Toward an individualized determination of dialysis adequacy: a narrative review with special emphasis on incremental hemodialysis
| Autor: | Antioco Fois, Linda Njandjo, Massimo Torreggiani, Giorgina Barbara Piccoli, Ciro Esposito, H. Fessi, Antoine Chatrenet, Elisa Longhitano |
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| Přispěvatelé: | Centre Hospitalier Le Mans (CH Le Mans), University of Messina, Motricité, interactions, performance EA 4334 / Movement - Interactions - Performance (MIP), Le Mans Université (UM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR des Sciences et Techniques des Activités Physiques et Sportives (UFR STAPS), Université de Nantes (UN)-Université de Nantes (UN), Istituti Clinici Scientifici Maugeri [Pavia] (IRCCS Pavia - ICS Maugeri), Università di Pavia, Service de Néphrologie et Dialyses [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population 030232 urology & nephrology 030204 cardiovascular system & hematology [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology incremental dialysis Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Renal Dialysis Genetics medicine Humans Urea Renal replacement therapy Intensive care medicine education Molecular Biology Aged education.field_of_study Dialysis adequacy dialysis adequacy business.industry Kt/V medicine.disease Dialysis efficiency middle molecules Comorbidity 3. Good health lowprotein diet Molecular Medicine Narrative review Hemodialysis Dialysis (biochemistry) business Biomarkers |
| Zdroj: | Expert Review of Molecular Diagnostics Expert Review of Molecular Diagnostics, Expert Reviews (formerly Future Drugs), 2021, 21 (11), pp.1119-1137. ⟨10.1080/14737159.2021.1987216⟩ |
| ISSN: | 1744-8352 1473-7159 |
| DOI: | 10.1080/14737159.2021.1987216 |
| Popis: | International audience; Introduction: The search for the 'perfect' renal replacement therapy has been paralleled by the search for the perfect biomarkers for assessing dialysis adequacy. Three main families of markers have been assessed: small molecules (prototype: urea); middle molecules (prototype β2-microglobulin); comprehensive and nutritional markers (prototype of the simplified assessment, albumin levels; composite indexes as malnutrition-inflammation score). After an era of standardization of dialysis treatment, personalized dialysis schedules are increasingly proposed, challenging the dogma of thrice-weekly hemodialysis.Areas covered: In this review, we describe the advantages and limitations of the approaches mentioned above, focusing on the open questions regarding personalized schedules and incremental hemodialysis.Expert opinion: In the era of personalized dialysis, the assessment of dialysis adequacy should be likewise personalized, due to the limits of 'one size fits all' approaches. We have tried to summarize some of the relevant issues regarding the determination of dialysis adequacy, attempting to adapt them to an elderly, highly comorbidity population, which would probably benefit from tailor-made dialysis prescriptions. While no single biomarker allows precisely tailoring the dialysis dose, we suggest using a combination of clinical and biological markers to prescribe dialysis according to comorbidity, life expectancy, residual kidney function, and small and medium-size molecule depuration. |
| Databáze: | OpenAIRE |
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