INTRODUCTION: The rapid advancement of artificial intelligence and big data analytics, including descriptive, diagnostic, predictive, and prescriptive analytics, has the potential to revolutionize many areas of medicine, including nephrology and dialysis. Artificial intelligence and big data analytics can be used to analyze large amounts of patient medical records, including laboratory results and imaging studies, to improve the accuracy of diagnosis, enhance early detection, identify patterns and trends, and personalize treatment plans for patients with kidney disease. Additionally, artificial intelligence and big data analytics can be used to identify patients' treatment who are not receiving adequate care, highlighting care inefficiencies in the dialysis provider, optimizing patient outcomes, reducing healthcare costs, and consequently creating values for all the involved stakeholders. OBJECTIVES: We present the results of a comprehensive survey aimed at exploring the attitudes of European physicians from eight countries working within a major hemodialysis network (Fresenius Medical Care NephroCare) toward the application of artificial intelligence in clinical practice. METHODS: An electronic survey on the implementation of artificial intelligence in hemodialysis clinics was distributed to 1,067 physicians. Of the 1,067 individuals invited to participate in the study, 404 (37.9%) professionals agreed to participate in the survey. RESULTS: The survey showed that a substantial proportion of respondents believe that artificial intelligence has the potential to support physicians in reducing medical malpractice or mistakes. CONCLUSION: While artificial intelligence's potential benefits are recognized in reducing medical errors and improving decision-making, concerns about treatment plan consistency, personalization, privacy, and the human aspects of patient care persist. Addressing these concerns will be crucial for successfully integrating artificial intelligence solutions in nephrology practice.

• MeSH
• dialýza ledvin MeSH
• lidé MeSH
• nefrologie * MeSH
• nefrologové MeSH
• průzkumy a dotazníky MeSH
• umělá inteligence * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Dialysate conductivity is routinely used as a surrogate for dialysate sodium concentration. However, dialysis machine manufacturers apply different conductivity temperature correction coefficients. With the same conductivity in dialysis machines manufactured by different manufacturers, dialysate sodium may significantly differ. Also, electrolyte prescriptions are individualized (K, Ca, HCO3) and this is associated with another variation in dialysate sodium in the order of 1-5 mmol/L and both deviations are cumulative and chronic for each patient. Equivalence of the prescribed dialysate sodium and the concentration measured in it is not granted. Both variables differ and it is machine dependent! This paper analyses those variations from a technical point of view and suggests how to detect them and how to deal with or avoid them in clinical practice.

• MeSH
• dialýza ledvin MeSH
• dialyzační roztoky chemie   MeSH
• elektrická vodivost MeSH
• lidé MeSH
• nevhodné předepisování MeSH
• sodík analýza   normy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The regional citrate anticoagulation (RCA) induces changes in total (Catot) and ionized (Ca2+) calcium. As of now, we do not have much information about parallel changes of total (Mgtot) and ionized (Mg2+) magnesium. METHODS: The authors compared changes of Mg2+ and Mgtot with changes of Ca2+ and Catot in 32 critically ill patients on 4% trisodium citrate (4% TSC) with calcium-free fluids. RESULTS: The median continuous venovenous hemodiafiltration balance of Mgtot was -0.91 (-1.18 to -0.53) mmol/h compared to the median balance of Catot 0.86 (0.08-1.55) mmol/h. Postfilter Mg2+ decreased by 68.3% (70.8-65.6) in parallel (r = 0.41, p = 0.03) to decrease of postfilter Ca2+ (by 70.2% (73.0-66.1)) and was significantly related to the postfilter Ca2+ (r = 0.50, p < 0.001). The decrease of prefilter to postfilter Ca2+ correlated to a dosage of 4% TSC per blood flow (r = 0.37, p = 0.04). CONCLUSIONS: The loss of Mgtot during RCA is not covered by magnesium concentration in ordinary dialysis/substitution fluid and may lead to the depletion of total body magnesium. The postfilter Mg2+ is significantly related to the postfilter Ca2+. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi = 440972.

• MeSH
• akutní poškození ledvin krev   patologie   terapie   MeSH
• antikoagulancia aplikace a dávkování   škodlivé účinky   MeSH
• citráty aplikace a dávkování   škodlivé účinky   MeSH
• hemodiafiltrace * MeSH
• hemofiltrace MeSH
• hořčík krev   MeSH
• jednotky intenzivní péče MeSH
• kationty dvojmocné MeSH
• kritický stav MeSH
• lidé středního věku MeSH
• lidé MeSH
• nedostatek hořčíku krev   etiologie   patologie   MeSH
• prospektivní studie MeSH
• senioři MeSH
• tekutinová terapie škodlivé účinky   metody   MeSH
• umělé dýchání MeSH
• vápník krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

BACKGROUND: The aim of the study was to evaluate the in vitro quality of cryopreserved red blood cells obtained from different sources with or without leucodepletion and stored at 4±2 °C in AS-3 for up to 21 days. MATERIALS AND METHODS: Red blood cells were collected by four methods: double erythrocytapheresis, whole blood collection with buffy coat removal, double erythrocytapheresis with in-line leucofiltration, or whole blood collection with in-line leucofiltration. All four types of red blood cells were frozen in 40% glycerol after collection and stored at a temperature below -65 °C for at least 30 days, thawed, deglycerolised and subsequently reconstituted in AS-3. The in vitro haematological and biochemical properties of the thawed red blood cells were tested on days 0, 7, 14, and 21 after deglycerolisation and reconstitution. RESULTS: Overall, 72 units were processed. Leucodepletion of cryopreserved red blood cells units reduced haemolysis, lowered ammonia concentration, preserved pH and osmolality and led to sustained higher concentrations of ATP. In contrast, the source of red blood cells (apheresis or whole blood) did not affect their quality. DISCUSSION: The quality of all investigated red blood cells units was the same as or even better than that of erythrocytes obtained from double erythrocytapheresis with a 24-hour survival of at least 86% after up to 3 weeks of storage in AS-3.

• MeSH
• adenosintrifosfát krev   MeSH
• amoniak krev   MeSH
• cytaferéza metody   MeSH
• erytrocyty * účinky léků   MeSH
• glycerol farmakologie   MeSH
• hemoglobiny analýza   MeSH
• hemolýza MeSH
• koncentrace vodíkových iontů MeSH
• konzervace krve * MeSH
• kryoprezervace * MeSH
• kryoprotektivní látky farmakologie   MeSH
• leukoredukce * MeSH
• lidé MeSH
• osmolární koncentrace MeSH
• techniky in vitro MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

BACKGROUND: Testing metabolic effects of a novel calcium-free, magnesium, phosphate and lactate containing solution (Lactocitrate) in combination with citrate anticoagulation. METHODS: Patients on CRRT (2,000 ml/h, blood flow (Qb) 100 ml/min, trisodium citrate (4% TSC)) with arterial lactate <3 mmol/l were included. At start, bicarbonate-buffered fluid was changed to Lactocitrate and the substitution of magnesium and phosphorus ceased. At 9 h the Qb was increased to 150 ml/min. At 18 h the CRRT dosage was increased to 3,000 ml/h. RESULTS: In 22 CVVHDF patients and another 23 on CVVH the pH, aHCO3 and Na (all p > 0.05) showed no significant changes regardless of the increased dosage of 4% TSC at 9 h (p < 0.001). Mgtot and phosphorus stabilised within normal range. Arterial lactate increased to 1.9 (1.6-2.6) mmol/l at 3,000 ml/h, p < 0.001). Citrate- and lactate-related energetic gains were up to 74 (61-86) kJ/h. CONCLUSIONS: The fluid performed well within ordinary CRRT dosage and Qb up to 150 ml/min. Lactate levels mildly increased and no magnesium and phosphorus replenishments were necessary.

• MeSH
• antikoagulancia aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• energetický metabolismus účinky léků   MeSH
• glukosa škodlivé účinky   terapeutické užití   MeSH
• hemodiafiltrace MeSH
• hemodialyzační roztoky škodlivé účinky   chemie   terapeutické užití   MeSH
• hemofiltrace * MeSH
• klinické křížové studie MeSH
• krevní glukóza analýza   MeSH
• laktáty krev   MeSH
• laktosa škodlivé účinky   terapeutické užití   MeSH
• lékové interakce MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada léků MeSH
• nedostatek hořčíku chemicky indukované   prevence a kontrola   MeSH
• prospektivní studie MeSH
• pufry MeSH
• renální insuficience krev   terapie   MeSH
• senioři MeSH
• spotřeba kyslíku účinky léků   MeSH
• studie proveditelnosti MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

• MeSH
• cévní přístupy škodlivé účinky   MeSH
• dialýza ledvin škodlivé účinky   přístrojové vybavení   metody   MeSH
• kongresy jako téma MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Anemia is a major complication of end-stage renal disease. Hemodialysis itself is regarded as a stimulus activating inflammation. Pro-inflammatory cytokines are able to suppress erythropoiesis. In this pilot study, we analyzed the changes in methylation status of promoters of immune response genes in cell-free DNA to detect the differences between diabetic subjects (n = 18) with different therapeutic doses of recombinant erythropoietin. METHODS: The extent of promoter methylation of 24 genes in plasma cell-free DNA was examined before and after hemodialysis using EpiTect Methyl qPCR Array Inflammatory Response and Autoimmunity (Qiagen). RESULTS: The patients with higher methylation status of gene sequences IL13RA1, IL15, EDG3 and INHA in interdialytic interval were significantly overrepresented in the group with none or mild anemia therapy. CONCLUSION: The results are in agreement with the fact that IL13 and IL15 are known inhibitors of erythropoiesis and with considered immunomodulatory role of cell-free DNA.

• MeSH
• anemie farmakoterapie   etiologie   MeSH
• cytokiny genetika   MeSH
• diabetické nefropatie komplikace   genetika   imunologie   terapie   MeSH
• dialýza ledvin škodlivé účinky   MeSH
• erythropoetin terapeutické užití   MeSH
• imunita genetika   MeSH
• lidé MeSH
• metylace DNA * MeSH
• promotorové oblasti (genetika) * MeSH
• shluková analýza MeSH
• stanovení celkové genové exprese MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: There are limited data on systemic delivery of metabolic substrates during citrate anticoagulation. The direct citrate measurements are usually not available. METHODS: Patients on 2.2% acid-citrate-dextrose (ACD, n = 41) were compared to a control group on unfractionated heparin (n = 17). All were treated on 1.9-m(2) polysulfone filters. Samples were taken from the central venous catheter, ports pre- and post-filter and from effluent. RESULTS: The gain of citrate in CVVH (n = 18) was not different from CVVHDF (n = 23, p = 0.8). Mean gain of citrate was 25.4 ± 6.4 mmol/h. The systemic loads of lactate (p = 0.12) and glucose (p = 0.23) in CVVH were similar to CVVHDF. Mean inputs of lactate and glucose were 62.9 ± 21.1 and 26.6 ± 10.4 mmol/h, respectively. The mean difference between post- and prefilter unmeasured anions (d-UA) correlated with mean difference of citrate concentrations (p < 0.0001, r(2) = 0.66). The estimated caloric load of the citrate modalities was 5,536 ± 1,385 kJ/ 24 h. CONCLUSIONS: ACD might represent a significant load of metabolic substrates, particularly if used with lactate buffer. Systemic delivery of citrate can be predicted using d-UA in the extracorporeal circuit.

• MeSH
• akutní poškození ledvin terapie   MeSH
• antikoagulancia metabolismus   terapeutické užití   MeSH
• design vybavení MeSH
• glukosa analogy a deriváty   metabolismus   terapeutické užití   MeSH
• heparin terapeutické užití   MeSH
• kyselina citronová metabolismus   terapeutické užití   MeSH
• kyselina mléčná metabolismus   MeSH
• lidé MeSH
• náhrada funkce ledvin přístrojové vybavení   metody   MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

BACKGROUND: We studied the influence of acute renal failure (ARF) on the relationship between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and hemodynamic parameters. METHODS: The echocardiographic parameters and NT-proBNP levels were compared between 26 mechanically ventilated patients with ARF requiring continuous hemodiafiltration and 44 control patients. RESULTS: The relationships between NT-proBNP and left ventricular ejection fraction (p = 0.001), left ventricular end-diastolic volume (p = 0.03), tricuspid annular plane systolic excursion (p = 0.008), and pulmonary artery pressure (p = 0.01) were found only in the control group. The median and interquartile range of NT-proBNP (1,717.5, 389.5-4,138 ng/l) were significantly higher (p < 0.001) in the low diuresis subgroup than the levels (748.8, 384.2-2,217 ng/l) in the subgroup where daily diuresis increased and both had significantly higher levels than controls (350.7, 130.2-661.2 ng/l, p < 0.001). CONCLUSION: The high levels of NT-proBNP >1,000 ng/l seem to be typical, particularly for oliguric ARF. It seems that ARF precludes its utilization for any hemodynamic diagnosis.

• MeSH
• akutní poškození ledvin krev   komplikace   MeSH
• dysfunkce levé srdeční komory ultrasonografie   MeSH
• hemodynamika MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• natriuretický peptid typu B krev   diagnostické užití   MeSH
• peptidové fragmenty krev   diagnostické užití   MeSH
• prospektivní studie MeSH
• senioři MeSH
• srdeční komory ultrasonografie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

AIM: To assess the variability of blood flow (QVA) through a native arteriovenous fistula (AVF) in the long-term and to determine the QVA reduction at which an intervention is appropriate.

• MeSH
• arteriovenózní píštěl patofyziologie   terapie   MeSH
• dialýza ledvin MeSH
• financování organizované MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• retrospektivní studie MeSH
• rychlost toku krve MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH