Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
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Randomized Controlled Trial Multicenter Study
Intermittent Oral Dosing of Roxadustat in Peritoneal Dialysis Chronic Kidney Disease Patients with Anemia: A Randomized, Phase 3, Multicenter, Open-Label Study.
Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor developed to treat anemia in chronic kidney disease (CKD) patients. This Phase 3, randomized, open-label, 24-week study investigated the efficacy and safety of roxadustat in Japanese CKD patients with anemia on peritoneal dialysis (PD) who were previously treated or not treated with erythropoiesis stimulating agents (ESAs). Patients not previously receiving ESA (ESA-Naïve group) were randomized to roxadustat at a starting dose of 50 or 70 mg three times weekly; patients previously receiving ESA (ESA-Converted group) switched from ESA to roxadustat 70 or 100 mg three times weekly depending on the prior ESA dose. ⋯ Average Hb levels (weeks 18-24) were 11.05 g/dL (95% CI: 10.67-11.42; ESA-Naïve) and 10.93 g/dL (95% CI: 10.73-11.13; ESA-Converted). Common TEAEs included nasopharyngitis and back pain. Roxadustat was well tolerated and effective in maintaining target Hb levels in CKD patients on PD who were previously treated or not treated with ESA.
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Comparative Study
In Vitro Evaluation of Resistance and Warming Performance of a Small Blood Warmer on a Continuous Renal Replacement Therapy Circuit.
Children on extracorporeal devices are at increased risk of hypothermia and require circuits with lower extracorporeal volume to avoid blood priming. We performed an in vitro study of the enFlow blood warmer to assess its warming performance and impact on circuit resistance at a high blood flow rate. The enFlow was added on the return line of a continuous renal replacement therapy circuit in a closed circuit primed with expired packed red blood cells (40% Hct). ⋯ Combining both warmers achieved a higher post-warmer temperature between 35.1 and 36.5°C. The enFlow can warm blood at high flow rates with minimal extracorporeal volume increase (~5 mL) and improve hypothermia prevention but may have resistance issues at the highest flows. The use of this device could benefit pediatric practice where smaller extracorporeal volumes are needed and patients are at increased risk of hypothermia.
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Comparative Study
Therapeutic plasma exchange in pediatric intensive care: Indications, results and complications.
Therapeutic plasma exchange (TPE) is an effective treatment method in selective indications. Secondary to access and technical features, it is more difficult to apply in pediatric population than adults. The aim of this study is investigate safety, clinical indications, and results of this method in critically ill pediatric patients who need TPE treatment. ⋯ TPE is a treatment method which can be safely provided in healthcare facilities with necessary medical and technical requirements. Although it is riskier to provide such treatment to critically ill children, complications can be minimized in experienced healthcare facilities. Overall results are good and can vary depending on indication.