Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration
Background We encountered a case of unstable predilution online HDF due to elevated transmembrane pressure (TMP) when performing constant-speed predilution online hemodiafiltration (HDF) as treatment for restless legs syndrome (RLS) in a dialysis patient. We report the effectiveness of incorporating...
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| Veröffentlicht in: | Journal of artificial organs 2019-09, Vol.22 (3), p.253-255 |
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| creator | Urabe, Shunichiro Hosono, Takashi Hyodo, Toru Kitamura, Makoto Hida, Miho Kurata, Yasuhisa Kokubo, Kenichi |
| description | Background
We encountered a case of unstable predilution online HDF due to elevated transmembrane pressure (TMP) when performing constant-speed predilution online hemodiafiltration (HDF) as treatment for restless legs syndrome (RLS) in a dialysis patient. We report the effectiveness of incorporating a newly developed constant-pressure predilution online HDF system as a preventive measure against unstable online HDF and frequent adjustment of settings when treating dialysis patients with RLS.
Case presentation
A 55-year-old man had suffered from RLS and been undergoing constant-speed online HDF with 45 L target predilution and an ABH-21P hemodiafilter. The symptoms of RLS rated 10 on the International Restless Legs Syndrome Rating Scale (IRLS). The α1-microglobulin (α
1
-MG) removal rate was only 27.8%, so the hemodiafilter was subsequently replaced with a PEPA hemodiafilter. However, episodes of elevated TMP exceeding 250 mmHg occurred frequently after the replacement and were managed by reducing dialysate flow rate. Therefore, we incorporated a constant-pressure predilution online HDF that maintains TMP below 200 mmHg. The amount of replacement was maintained at approximately 43.5 ± 6.98 L and the α
1
-MG removal rate was 39.5%, with no need to manually reduce the flow rate. The Alb leakage in dialysate waste was 7.9 g. The patient has maintained an IRLS rating of 0 with no RLS symptoms for the past 4 years.
Conclusions
Using the constant-pressure mode enabled achieved the clinical endpoint, namely, resolution of RLS with no need to manually reduce the flow rate. |
| doi_str_mv | 10.1007/s10047-019-01100-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2199189362</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2199189362</sourcerecordid><originalsourceid>FETCH-LOGICAL-c464t-dbf867b8e1a062a33487eb99a7f6986b1c39eba628f32175027fc76c94d583853</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhoMotlb_gAsJuHEzmq-bj6UUv6BQELsOmZmTNiWTXJOMMv--ub1VwUUXSd5wnvMmhxeh15S8p4SoD7XvQg2Emr66HrYn6JTKw9UQ8bRrwcWgGDMn6EWtt4RQtVPkOTrhxFBDJTlF_jvUFqFWHOG64rqlueQFMHgPUwu_IG64FXANZvw7tBs85VSbS23Yl961FsBdzCGuLeSEc4ohAb6BJc_B-RBbcYfCS_TMu1jh1cN5hq4-f_px_nW4uPzy7fzjxTAJKdowj15LNWqgjkjmOBdawWiMU14aLUc6cQOjk0x7zvowhCk_KTkZMe801zt-ht4dffcl_1z7aHYJdYIYXYK8VsuoMVQbLllH3_6H3ua1pP47y5g0ggnDzKMUNZozQrToFDtSU8m1FvB2X8LiymYpsYes7DEr27Oy91nZrTe9ebBexwXmvy1_wukAPwK1l9I1lH9vP2J7B8vloEw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2198320084</pqid></control><display><type>article</type><title>Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Urabe, Shunichiro ; Hosono, Takashi ; Hyodo, Toru ; Kitamura, Makoto ; Hida, Miho ; Kurata, Yasuhisa ; Kokubo, Kenichi</creator><creatorcontrib>Urabe, Shunichiro ; Hosono, Takashi ; Hyodo, Toru ; Kitamura, Makoto ; Hida, Miho ; Kurata, Yasuhisa ; Kokubo, Kenichi</creatorcontrib><description>Background
We encountered a case of unstable predilution online HDF due to elevated transmembrane pressure (TMP) when performing constant-speed predilution online hemodiafiltration (HDF) as treatment for restless legs syndrome (RLS) in a dialysis patient. We report the effectiveness of incorporating a newly developed constant-pressure predilution online HDF system as a preventive measure against unstable online HDF and frequent adjustment of settings when treating dialysis patients with RLS.
Case presentation
A 55-year-old man had suffered from RLS and been undergoing constant-speed online HDF with 45 L target predilution and an ABH-21P hemodiafilter. The symptoms of RLS rated 10 on the International Restless Legs Syndrome Rating Scale (IRLS). The α1-microglobulin (α
1
-MG) removal rate was only 27.8%, so the hemodiafilter was subsequently replaced with a PEPA hemodiafilter. However, episodes of elevated TMP exceeding 250 mmHg occurred frequently after the replacement and were managed by reducing dialysate flow rate. Therefore, we incorporated a constant-pressure predilution online HDF that maintains TMP below 200 mmHg. The amount of replacement was maintained at approximately 43.5 ± 6.98 L and the α
1
-MG removal rate was 39.5%, with no need to manually reduce the flow rate. The Alb leakage in dialysate waste was 7.9 g. The patient has maintained an IRLS rating of 0 with no RLS symptoms for the past 4 years.
Conclusions
Using the constant-pressure mode enabled achieved the clinical endpoint, namely, resolution of RLS with no need to manually reduce the flow rate.</description><identifier>ISSN: 1434-7229</identifier><identifier>EISSN: 1619-0904</identifier><identifier>DOI: 10.1007/s10047-019-01100-y</identifier><identifier>PMID: 30919160</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Case Report ; Dialysis ; Flow velocity ; Hemodiafiltration - methods ; Humans ; Internet ; Leg ; Legs ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nephrology ; On-line systems ; Patients ; Pressure ; Restless legs syndrome ; Restless Legs Syndrome - therapy ; Rotation ; Signs and symptoms ; Treatment Outcome</subject><ispartof>Journal of artificial organs, 2019-09, Vol.22 (3), p.253-255</ispartof><rights>The Japanese Society for Artificial Organs 2019</rights><rights>Journal of Artificial Organs is a copyright of Springer, (2019). All Rights Reserved.</rights><rights>Copyright Springer Nature B.V. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-dbf867b8e1a062a33487eb99a7f6986b1c39eba628f32175027fc76c94d583853</citedby><cites>FETCH-LOGICAL-c464t-dbf867b8e1a062a33487eb99a7f6986b1c39eba628f32175027fc76c94d583853</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10047-019-01100-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10047-019-01100-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30919160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Urabe, Shunichiro</creatorcontrib><creatorcontrib>Hosono, Takashi</creatorcontrib><creatorcontrib>Hyodo, Toru</creatorcontrib><creatorcontrib>Kitamura, Makoto</creatorcontrib><creatorcontrib>Hida, Miho</creatorcontrib><creatorcontrib>Kurata, Yasuhisa</creatorcontrib><creatorcontrib>Kokubo, Kenichi</creatorcontrib><title>Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration</title><title>Journal of artificial organs</title><addtitle>J Artif Organs</addtitle><addtitle>J Artif Organs</addtitle><description>Background
We encountered a case of unstable predilution online HDF due to elevated transmembrane pressure (TMP) when performing constant-speed predilution online hemodiafiltration (HDF) as treatment for restless legs syndrome (RLS) in a dialysis patient. We report the effectiveness of incorporating a newly developed constant-pressure predilution online HDF system as a preventive measure against unstable online HDF and frequent adjustment of settings when treating dialysis patients with RLS.
Case presentation
A 55-year-old man had suffered from RLS and been undergoing constant-speed online HDF with 45 L target predilution and an ABH-21P hemodiafilter. The symptoms of RLS rated 10 on the International Restless Legs Syndrome Rating Scale (IRLS). The α1-microglobulin (α
1
-MG) removal rate was only 27.8%, so the hemodiafilter was subsequently replaced with a PEPA hemodiafilter. However, episodes of elevated TMP exceeding 250 mmHg occurred frequently after the replacement and were managed by reducing dialysate flow rate. Therefore, we incorporated a constant-pressure predilution online HDF that maintains TMP below 200 mmHg. The amount of replacement was maintained at approximately 43.5 ± 6.98 L and the α
1
-MG removal rate was 39.5%, with no need to manually reduce the flow rate. The Alb leakage in dialysate waste was 7.9 g. The patient has maintained an IRLS rating of 0 with no RLS symptoms for the past 4 years.
Conclusions
Using the constant-pressure mode enabled achieved the clinical endpoint, namely, resolution of RLS with no need to manually reduce the flow rate.</description><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Case Report</subject><subject>Dialysis</subject><subject>Flow velocity</subject><subject>Hemodiafiltration - methods</subject><subject>Humans</subject><subject>Internet</subject><subject>Leg</subject><subject>Legs</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>On-line systems</subject><subject>Patients</subject><subject>Pressure</subject><subject>Restless legs syndrome</subject><subject>Restless Legs Syndrome - therapy</subject><subject>Rotation</subject><subject>Signs and symptoms</subject><subject>Treatment Outcome</subject><issn>1434-7229</issn><issn>1619-0904</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1rFTEUhoMotlb_gAsJuHEzmq-bj6UUv6BQELsOmZmTNiWTXJOMMv--ub1VwUUXSd5wnvMmhxeh15S8p4SoD7XvQg2Emr66HrYn6JTKw9UQ8bRrwcWgGDMn6EWtt4RQtVPkOTrhxFBDJTlF_jvUFqFWHOG64rqlueQFMHgPUwu_IG64FXANZvw7tBs85VSbS23Yl961FsBdzCGuLeSEc4ohAb6BJc_B-RBbcYfCS_TMu1jh1cN5hq4-f_px_nW4uPzy7fzjxTAJKdowj15LNWqgjkjmOBdawWiMU14aLUc6cQOjk0x7zvowhCk_KTkZMe801zt-ht4dffcl_1z7aHYJdYIYXYK8VsuoMVQbLllH3_6H3ua1pP47y5g0ggnDzKMUNZozQrToFDtSU8m1FvB2X8LiymYpsYes7DEr27Oy91nZrTe9ebBexwXmvy1_wukAPwK1l9I1lH9vP2J7B8vloEw</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Urabe, Shunichiro</creator><creator>Hosono, Takashi</creator><creator>Hyodo, Toru</creator><creator>Kitamura, Makoto</creator><creator>Hida, Miho</creator><creator>Kurata, Yasuhisa</creator><creator>Kokubo, Kenichi</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20190901</creationdate><title>Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration</title><author>Urabe, Shunichiro ; Hosono, Takashi ; Hyodo, Toru ; Kitamura, Makoto ; Hida, Miho ; Kurata, Yasuhisa ; Kokubo, Kenichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-dbf867b8e1a062a33487eb99a7f6986b1c39eba628f32175027fc76c94d583853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Case Report</topic><topic>Dialysis</topic><topic>Flow velocity</topic><topic>Hemodiafiltration - methods</topic><topic>Humans</topic><topic>Internet</topic><topic>Leg</topic><topic>Legs</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>On-line systems</topic><topic>Patients</topic><topic>Pressure</topic><topic>Restless legs syndrome</topic><topic>Restless Legs Syndrome - therapy</topic><topic>Rotation</topic><topic>Signs and symptoms</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Urabe, Shunichiro</creatorcontrib><creatorcontrib>Hosono, Takashi</creatorcontrib><creatorcontrib>Hyodo, Toru</creatorcontrib><creatorcontrib>Kitamura, Makoto</creatorcontrib><creatorcontrib>Hida, Miho</creatorcontrib><creatorcontrib>Kurata, Yasuhisa</creatorcontrib><creatorcontrib>Kokubo, Kenichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of artificial organs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Urabe, Shunichiro</au><au>Hosono, Takashi</au><au>Hyodo, Toru</au><au>Kitamura, Makoto</au><au>Hida, Miho</au><au>Kurata, Yasuhisa</au><au>Kokubo, Kenichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration</atitle><jtitle>Journal of artificial organs</jtitle><stitle>J Artif Organs</stitle><addtitle>J Artif Organs</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>22</volume><issue>3</issue><spage>253</spage><epage>255</epage><pages>253-255</pages><issn>1434-7229</issn><eissn>1619-0904</eissn><abstract>Background
We encountered a case of unstable predilution online HDF due to elevated transmembrane pressure (TMP) when performing constant-speed predilution online hemodiafiltration (HDF) as treatment for restless legs syndrome (RLS) in a dialysis patient. We report the effectiveness of incorporating a newly developed constant-pressure predilution online HDF system as a preventive measure against unstable online HDF and frequent adjustment of settings when treating dialysis patients with RLS.
Case presentation
A 55-year-old man had suffered from RLS and been undergoing constant-speed online HDF with 45 L target predilution and an ABH-21P hemodiafilter. The symptoms of RLS rated 10 on the International Restless Legs Syndrome Rating Scale (IRLS). The α1-microglobulin (α
1
-MG) removal rate was only 27.8%, so the hemodiafilter was subsequently replaced with a PEPA hemodiafilter. However, episodes of elevated TMP exceeding 250 mmHg occurred frequently after the replacement and were managed by reducing dialysate flow rate. Therefore, we incorporated a constant-pressure predilution online HDF that maintains TMP below 200 mmHg. The amount of replacement was maintained at approximately 43.5 ± 6.98 L and the α
1
-MG removal rate was 39.5%, with no need to manually reduce the flow rate. The Alb leakage in dialysate waste was 7.9 g. The patient has maintained an IRLS rating of 0 with no RLS symptoms for the past 4 years.
Conclusions
Using the constant-pressure mode enabled achieved the clinical endpoint, namely, resolution of RLS with no need to manually reduce the flow rate.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>30919160</pmid><doi>10.1007/s10047-019-01100-y</doi><tpages>3</tpages></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Biomedical Engineering and Bioengineering Cardiac Surgery Case Report Dialysis Flow velocity Hemodiafiltration - methods Humans Internet Leg Legs Male Medicine Medicine & Public Health Middle Aged Nephrology On-line systems Patients Pressure Restless legs syndrome Restless Legs Syndrome - therapy Rotation Signs and symptoms Treatment Outcome |
| title | Restless legs syndrome effectively treated with constant-pressure predilution online hemodiafiltration |
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