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Titolo:
Phosphate removal and hemodialysis conditions
Autore:
Pohlmeier, R; Vienken, J;
Indirizzi:
Sci & Prod Consulting, Fresenius Med Care, D-61346 Bad Homburg, Germany Sci & Prod Consulting Bad Homburg Germany D-61346 6 Bad Homburg, Germany
Titolo Testata:
KIDNEY INTERNATIONAL
, volume: 59, anno: 2001, supplemento:, 78
pagine: S190 - S194
SICI:
0085-2538(200102)59:<S190:PRAHC>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
HOME HEMODIALYSIS; SERUM PHOSPHATE; RENAL-FAILURE; HYPERPHOSPHATEMIA; ASSOCIATION; EXPERIENCE; ACIDOSIS; RISK;
Keywords:
dialysis frequency; hyperphosphatemia; cardiovascular mortality; end-stage renal disease; uremic toxins;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Pohlmeier, R Sci & Prod Consulting, Fresenius Med Care, D-61346 Bad Homburg, Germany Sci & Prod Consulting Bad Homburg Germany D-61346 , Germany
Citazione:
R. Pohlmeier e J. Vienken, "Phosphate removal and hemodialysis conditions", KIDNEY INT, 59, 2001, pp. S190-S194

Abstract

Hyperphosphatemia is frequently found in hemodialysis patients, and the association with an increased risk of mortality has been demonstrated. Other authors have linked hyperphosphatemia to increased cardiovascular mortality. The normalization of phosphate plasma levels is therefore an important goal in the treatment of end-stage renal disease patients. Absorption of phosphate from the food exceeds the elimination through a hemodialysis treatment, and this leads to a chronic phosphate load for the majority of hemodialysis patients. This imbalance should be improved by either a reduction of phosphate absorption or an increased removal of phosphate. A reduction of phosphate absorption can be achieved by reducing the amount of phosphate in the diet or by the administration of phosphate binders. Unfortunately, these measures imply practical difficulties, for example, a lack of patient compliance or other side effects. When considering modifications of the hemodialysis treatment, an essential understanding of the kinetics of dialytic phosphate removal is mandatory. Phosphate is unevenly distributed in different compartments of the body. Only a very small amount of phosphate is present in the easily accessible plasma compartment. The major part of phosphate removed during hemodialysis originates from the cytoplasm of cells. A transfer from intracellular space to the plasma and further from the plasma to thedialysate is necessary. However, if we consider improvement to phosphate removal by dialysis procedures, full dialyzer clearance is effective in onlythe initial phase of the dialysis treatment. After this initial phase, thetransfer rate for phosphate from the intracellular space to the plasma becomes the rate-limiting step for phosphate transport. Attempts to improve this transfer rate have recently been investigated by acidosis correction, but turned out not to be consistently successful. Furthermore, modifications of the treatment schedule have been described in the literature as measuresto influence the phosphate balance consistently. Successful improvements of the phosphate balance can be achieved specifically through increasing thefrequency of the dialysis treatments.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 16:03:16