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  1. Article ; Online: Conductivity variations and changes in serum sodium concentration during dialysis related to monitor switching.

    Maduell, Francisco / Broseta, José Jesús / Casals, Joaquim / Gómez, Miquel / Rodas, Lida M / Arias-Guillén, Marta / Vera, Manel / Fontseré, Néstor

    Nefrologia

    2024  Volume 43, Issue 6, Page(s) 750–756

    Abstract: Introduction: The sodium gradient during hemodialysis sessions is one of the key factors in sodium balance in patients with dialysis-dependent chronic kidney disease; however, until the appearance of the new monitors with sodium modules, the differences ...

    Abstract Introduction: The sodium gradient during hemodialysis sessions is one of the key factors in sodium balance in patients with dialysis-dependent chronic kidney disease; however, until the appearance of the new monitors with sodium modules, the differences between prescribed and measured sodium have been understudied. The present study aimed to compare the impact on the measured conductivity and the initial and final plasma sodium after changing the 5008 Cordiax to the new 6008 Cordiax monitor.
    Material and methods: 106 patients on hemodialysis were included. Each patient underwent 2 dialysis sessions in which only the monitor was varied. The variables collected were dialysate, sodium and bicarbonate prescribed, real conductivity, initial and final plasma sodium measured, and the calculated sodium gradient (ΔPNa).
    Results: The change of dialysis monitor showed small but statistically significant differences in the initial (138.14mmol/L with 5008 vs. 138.81mmol/L with 6008) and final plasma sodium (139.58mmol/L vs. 140.97mmol/L), as well as in the actual conductivity obtained (13.97 vs. 14.1mS/cm). The ΔPNa also increased significantly.
    Conclusion: The change from 5008 to 6008 monitor is associated with increased conductivity, leading the patient to end the sessions with higher plasma sodium and ΔPNa. Knowing and confirming this change will allow us to individualize the sodium prescription and avoid possible undesirable effects. It could be the preliminary study to explore the new sodium biosensor incorporated into the new generation of monitors.
    MeSH term(s) Humans ; Renal Dialysis/adverse effects ; Sodium ; Dialysis Solutions
    Chemical Substances Sodium (9NEZ333N27) ; Dialysis Solutions
    Language English
    Publishing date 2024-01-18
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 2837917-2
    ISSN 2013-2514 ; 2013-2514
    ISSN (online) 2013-2514
    ISSN 2013-2514
    DOI 10.1016/j.nefroe.2024.01.006
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  2. Article ; Online: Comparison of efficacy and safety of the new generation helixone dialyzers.

    Maduell, Francisco / Broseta, José Jesús / Rodríguez-Espinosa, Diana / Rodas, Lida María / Gómez, Miquel / Arias-Guillén, Marta / Fontseré, Néstor / Vera, Manel / Salgado, Maria Del Carmen / Rico, Nayra / Ramos, Rosa

    Nefrologia

    2024  

    Abstract: Introduction: New generation helixone dialyzers has recently been developed as part of the ongoing effort to improve dialyzer hemocompatibility and avoid adverse reactions to synthetic dialyzers. This study aimed to assess the performance and albumin ... ...

    Abstract Introduction: New generation helixone dialyzers has recently been developed as part of the ongoing effort to improve dialyzer hemocompatibility and avoid adverse reactions to synthetic dialyzers. This study aimed to assess the performance and albumin loss of this new dialyzer series in hemodiafiltration and compare it with the previous generation helixone series.
    Material and methods: A prospective study was conducted in 19 patients. Each patient underwent eight dialysis sessions with the same routine dialysis parameters; only the dialyzer varied: FX60 CorDiax, FX CorAL 60, FX600 CorDiax, FX CorAL 600, FX80 CorDiax, FX CorAL 80, FX800 CorDiax, and FX CorAL 800. The reduction ratios (RR) of urea, creatinine, ß
    Results: All treatments were well tolerated. The mean amount of replacement fluid ranged from 31 to 34 L. Comparison of dialysis treatments showed no differences between small molecules and even up to those the size of β2-microglobulins. Little differences were found between myoglobin, κFLC, prolactin, α
    Conclusion: The new generation helixone dialyzers series has been updated to minimise the risk of adverse reactions, while maintaining the effectiveness and albumin loss achieved by the previous most advanced helixone generation.
    Language English
    Publishing date 2024-04-27
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 2837917-2
    ISSN 2013-2514 ; 2013-2514
    ISSN (online) 2013-2514
    ISSN 2013-2514
    DOI 10.1016/j.nefroe.2024.04.005
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  3. Article ; Online: Most recently developed polyester polymer alloy dialyzer: A new medium cut-off membrane?

    Maduell, Francisco / Rodríguez-Espinosa, Diana / Rodas, Lida María / Gómez, Miquel / Arias-Guillén, Marta / Fontseré, Néstor / Vera, Manel / Del Carmen Salgado, Maria / Rico, Nayra / Broseta, José Jesús

    Artificial organs

    2024  

    Abstract: Background: New versions of the polyester polymer alloy (PEPA) membrane have appeared over the years, with increases in both the pore size and the amount of polyvinylpyrrolidone (PVP) to optimize hydrophilicity performance. This study aimed to assess ... ...

    Abstract Background: New versions of the polyester polymer alloy (PEPA) membrane have appeared over the years, with increases in both the pore size and the amount of polyvinylpyrrolidone (PVP) to optimize hydrophilicity performance. This study aimed to assess the efficacy of the most recently developed PEPA dialyzer, the FDY series, in hemodialysis (HD) modality in terms of uremic toxin removal and albumin loss and to compare it with that of several high-flux dialyzers currently used in HD and post-dilution hemodiafiltration (HDF) treatments.
    Methods: A prospective study was carried out in 21 patients. All patients underwent six dialysis sessions with the same routine dialysis parameters; only the dialyzer and/or the dialysis modality varied: FX80 in HD, FDY 180 in HD, Clearum HS17 in HDF, Elisio 19H in HDF, Vitapes 180 in HDF, and FX80 in post-dilution HDF. The reduction ratios (RR) of urea, creatinine, ß
    Results: Both membranes FDY and FX80 are high-flux dialyzers and are applied here in high-flux HD. The average RR of β
    Conclusions: The most recently developed PEPA dialyzers in the HD modality were as effective as all treatments in the HDF modality and were clearly superior to high-flux helixone HD treatment. These results confirm that this dialyzer should be categorized within the medium cut-off (MCO) membrane classification.
    Language English
    Publishing date 2024-02-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 441812-8
    ISSN 1525-1594 ; 0160-564X
    ISSN (online) 1525-1594
    ISSN 0160-564X
    DOI 10.1111/aor.14726
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  4. Article ; Online: Humoral response of the mRNA-1273 SARS-CoV-2 vaccine in peritoneal dialysis patients.

    Rodríguez-Espinosa, Diana / Broseta, José Jesús / Maduell, Francisco / Bedini, José Luis / Vera, Manel

    Kidney international

    2021  Volume 100, Issue 2, Page(s) 476–477

    MeSH term(s) COVID-19/prevention & control ; COVID-19 Vaccines/immunology ; Humans ; Immunity, Humoral ; Peritoneal Dialysis ; Vaccines, Synthetic/immunology ; mRNA Vaccines
    Chemical Substances COVID-19 Vaccines ; Vaccines, Synthetic
    Language English
    Publishing date 2021-05-31
    Publishing country United States
    Document type Letter
    ZDB-ID 120573-0
    ISSN 1523-1755 ; 0085-2538
    ISSN (online) 1523-1755
    ISSN 0085-2538
    DOI 10.1016/j.kint.2021.05.018
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  5. Article: Practical implementation and clinical benefits of the new automated dialysate sodium control biosensor.

    Maduell, Francisco / Broseta, José J / Rodríguez-Espinosa, Diana / Casals, Joaquim / Escudero, Victor / Gomez, Miquel / Rodas, Lida M / Arias-Guillén, Marta / Vera, Manel / Fontseré, Néstor

    Clinical kidney journal

    2023  Volume 16, Issue 5, Page(s) 859–867

    Abstract: Background: A key feature of dialysis treatment is the prescription of dialysate sodium (Na). This study aimed to describe the practical implementation of a new automated dialysate Na control biosensor and to assess its tolerance and the beneficial ... ...

    Abstract Background: A key feature of dialysis treatment is the prescription of dialysate sodium (Na). This study aimed to describe the practical implementation of a new automated dialysate Na control biosensor and to assess its tolerance and the beneficial clinical effects of isonatraemic dialysis.
    Methods: A prospective study was carried out in 86 patients who, along with their usual parameters, received the following five consecutive phases of treatment for 3 weeks each: phase 0: baseline 5008 machine; phases 1 and 2: 6008 machine without activation of the Na control biosensor and the same fixed individualized Na dialysate prescription or adjusted to obtain similar conductivity to phase 0; phases 3 and 4: activated Na control to isonatraemic dialysis (Na dialysate margins 135-141 or 134-142 mmol/L).
    Results: When the Na control was activated, the few episodes of cramps or hypotension disappeared when the lower dialysate Na margin was increased by 1 or 2 mmol/L. The activated Na control module showed significant differences compared with baseline and the non-activated Na module in final serum Na values, diffusive Na balance, and changes in pre- to postdialysis plasma Na values. The mean predialysis systolic blood pressure value was significantly lower in phase 4 than in phase 1. There were no significant differences in total Na balance in the four 6008 phases evaluated.
    Conclusions: The implementation of the automated dialysate Na control module is a useful new tool, which reduced the diffusive load of Na with good tolerance. The module had the advantages of reducing thirst, interdialytic weight gain and intradialytic plasma Na changes.
    Language English
    Publishing date 2023-01-23
    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/sfad013
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  6. Article ; Online: Results of Salt Intake Restriction Monitored with the New Sodium Control Biosensor.

    Maduell, Francisco / Cholbi, Ester / Morantes, Laura / Escudero-Saiz, Víctor Joaquín / Ollé, Júlia / Martínez-Chillarón, Marta / Rodas, Lida Maria / Rodríguez-Espinosa, Diana / Arias-Guillen, Marta / Vera, Manel / Fontseré, Néstor / Broseta, José Jesús

    American journal of nephrology

    2023  Volume 54, Issue 7-8, Page(s) 291–298

    Abstract: Introduction: Adherence to a low-sodium (Na) diet is crucial in patients under hemodialysis, as it improves cardiovascular outcomes and reduces thirst and interdialytic weight gain. Recommended salt intake is lower than 5 g/day. The new 6008 CAREsystem ... ...

    Abstract Introduction: Adherence to a low-sodium (Na) diet is crucial in patients under hemodialysis, as it improves cardiovascular outcomes and reduces thirst and interdialytic weight gain. Recommended salt intake is lower than 5 g/day. The new 6008 CAREsystem monitors incorporate a Na module that offers the advantage of estimating patients' salt intake. The objective of this study was to evaluate the effect of dietary Na restriction for 1 week, monitored with the Na biosensor.
    Methods: A prospective study was conducted in 48 patients who maintained their usual dialysis parameters and were dialyzed with a 6008 CAREsystem monitor with activation of the Na module. Total Na balance, pre-/post-dialysis weight, serum Na (sNa), changes in pre- to post-dialysis sNa (ΔsNa), diffusive balance, and systolic and diastolic blood pressure were compared twice, once after 1 week of patients' usual Na diet and again after another week with more restricted Na intake.
    Results: Restricted Na intake increased the percentage of patients on a low-Na diet (<85 Na mmol/day) from 8% to 44%. Average daily Na intake decreased from 149 ± 54 to 95 ± 49 mmol, and interdialytic weight gain was reduced by 460 ± 484 g per session. More restricted Na intake also decreased pre-dialysis sNa and increased both intradialytic diffusive balance and ΔsNa. In hypertensive patients, reducing daily Na by more than 3 g Na/day lowered their systolic blood pressure.
    Conclusions: The new Na module allowed objective monitoring of Na intake, which in turn could permit more precise personalized dietary recommendations in patients under hemodialysis.
    MeSH term(s) Humans ; Sodium ; Sodium Chloride, Dietary ; Prospective Studies ; Renal Dialysis/methods ; Diet, Sodium-Restricted ; Blood Pressure ; Weight Gain
    Chemical Substances Sodium (9NEZ333N27) ; Sodium Chloride, Dietary
    Language English
    Publishing date 2023-06-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000531521
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  7. Article ; Online: Fatal SARS-CoV-2 reinfection in an immunosuppressed patient on hemodialysis.

    Rodríguez-Espinosa, Diana / Broseta Monzó, José Jesús / Casals, Quim / Piñeiro, Gastón J / Rodas, Lida / Vera, Manel / Maduell, Francisco

    Journal of nephrology

    2021  Volume 34, Issue 4, Page(s) 1041–1043

    MeSH term(s) COVID-19 ; Humans ; Immunocompromised Host ; Reinfection ; Renal Dialysis/adverse effects ; SARS-CoV-2
    Language English
    Publishing date 2021-06-07
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 1093991-x
    ISSN 1724-6059 ; 1120-3625 ; 1121-8428
    ISSN (online) 1724-6059
    ISSN 1120-3625 ; 1121-8428
    DOI 10.1007/s40620-021-01039-5
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  8. Article ; Online: Non-valvular atrial fibrillation in patients on peritoneal dialysis, prevalence, treatment and professionals involved.

    Perez-Bernat, Elisa / Viñas, M ª Angeles / Vera, Manel / González-Rico, Miguel / Montomoli, Marco / Astudillo-Cortés, Elena / Quevedo-Reina, Juan Carlos / García-Méndez, Isabel / Martinez-Losa, Adoración / Rama-Arias, Ines / Maldonado-Martín, María / Munar, M ª Antonia / Cerrato, Agustín Ortega / Beltrán-Catalán, Sandra / Peso, Gloria Del / Cases, Aleix / Górriz, Jose Luis

    Nefrologia

    2024  Volume 44, Issue 2, Page(s) 268–275

    Abstract: Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillars for the prevention of ... ...

    Abstract Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillars for the prevention of thromboembolic events. However, there are no randomized clinical trials on the risk-benefit profile of oral anticoagulation in patients with chronic kidney disease stage 5 on peritoneal dialysis and there is little evidence in the literature in this population. The objective of our study was to know the prevalence, treatment and professionals involved in the management of atrial fibrillation in peritoneal dialysis patients. For this purpose, we performed a descriptive analysis through a survey sent to different peritoneal dialysis units in Spain. A total of 1,403 patients on peritoneal dialysis were included in the study, of whom 186 (13.2%) had non-valvular atrial fibrillation. In addition, the assessment of the scores of thromboembolic and bleeding risks for the indication of oral anticoagulation was mainly carried out by the cardiologist (60% of the units), as well as its prescription (cardiologist 47% or in consensus with the nephrologist 43%). In summary, patients on peritoneal dialysis have a remarkable prevalence of non-valvular atrial fibrillation. Patients frequently receive oral anticoagulation with vitamin K antagonists, as well as direct oral anticoagulants. The data obtained regarding the scores used for the assessment of thromboembolic and bleeding risk, treatment and involvement by Nephrology indicates that there is a need for training and involvement of the nephrologist in this pathology.
    MeSH term(s) Humans ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/complications ; Peritoneal Dialysis/adverse effects ; Prevalence ; Male ; Female ; Anticoagulants/therapeutic use ; Anticoagulants/adverse effects ; Spain/epidemiology ; Aged ; Middle Aged ; Practice Patterns, Physicians'/statistics & numerical data ; Thromboembolism/prevention & control ; Thromboembolism/etiology ; Thromboembolism/epidemiology ; Cardiologists ; Administration, Oral
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2024-04-11
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 2837917-2
    ISSN 2013-2514 ; 2013-2514
    ISSN (online) 2013-2514
    ISSN 2013-2514
    DOI 10.1016/j.nefroe.2024.03.008
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  9. Article: Comparison of four medium cut-off dialyzers.

    Maduell, Francisco / Broseta, José Jesús / Rodríguez-Espinosa, Diana / Del Risco, Jimena / Rodas, Lida María / Arias-Guillén, Marta / Vera, Manel / Fontseré, Néstor / Salgado, Maria Del Carmen / Rico, Nayra

    Clinical kidney journal

    2022  Volume 15, Issue 12, Page(s) 2292–2299

    Abstract: Background: Recently, several pharmaceutical companies have developed new medium cut-off (MCO) dialyzers for expanded hemodialysis (HDx). This study aimed to compare the safety and efficacy of four MCO dialyzers, against each other and versus high-flux ... ...

    Abstract Background: Recently, several pharmaceutical companies have developed new medium cut-off (MCO) dialyzers for expanded hemodialysis (HDx). This study aimed to compare the safety and efficacy of four MCO dialyzers, against each other and versus high-flux hemodialysis (HD) and post-dilution hemodiafiltration (HDF).
    Methods: A prospective study was carried out on 23 patients who underwent six dialysis sessions: two sessions with the FX80 Cordiax in HD and HDF, and four HDx sessions with the Phylther 17-SD, Vie-18X, Elisio HX19 and Theranova 400 dialyzers. The reduction ratios (RRs) of urea, creatinine, β
    Results: The differences in efficacy between the evaluated dialyzers were minimal in small molecules and even up to the size of β
    Conclusions: The results of the four MCO dialyzers evaluated in this study showed good efficiency, with no significant performance differences between them while being completely safe in terms of albumin loss. Likewise, the study confirms the superiority of HDx over high-flux HD with an efficacy close to that of post-dilution HDF.
    Language English
    Publishing date 2022-07-13
    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/sfac167
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  10. Article ; Online: Efficacy and Safety of the Medium Cut-Off Elisio HX Dialyzer.

    Maduell, Francisco / Broseta, José Jesús / Rodríguez-Espinosa, Diana / Del Risco-Zevallos, Jimena / Gómez, Miquel / Rodas, Lida M / Arias-Guillén, Marta / Vera, Manel / Fontseré, Néstor / Salgado, Maria Del Carmen / Rico, Nayra

    Blood purification

    2022  Volume 52, Issue 1, Page(s) 68–74

    Abstract: Introduction: The medium cut-off Elisio HX dialyzer by Nipro became commercially available in Europe in 2021, but there are still no reports of in vivo data. This study aimed to evaluate the safety and efficacy of it compared with previously evaluated ... ...

    Abstract Introduction: The medium cut-off Elisio HX dialyzer by Nipro became commercially available in Europe in 2021, but there are still no reports of in vivo data. This study aimed to evaluate the safety and efficacy of it compared with previously evaluated hemodialysis (HD), expanded HD (HDx), and postdilution hemodiafiltration (HDF) treatments.
    Methods: A prospective study was carried out on 18 patients who underwent 5 dialysis sessions: FX80 Cordiax in HD, Elisio H19 in HD, Elisio HX19 in HDx, Theranova 400 in HDx, and FX80 Cordiax in HDF. The reduction ratios of urea, creatinine, ß2-microglobulin, myoglobin, kappa FLC, prolactin, α1-microglobulin, α1-acid glycoprotein, lambda FLC, and albumin were compared. Dialysate albumin loss was measured.
    Results: The comparison between the different dialysis modalities revealed no difference for small molecules, but HDx and HDF were significantly more efficient than HD for medium and large molecule removal. The efficacy of Elisio HX19 dialyzer in HDx was similar to the Theranova 400, superior to both dialyzers in HD, and slightly lower than HDF. Albumin losses in dialysate with HD dialyzers were less than 1 g, but between 1.5 and 2.5 g in HDx and HDF. The global removal score (GRS) values with HDx treatments were statistically significantly higher than those with HD. The highest GRS was obtained with the helixone dialyzer in HDF.
    Conclusions: The new MCO dialyzer, Elisio HX, performs with excellent behavior and tolerance. It represents an upgrade compared to their predecessor and is very close to the removal capacity of HDF treatment.
    MeSH term(s) Humans ; Renal Dialysis ; Prospective Studies ; Hemodiafiltration/adverse effects ; Albumins ; Dialysis Solutions
    Chemical Substances Albumins ; Dialysis Solutions
    Language English
    Publishing date 2022-05-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 605548-5
    ISSN 1421-9735 ; 0253-5068
    ISSN (online) 1421-9735
    ISSN 0253-5068
    DOI 10.1159/000524644
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