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Dialysis01:15

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Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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Dialysis01:27

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Hemodialysis II: Procedure and Complications01:24

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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Peritoneal Dialysis III: Nursing Management01:25

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Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
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Dialysis therapy is associated with peripheral marginal zone B-cell augmentation.

Lucia Stranavova1, Petra Hruba1, Janka Slatinska2

  • 1Transplant Laboratory, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.

Transplant Immunology
|April 2, 2020
PubMed
Summary

Dialysis patients with chronic kidney disease stage 5 (CKD5) show increased marginal zone B cells (MZB), a type of immune cell. This difference was most pronounced in patients on dialysis for over 12 months.

Keywords:
Chronic kidney disease stage 5 (CKD5)DialysisMarginal zone B cells

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Isolation of Double Negative &#945;&#946; T Cells from the Kidney
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Area of Science:

  • Immunology
  • Nephrology
  • Transplantation Immunology

Background:

  • Patients with chronic kidney disease stage 5 (CKD5) often experience immune impairments due to long-term uremic exposure.
  • Understanding these immune alterations is crucial for optimizing outcomes in kidney transplant candidates.

Purpose of the Study:

  • To investigate differences in peripheral immune cell populations, specifically virus-specific effector/memory cells and T, B, and dendritic cell (DC) subsets, between pre-emptive kidney transplant candidates and those on dialysis.
  • To identify specific immune cell changes associated with long-term dialysis therapy.

Main Methods:

  • Peripheral blood samples were collected from 74 low-risk kidney transplant candidates without anti-HLA antibodies.
  • Immune cell populations were analyzed using ELISPOT and Fluorescence-Activated Cell Sorting (FACS).
  • Specific focus on T cells, B cells (including marginal zone B cells - MZB), and DC subsets, as well as virus-specific effector/memory T cells (CMV, BKV, EBV).

Main Results:

  • A significant difference in circulating marginal zone B cells (MZB) (IgDhighCD27high) was observed between dialysis patients and pre-emptive transplant recipients (P = .002).
  • Patients on dialysis for over 12 months had a 4.2-fold increased risk of elevated absolute MZB numbers (P = .004).
  • No significant differences were found in other B, T, or DC cell subsets, nor in virus-specific effector/memory T cell numbers.

Conclusions:

  • Long-term dialysis therapy in CKD5 patients is associated with an expansion of circulating marginal zone B cells (MZB).
  • This expansion of MZB cells appears to be a specific immune alteration related to dialysis, not affecting other major immune cell subsets or virus-specific T cell responses.
  • Further research is needed to understand the clinical implications of increased MZB in dialysis patients awaiting kidney transplantation.