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Raymond C. Vanholder Griet L. Glorieux Rita V. De Smet 《Hemodialysis international. International Symposium on Home Hemodialysis》2003,7(2):162-167
A convenient way to classify uremic solutes is to subdivide them according to the physicochemical characteristics influencing their dialytic removal into small water‐soluble compounds (<500 Da), protein‐bound compounds, and middle molecules (>500 Da). The prototype of small water‐soluble solutes remains urea although the proof of its toxicity is scanty. Only a few other water‐soluble compounds exert toxicity (e.g., the guanidines, the purines), but most of these are characterized by an intra‐dialytic behavior, which is different from that of urea. In addition, the protein‐bound compounds and the middle molecules behave in a different way from urea, due to their protein binding and their molecular weights, respectively. Because of these specific removal patterns, it is suggested that new approaches of influencing uremic solute concentration should be explored, such as specific adsorptive systems, alternative dialytic timeframes, removal by intestinal adsorption, modification of toxin, or general metabolism by drug administration. Middle molecule removal has been improved by the introduction of large pore, high‐flux membranes, but this approach seems to have come close to its maximal removal capacity, whereas multicompartmental behavior might become an additional factor hampering attempts to decrease toxin concentration. Hence, further enhancement of uremic toxin removal should be pursued by the introduction of alternative concepts of elimination. 相似文献
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Raymond C. Vanholder Griet L. Glorieux Rita V. De Smet 《Hemodialysis international. International Symposium on Home Hemodialysis》2003,7(1):52-57
Middle molecules can be defined as compounds with a molecular weight (MW) above 500 Da. An even broader definition includes those molecules that do not cross the membranes of standard low‐flux dialyzers, not only because of molecular weight, but also because of protein binding and/or multicompartmental behavior. Recently, several of these middle molecules have been linked to the increased tendency of uremic patients to develop inflammation, malnutrition, and atheromatosis. Other toxic actions can also be attributed to the middle molecules. In the present publication we will consider whether improved removal of middle molecules by large pore membranes has an impact on clinical conditions related to the uremic syndrome.
The clinical benefits of large pore membranes are reduction of uremia‐related amyloidosis; maintenance of residual renal function; and reduction of inflammation, malnutrition, anemia, dyslipidemia, and mortality. It is concluded that middle molecules play a role in uremic toxicity and especially in the processes related to inflammation, atherogenesis, and malnutrition. Their removal seems to be related to a better outcome, although better biocompatibility of membranes might be a confounding factor. 相似文献
The clinical benefits of large pore membranes are reduction of uremia‐related amyloidosis; maintenance of residual renal function; and reduction of inflammation, malnutrition, anemia, dyslipidemia, and mortality. It is concluded that middle molecules play a role in uremic toxicity and especially in the processes related to inflammation, atherogenesis, and malnutrition. Their removal seems to be related to a better outcome, although better biocompatibility of membranes might be a confounding factor. 相似文献
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Farin Rashid‐Farokhi Guitti Pourdowlat Mohammad‐Reza Nikoonia Neda Behzadnia Shahram Kahkouee Amir‐Ahmad Nassiri Mohammad‐Reza Masjedi 《Hemodialysis international. International Symposium on Home Hemodialysis》2013,17(1):94-100
Chronic hemodialysis (HD) patients are predisposed to several complications associated with pleural effusion. In addition, uremia can directly cause pleuritis. However, there are inadequate data about pathogenesis and natural course of uremic pleuritis. In this study, 76 chronic HD patients with pleural effusion admitted to the Respiratory Center of Masih Daneshvari Hospital, in Tehran, Iran between June 2005 and May 2011 were evaluated to figure out the etiology of their pleural disease. Among these patients, patients with uremic pleuritis were identified and studied. The rate of uremic pleuritis was 23.7%. Other frequent etiologies of pleural effusion were parapneumonic effusion (23.7%), cardiac failure (19.7%), tuberculosis (6.6%), volume overload, malignancy, and unknown. In patients with uremic pleuritis, dyspnea was the most common symptom, followed by cough, weight loss, anorexia, chest pain, and fever. Compared to patients with parapneumonic effusion, patients with uremic effusion had a significantly higher rate of dyspnea and lower rate of cough and fever. Pleural fluid analysis showed that these patients had a significantly lower pleural to serum lactic dehydrogenase ratio, total pleural leukocytes, and polymorphonuclear count compared to patients with parapneumonic effusion. Improvement was achieved in 94.1% of patients with uremic pleuritis by continuation of HD, chest tube insertion or pleural decortication; an outcome better than the previous reports. Despite the association with an exudative effusion, inflammatory pleural reactions in patients with uremic pleuritis may not be as severe as infection‐induced effusions. Owing to the advancement in HD technology and other interventions, outcome of uremic pleuritis may be improved. 相似文献
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Efthimia P. Mourvati Ploumis S. Passadakis Elias D. Thodis Stelios A. Panagoutsos Omiros G. Galtsidopoulos Vassilis A. Vargemezis 《Hemodialysis international. International Symposium on Home Hemodialysis》2001,5(1):37-41
Uremic polyneuropathy is one of the major complications of long‐term end‐stage renal disease. In the present study, we performed an electrophysiologic evaluation in 17 patients having a mean age of 49 ± 11 years. The patients were divided into two groups according to dialysis method. Group A included 9 patients who were undergoing conventional hemodialysis (mean age, 44.2 ± 12.5 years; mean duration on dialysis, 21.7 ± 4.3 months); group B included 8 patients undergoing hemofiltration (mean age, 55.2 ± 5.2 years; mean duration on treatment, 27 ± 7.6 months). Measurements of the distal latency time of the sensory fibers (median, ulnar, and sural nerves), and measurements of the distal latency time and peripheral conduction velocity of the motor fibers (median and peroneal nerves) were performed. In addition, we recorded somatosensory evoked potentials after peripheral stimulation of the median and peroneal nerves. The electrophysiologic evaluations were repeated two times at intervals of 12 months. In group A, a statistically significant worsening of motor and sensory conductance in the upper and lower limbs was observed; in group B, a statistically significant improvement was found. These findings suggest that hemofiltration has a more beneficial effect on motor and sensory conductivity than does conventional hemodialysis. 相似文献
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Twardowski ZJ 《Hemodialysis international. International Symposium on Home Hemodialysis》2008,12(2):173-210
Accumulation of knowledge requisite for development of hemodialysis started in antiquity and continued through Middle Ages until the 20th century. Firstly, it was determined that the kidneys produce urine containing toxic substances that accumulate in the body if the kidneys fail to function properly; secondly, it was necessary to discover the process of diffusion and dialysis; thirdly, it was necessary to develop a safe method to prevent clotting in the extracorporeal circulation; and fourthly, it was necessary to develop biocompatible dialyzing membranes. Most of the essential knowledge was acquired by the end of the 19th century. Hemodialysis as a practical means of replacing kidney function started and developed in the 20th century. The original hemodialyzers, using celloidin as a dialyzing membrane and hirudin as an anticoagulant, were used in animal experiments at the beginning of the 20th century, and then there were a few attempts in humans in the 1920s. Rapid progress started with the application of cellophane membranes and heparin as an anticoagulant in the late 1930s and 1940s. The explosion of new dialyzer designs continued in the 1950s and 1960s and ended with the development of capillary dialyzers. Cellophane was replaced by other dialyzing membranes in the 1960s, 1970s, and 1980s. Dialysis solution was originally prepared in the tank from water, electrolytes, and glucose. This solution was recirculated through the dialyzer and back to the tank. In the 1960s, a method of single-pass dialysis solution preparation and delivery system was designed. A large quantity of dialysis solution was used for a single dialysis. Sorbent systems, using a small volume of regenerated dialysis solution, were developed in the mid 1960s, and continue to be used for home hemodialysis and acute renal failure. At the end of the 20th century, a new closed system, which prepared and delivered ultrapure dialysis solution preparation, was developed. This system also had automatic reuse of lines and dialyzers and prepared the machine for the next dialysis. This was specifically designed for quotidian home hemodialysis. Another system for frequent home hemodialysis or acute renal failure was developed at the turn of the 21st century. This system used premanufactured dialysis solution, delivered to the home or dialysis unit, as is done for peritoneal dialysis. 相似文献
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Julie Ann Kemp Marta Esgalhado Renata Azevedo Macedo Bruna Regis Ngila Raquel Teixeira Damasceno Elizabeth Aparecida Ferraz da Silva Torres Gustavo Henrique Ferreira Gonalinho Natlia Alvarenga Borges Lia Sumie Nakao Denis Fouque Denise Mafra 《Hemodialysis international. International Symposium on Home Hemodialysis》2019,23(2):189-197
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Mark K. Tiong Rathika Krishnasamy Edward R. Smith Colin A. Hutchison Elizabeth G. Ryan Elaine M. Pascoe Carmel M. Hawley Tim D. Hewitson Meg J. Jardine Matthew A. Roberts Yeoungjee Cho Muh Geot Wong Anne Heath Craig L. Nelson Shaundeep Sen Peter F. Mount Liza A. Vergara Peta-Anne Paul-Brent David W. Johnson Nigel D. Toussaint 《Hemodialysis international. International Symposium on Home Hemodialysis》2021,25(3):322-332
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Sponza DT 《Journal of hazardous materials》2006,138(3):438-447
This study investigated the acute toxicity of chemical dye production industry wastewaters by traditional and enrichment toxicity tests and emphasized the importance of toxicity tests in wastewater discharge regulations. The enrichment toxicity tests are novel applications indicating whether there is potential toxicity or stimulation conditions. Different organisms were used including bacteria (floc-Zoogloea ramigera and coliform-Escherichia coli bacteria), algae (Chlorella vulgaris), fish (lepistes-Poecilia reticulate) and protozoan (Vorticella campanula) to represent four tropic levels. The toxicity test results were compared with chemical analyses to identify the pollutants responsible for the toxicity in the effluent wastewater samples. Toxicity of the effluents could not be explained by using physicochemical analyses in four cases. The results clearly showed that the use of bioassay tests produce additional information about the toxicity potential of industrial discharges and effluents. 相似文献
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交联壳聚糖吸附剂对多肽的吸附性能 总被引:4,自引:0,他引:4
为了研究血液灌流用多肽吸附剂以治疗尿毒症,本文以戊二醛为交联剂,用反向悬浮聚合方法制备了交联壳聚糖吸附剂,继而用NaBH4还原处理,并对其还原效果和溶胀性能作了表征.吸附实验结果表明,吸附剂对选取的六种多肽均有不同程度的吸附;随着多肽链的增长,吸附剂对其的吸附能力体现出先增强后减小的趋势;对分子量为1 100的垂体后叶素吸附效果最好.同时,吸附动力学曲线表明,随着肽分子量的增大,达到吸附平衡的时间也延长,对六种肽的吸附分别在0.6~2 h内达到平衡. 相似文献
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Tanya S. Hauck Robin E. Anderson Hans C. Fischer Susan Newbigging Warren C. W. Chan 《Small (Weinheim an der Bergstrasse, Germany)》2010,6(1):138-144
Quantum dots have potential in biomedical applications, but concerns persist about their safety. Most toxicology data is derived from in vitro studies and may not reflect in vivo responses. Here, an initial systematic animal toxicity study of CdSe–ZnS core–shell quantum dots in healthy Sprague–Dawley rats is presented. Biodistribution, animal survival, animal mass, hematology, clinical biochemistry, and organ histology are characterized at different concentrations (2.5–15.0 nmol) over short‐term (<7 days) and long‐term (>80 days) periods. The results show that the quantum dot formulations do not cause appreciable toxicity even after their breakdown in vivo over time. To generalize the toxicity of quantum dots in vivo, further investigations are still required. Some of these investigations include the evaluation of quantum dot composition (e.g., PbS versus CdS), surface chemistry (e.g., functionalization with amines versus carboxylic acids), size (e.g., 2 versus 6 nm), and shape (e.g., spheres versus rods), as well as the effect of contaminants and their byproducts on biodistribution behavior and toxicity. Combining the results from all of these studies will eventually lead to a conclusion regarding the issue of quantum dot toxicity. 相似文献
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Toxicity of Metal Oxide Nanoparticles: Mechanisms,Characterization, and Avoiding Experimental Artefacts 下载免费PDF全文
Aleksandra B. Djurišić Yu Hang Leung Alan M. C. Ng Xiao Ying Xu Patrick K. H. Lee Natalie Degger R. S. S. Wu 《Small (Weinheim an der Bergstrasse, Germany)》2015,11(1):26-44
Metal oxide nanomaterials are widely used in practical applications and represent a class of nanomaterials with the highest global annual production. Many of those, such as TiO2 and ZnO, are generally considered non‐toxic due to the lack of toxicity of the bulk material. However, these materials typically exhibit toxicity to bacteria and fungi, and there have been emerging concerns about their ecotoxicity effects. The understanding of the toxicity mechanisms is incomplete, with different studies often reporting contradictory results. The relationship between the material properties and toxicity appears to be complex and diifficult to understand, which is partly due to incomplete characterization of the nanomaterial, and possibly due to experimental artefacts in the characterization of the nanomaterial and/or its interactions with living organisms. This review discusses the comprehensive characterization of metal oxide nanomaterials and the mechanisms of their toxicity. 相似文献
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WANGJia-xiang HEXin 《国际设备工程与管理》2005,10(2):119-124
Until recently, investment in logistics has focused mainly on the flows from companies to markets. Growing concerns for the environment and conserving resources have created new logistical approaches to more effectively manage the distribution function, and make better use of the resources available to an organization. One such approach is reverse logistics, which uses various methods to give scope for a back-load of finished products, components, waste, reusable packing, etc. from consumer to manufacturer. Back-loads allow manufacturers to reduce costs by using the distribution vehicle‘s return journey to create income or added value. This basic concept is now being developed to create novel solutions to the problems of reducing pollution, costs and vehicle movements, whilst maintaining high customer service levels. In this paper, the idea of reverse logistics is presented; motivations for it are analyzed, several successful practices are demonstrated and some important truths regarding successful reverse logistics are identified, trend of reverse logistics is provided. 相似文献