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Mariano Feriani

Publications and source records attributed to Mariano Feriani.

5 recordsLinked to original sources
PubMed2003

Acid-base homeostasis with the high convective dialysis treatments.

The feedback between metabolic acid production and dialytic base gain ensures a neutral acid-base balance in patients on renal replacement therapy (RRT). Despite acid not accumulating continuously, clinical studies demonstrated that normalizing pre-dialysis serum bicarbonate results in nutritional and osteodystrophy improvements. Full correction of acidosis is not an easy task in dialysis patients because it depends on both some intrinsic characteristics of patients and dialysis prescriptions. Thus, a large variation in the result is often recorded among dialysis populations and in acid-base studies. Highly convective dialysis treatments make the individualization of dialytic parameters easier than conventional dialysis. Up to now, few clinical data have been published. However, knowledge of and the quantification of the kinetic phenomena that govern the buffer transfer during a session of these high performance treatments can provide a rational approach to the optimal dialysis prescription.

Acid-Base Equilibrium↗
PubMed2003

Convection versus diffusion in dialysis: an Italian prospective multicentre study.

The concept of dialysis adequacy has to be widened to include medium size and large molecule removal in addition to urea kinetics. The HEMO study found a non-significant trend toward a beneficial effect on mortality of high-flux dialysis compared with low-flux dialysis. In that study, the beneficial effect of convection could have been attenuated by the fact that 'internal filtration' in high-flux haemodialysis (HD) is lower than that expected by convection in haemofiltration (HF) or haemodiafiltration (HDF). To explore the putative beneficial effect of convection, this Italian multicentre study was planned, comparing on-line convective treatments (HF and HDF) with standard, low-flux HD. The enrolled patients will be evaluated prospectively on their usual treatment for 2 months (baseline period) and subsequently randomized to continue either with low-flux HD (50%) or to start on-line convective treatment (50%), HF or HDF according to a 1:1 ratio. The primary end point of the study will be cardiovascular stability and blood pressure control. As secondary aims of the study, the impact on symptoms, morbidity and mortality will be assessed. Feasibility and patient compliance during HF and HDF treatments will also be evaluated. The experimental phase of the study, of at least 2 years, is divided into a 3-month adaptation period and a subsequent evaluation period. A recruitment period of 1 year is planned. The study design has adequate power to detect an absolute reduction of 3% hypotensive episodes with the experimental convective treatments compared with standard low-flux HD.

Convection↗