online)	1525-139X
ISSN	0894-0959
DOI	10.1111/sdi.13163
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Zs.A 2879: Show issues

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Article ; Online: Association of fine particulate matter (PM

Wathanavasin, Wannasit / Banjongjit, Athiphat / Phannajit, Jeerath / Eiam-Ong, Somchai / Susantitaphong, Paweena

Scientific reports

2024 Volume 14, Issue 1, Page(s) 1048

Abstract: Several studies have reported an increased risk of chronic kidney disease (CKD) outcomes after long-term exposure (more than 1 year) to particulate matter with an aerodynamic diameter of ≤ 2.5 µm ( ... ...

Abstract	Several studies have reported an increased risk of chronic kidney disease (CKD) outcomes after long-term exposure (more than 1 year) to particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM
MeSH term(s)	Humans ; Cross-Sectional Studies ; Renal Insufficiency, Chronic/chemically induced ; Renal Insufficiency, Chronic/epidemiology ; Kidney Failure, Chronic ; Odds Ratio ; Particulate Matter/adverse effects
Chemical Substances	Particulate Matter
Language	English
Publishing date	2024-01-10
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-51554-1
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Article: Metabolic alkalosis masked presentation of diabetic ketoacidosis: A case report.

Wuttiputhanun, Thunyatorn / Townamchai, Natavudh / Eiam-Ong, Somchai / Takkavatakarn, Kullaya

Clinical case reports

2023 Volume 11, Issue 12, Page(s) e8250

Abstract: Managing mixed acid-base disorders can be diagnostically challenging, particularly when metabolic acidosis and metabolic alkalosis occur simultaneously. When dealing with metabolic alkalosis, a comprehensive approach involves taking a detailed medical ... ...

Abstract	Managing mixed acid-base disorders can be diagnostically challenging, particularly when metabolic acidosis and metabolic alkalosis occur simultaneously. When dealing with metabolic alkalosis, a comprehensive approach involves taking a detailed medical history, assessing volume status, and performing urine chloride analysis. Routine calculation of the anion gap is important to identify masked wide anion gap metabolic acidosis. We report a case of a 32-year-old female with type 1 diabetes mellitus, presented with intractable vomiting for 2 days with hyperglycemia, hypokalemia, and metabolic alkalosis, along with a wide anion gap. She was diagnosed with "diabetic ketoalkalosis" due to diabetic ketoacidosis combined with vomiting-induced metabolic alkalosis. She became clinically stable after resuscitation with normal saline, intravenous potassium, and intravenous insulin.
Language	English
Publishing date	2023-11-27
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.8250
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Article: Severe hyponatremia as the presenting manifestation of primary empty sella syndrome.

Takkavatakarn, Kullaya / Wipattanakitcharoen, Aschariya / Katavetin, Pisut / Eiam-Ong, Somchai

Clinical case reports

2022 Volume 10, Issue 2, Page(s) e05369

Abstract: Severe hyponatremia is associated with neurological impairment and mortality. Furthermore, severe hyponatremia can be the first presentation of several diseases. Therefore, an appropriate investigation for the underlying causes of hyponatremia apart from ...

Abstract	Severe hyponatremia is associated with neurological impairment and mortality. Furthermore, severe hyponatremia can be the first presentation of several diseases. Therefore, an appropriate investigation for the underlying causes of hyponatremia apart from the proper correction of sodium levels, might lead to a diagnosis of occult diseases.
Language	English
Publishing date	2022-02-03
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.5369
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Article ; Online: The role of a low protein diet supplemented with ketoanalogues on kidney progression in pre-dialysis chronic kidney disease patients.

Ariyanopparut, Saravanee / Metta, Kamonchanok / Avihingsanon, Yingyos / Eiam-Ong, Somchai / Kittiskulnam, Piyawan

Scientific reports

2023 Volume 13, Issue 1, Page(s) 15459

Abstract: In slowing kidney progression, numerous pre-dialysis chronic kidney disease (CKD) patients could not adhere to the well-established dietary pattern, including a very low protein diet, 0.3-0.4 g/kg/day, plus a full dose ketoanalogues (KAs) of amino acids. ...

Abstract	In slowing kidney progression, numerous pre-dialysis chronic kidney disease (CKD) patients could not adhere to the well-established dietary pattern, including a very low protein diet, 0.3-0.4 g/kg/day, plus a full dose ketoanalogues (KAs) of amino acids. We evaluated the role of a low protein diet (LPD), 0.6-0.8 g/kg/day, combined with KAs (LPD-KAs) on CKD progression. We extracted data in the retrospective cohort using electronic medical records (n = 38,005). Participants with LPD-KAs for longer than six months were identified. An unmatched control group, LPD alone, was retrieved from the same database. Cox proportional hazard models were performed to examine the associations between LPD-KAs and outcomes. The primary outcome was either a rapid estimated glomerular filtration rate (eGFR) decline > 5 mL/min/1.73m
MeSH term(s)	Humans ; Diet, Protein-Restricted/adverse effects ; Dialysis ; Dietary Proteins ; Retrospective Studies ; Kidney ; Renal Insufficiency, Chronic
Chemical Substances	Dietary Proteins
Language	English
Publishing date	2023-09-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-42706-w
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Article: Incremental versus conventional haemodialysis in end-stage kidney disease: a systematic review and meta-analysis.

Takkavatakarn, Kullaya / Jintanapramote, Kavita / Phannajit, Jeerath / Praditpornsilpa, Kearkiat / Eiam-Ong, Somchai / Susantitaphong, Paweena

Clinical kidney journal

2023 Volume 17, Issue 1, Page(s) sfad280

Abstract: Background: Appropriate dialysis prescription in the transitional setting from chronic kidney disease to end-stage kidney disease is still challenging. Conventional thrice-weekly haemodialysis (HD) might be associated with rapid loss of residual kidney ... ...

Abstract	Background: Appropriate dialysis prescription in the transitional setting from chronic kidney disease to end-stage kidney disease is still challenging. Conventional thrice-weekly haemodialysis (HD) might be associated with rapid loss of residual kidney function (RKF) and high mortality. The benefits and risks of incremental HD compared with conventional HD were explored in this systematic review and meta-analysis. Methods: We searched MEDLINE, Scopus and Cochrane Central Register of Controlled Trials up to April 2023 for studies that compared the impacts of incremental (once- or twice-weekly HD) and conventional thrice-weekly HD on cardiovascular events, RKF, vascular access complications, quality of life, hospitalization and mortality. Results: A total of 36 articles (138 939 participants) were included in this meta-analysis. The mortality rate and cardiovascular events were similar between incremental and conventional HD {odds ratio [OR] 0.87 [95% confidence interval (CI)] 0.72-1.04 and OR 0.67 [95% CI 0.43-1.05], respectively}. However, hospitalization and loss of RKF were significantly lower in patients treated with incremental HD [OR 0.44 (95% CI 0.27-0.72) and OR 0.31 (95% CI 0.25-0.39), respectively]. In a sensitivity analysis that included studies restricted to those with RKF or urine output criteria, incremental HD had significantly lower cardiovascular events [OR 0.22 (95% CI 0.08-0.63)] and mortality [OR 0.54 (95% CI 0.37-0.79)]. Vascular access complications, hyperkalaemia and volume overload were not statistically different between groups. Conclusions: Incremental HD has been shown to be safe and may provide superior benefits in clinical outcomes, particularly in appropriately selected patients. Large-scale randomized controlled trials are required to confirm these potential advantages.
Language	English
Publishing date	2023-11-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfad280
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Zs.A 6587: Show issues

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Article: Peritonitis Caused by Various Species of Diaporthe in Peritoneal Dialysis Patients: A Plant Pathogen to Human Infection.

Halue, Guttiga / Chieochanthanakij, Rutchanee / Kittipanyaworakun, Thanapat / Passorn, Panthira / Kaewboonsert, Donkum / Tharavichitkul, Tanyalak / Banjongjit, Athiphat / Kanjanabuch, Talerngsak / Eiam-Ong, Somchai

Cureus

2024 Volume 16, Issue 3, Page(s) e57016

Abstract: Peritonitis caused by dematiaceous molds is uncommon but poses a significant threat to patients undergoing peritoneal dialysis (PD), leading to high mortality and morbidity. This report highlights three cases of peritonitis caused by three distinct ... ...

Abstract	Peritonitis caused by dematiaceous molds is uncommon but poses a significant threat to patients undergoing peritoneal dialysis (PD), leading to high mortality and morbidity. This report highlights three cases of peritonitis caused by three distinct species of
Language	English
Publishing date	2024-03-27
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.57016
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Article ; Online: Phytopathogen transmitted from plant to human causing peritoneal dialysis-associated peritonitis.

Jaroenpattrawut, Bunpring / Poonvivatchaikarn, Ussanee / Kanjanabuch, Talerngsak / Eiam-Ong, Somchai

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

2021 Volume 42, Issue 2, Page(s) 223–226

Abstract: We report the first case of peritoneal dialysis (PD)-associated peritonitis due ... ...

Abstract	We report the first case of peritoneal dialysis (PD)-associated peritonitis due to
MeSH term(s)	Antifungal Agents/therapeutic use ; Humans ; Mycoses/diagnosis ; Mycoses/drug therapy ; Mycoses/etiology ; Peritoneal Dialysis/adverse effects ; Peritonitis/etiology ; Peritonitis/microbiology
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2021-09-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	645010-6
ISSN	1718-4304 ; 0896-8608
ISSN (online)	1718-4304
ISSN	0896-8608
DOI	10.1177/08968608211048063
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Zs.A 1936: Show issues

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Article ; Online: Comparative Effectiveness between Expanded Hemodialysis (Hemodialysis Using a Medium Cut-Off Dialyzer) and Mixed-Dilution Online Hemodiafiltration Using a High-Flux Dialyzer in Removing Middle-Molecule Uremic Toxins.

Eiamcharoenying, Jirarat / Takkavatakarn, Kullaya / Chariyavilaskul, Pajaree / Susantitaphong, Paweena / Eiam-Ong, Somchai / Tiranathanagul, Khajohn

Blood purification

2022 Volume 51, Issue 11, Page(s) 923–931

Abstract: Introduction: Expanded hemodialysis (HD using a medium cut-off dialyzer [HD + MCO]) provides comparable or better removal of various uremic toxins, particularly large middle-molecule uremic toxins, than post-dilution online hemodiafiltration (olHDF). ... ...

Abstract	Introduction: Expanded hemodialysis (HD using a medium cut-off dialyzer [HD + MCO]) provides comparable or better removal of various uremic toxins, particularly large middle-molecule uremic toxins, than post-dilution online hemodiafiltration (olHDF). Uremic toxin-removing effectiveness between HD + MCO and mixed-dilution olHDF, one of the currently most efficient olHDF modalities, has not been assessed. Method: This randomized controlled trial was conducted in 14 prevalent thrice-a-week HD patients with blood flow rate above 400 mL/min. The patients were randomized into two sequences of 2-week treatment periods of HD + MCO and later mixed-dilution olHDF or vice versa. The reduction ratio (RR) values of small-molecule as well as middle-molecule uremic toxins and protein-bound uremic toxins were measured at baseline and at the end of the treatment. Results: When compared with mixed-dilution olHDF, HD + MCO provided slightly lower β2M RR, but the value was still higher than 75%; showed similar κFLC RR, IS RR, and URR; and yielded significantly higher RR values of α1M (p < 0.001) and λFLC (p < 0.001). Despite higher albumin loss in HD + MCO, the serum albumin levels at the end of the study were comparable between both groups. Conclusion: Expanded HD (HD + MCO) provided similar effectiveness in removing various uremic toxins and could exhibit greater removal of large middle-molecule uremic toxins, such as α1M and λFLC. Expanded HD can be used as an effective alternative option for mixed-dilution olHDF.
MeSH term(s)	Humans ; Hemodiafiltration ; Renal Dialysis/adverse effects ; Uremic Toxins ; Prospective Studies
Chemical Substances	Uremic Toxins ; MCO (56369-20-1)
Language	English
Publishing date	2022-03-11
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000521886
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Zs.A 1872: Show issues

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Article ; Online: Peritonitis after exposure to biocontrol-agent fumes containing Talaromyces flavus: a case report in peritoneal dialysis patient.

Sookto, Phanit / Kanjanabuch, Talerngsak / Chamroensakchai, Tamonwan / Thongbor, Nisa / Eiam-Ong, Somchai

BMC nephrology

2022 Volume 23, Issue 1, Page(s) 279

Abstract: Background: The first case of Taralomyces flavus infection in human and peritoneal dialysis (PD) patient after exposure to biocontrol agent fumes is reported here.: Case presentation: A 77-year-old Thai female farmer with kidney failure presented ... ...

Abstract	Background: The first case of Taralomyces flavus infection in human and peritoneal dialysis (PD) patient after exposure to biocontrol agent fumes is reported here. Case presentation: A 77-year-old Thai female farmer with kidney failure presented with peritonitis and PD catheter obstruction from fungal biofilms. The potential root cause of infection was associated with exposure to biocontrol-agent fumes containing pathogen during agricultural work in her garden. This source of infection has not been mentioned previously. Showering and changing clothes right after outdoor activity with a high density of fungal matters or dust should be added to the routine aseptic technique before performing PD bag exchange to prevent the system contamination. Although the patient received early treatment with liposomal amphotericin B, itraconazole, and catheter removal, according to the ISPD Guideline 2016 and the Global Guideline 2021, the outcome was unfavorable. Antifungal susceptibility testing later revealed that the pathogen was only susceptible to voriconazole. Thus, antifungal susceptibility should be tested if the patient fails or slowly responds to the primary antifungal regimen. Conclusions: T. flavus peritonitis is reported here after exposure to biocontrol-agent fumes containing the pathogen. This work also alerts and reiterates nephrology peers to be aware of this overlooked source of peritonitis, the exposure to dusty environments, specifically containing biocontrol-agent fumes.
MeSH term(s)	Aged ; Antifungal Agents/adverse effects ; Female ; Humans ; Peritoneal Dialysis/adverse effects ; Peritonitis/etiology ; Peritonitis/microbiology ; Talaromyces
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2022-08-09
Publishing country	England
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-022-02898-1
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