News and Traditional Indications from Short Daily Dialysis: Different Schemes to Optimized ESF Response
Notice bibliographique
Résumé
Interest in quotidian (daily) hemodialysis (DHD) seems to be growing. DHD improves quality of life, blood pressure control, and nutrition, and decreases the need of medications, including erythropoiesis stimulating factors (ESF). We evaluate the short daily dialysis (SDHD) efficacy in 14 patients in conventional hemodialysis (HD) (3 weekly sessions/4 h), mean age 52.1 years, range 25–75, 10 males and 4 females, and found that they needed to increase dialysis efficiency by different medical indications: in 11 cases traditional indications – 5 cases with hypertensive myocardiopathy and severe LVH (2 of them with low left ventricle ejection fraction), 2 cases with symptomatic, ischemic cardiopathy 2 patient with big body‐surface area and elevated phosphorus levels, and 2 patients by inadequate dialysis (infradialysis conditioning malnutrition status) secondary to HD with permanent catheter. In one female (25 yr old), SDHD was prescribed to improve cardiac toxicity secondary to chemotherapy for acute promyelocytic leukemia. The index resistance of ESF decreased since the first month, and the Aranesp doses decreased by more than 40%. 1 male (49 years) with nephrogenic fibrosing dermopathy showed skin lesions with osteoblastic transformation. The skin lesions were improving since the first week, obtaining a decrease of the index resistance ESF higher than 60% in the first month. 1 male with symptomatic obstructive hypertrophic myocardiopathy showed improvement of symptoms and quality of life since the first weeks, as well as echocardiograpic signs and improvement in Hb levels and decreasing dose of ESF. The schedule in all of them was 5–6 days/week sessions between 2.15 h and 3 h, depending on body‐surface area. To obtain a weekly Kt/V nearest to 4, HD sessions were realized in the hospital (7 pts) or in satellite unit (7 pts). The time remaining in this schedule was between 1 and 42 months. All the patients showed clinical improvement, subjective and objective, since the first week of start of SDHD. 3 patients could be included in Tx waiting list again. Anemia improved, decreasing index resistance of ESF. In relation with this, the time necessary to improve the response to ESF was different, showing a decrease in the first month higher than 40% in two cases dialyzing with a membrane high‐flux with pore size 100 A, appearing high Hb levels also in a polycystic patient always without ESF. We observed by analyzing the results in 12 stable patients; the patients with high‐flux dialyzers showed better response to ESF. Perhaps it could offer a better clearance of large molecules (inhibitor erythropoiesis factor and high molecular weight toxins) that participate to respond to ESF. Conclusion: Our experience shows new indications for SDHD with very good results. Anemia was improved in relation with SDHD, when synthetic high‐flux membranes and high pore size were used.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».