Narrative Review of Incremental Hemodialysis.

The prescription of hemodialysis (HD) in patients with incident end-stage kidney disease (ESKD) is fundamentally empirical. The abrupt transition from nondialysis chronic kidney disease (CKD) to thrice-weekly in-center HD of much the same dialysis intensity as in those with prevalent ESKD underappreciates the progressive nature of kidney disease whereby the decline in renal function has been gradual and ongoing-including at the time of HD initiation. Adjuvant pharmacologic treatment (i.e., diuretics, acid buffers, potassium binders), coupled with residual kidney function (RKF), can complement an initial HD regimen of lower intensity. Barriers to less intensive HD in incident ESKD include risk of inadequate clearance of uremic toxins due to variable and unexpected loss of RKF, lack of patient adherence to assessments of RKF or adjustment of HD intensity, increased burden for all stakeholders in the dialysis units, and negative financial repercussions. A stepped dialysis regimen with scheduled transition from time-delineated twice-weekly HD to thrice-weekly HD could represent an effective and safe strategy to standardize incremental HD in patients with CKD transitioning to early-stage ESKD. Patients' adherence and survival as well as other clinical outcomes should be rigorously evaluated in clinical trials before large-scale implementation of different incremental schedules of HD. This review discusses potential benefits of and barriers to alternative dialysis regimens in patients with incident ESKD, with emphasis on twice-weekly HD with pharmacologic therapy, and summarizes in-progress clinical trials of incremental HD schedules

Volume Control by Using the Body Composition Monitor in a Puerperal Patient on Hemodialysis

Accurate measurement of the volume status in hemodialysis patients is important as it can affect mortality. However, no studies have been conducted regarding volume management in cases where a sudden change of body fluid occurs, such as during puerperium in hemodialysis patients. This report presents a case in which the patient was monitored for her body composition and her volume status was controlled using a body composition monitor (BCM) during the puerperal period. This case suggests that using a BCM for volume management may help maintain hemodynamic stability in patients with a rapidly changing volume status for a short term period, such as during puerperium

Diabetes mellitus: Complex interplay between metformin, AKI and lactic acidosis.

Debate exists regarding the safety of metformin and the risk of metformin-associated lactic acidosis, particularly in the setting of kidney dysfunction. Data from two studies examining the interplay between metformin, acute kidney injury, and complications including lactic acidosis suggest that metformin should be used conservatively in patients with kidney dysfunction

Biosensors based on two-dimensional MoS2

The unique properties of two-dimensional molybdenum disulfide (2D MoS2) have so far led to immense research regarding this material's fundamentals, applications, and, more recently, its potential for biosensing. 2D MoS2 has properties that make it of great interest for developing biosensors. These properties include large surface area, tunable energy band diagrams, a comparatively high electron mobility, photoluminescence, liquid media stability, relatively low toxicity, and intercalatable morphologies. In this Review, the current progress on 2D MoS2 based biosensors is presented and the prospects for future possibilities of expanding its applications for a variety of biosensing applications are discussed

An equivalent circuit for simulating Love mode acoustic wave transducers: comparison of simulation and results

A simulation was performed using the equivalent circuit previously developed for a Love mode surface acoustic wave transducer. The present model is based on the Mason equivalent circuit for inter-digital fingers. A Love mode SiO2/ST-cut quartz transducer with operating frequency at 96 MHz was fabricated and the transfer function and input impedance were measured. Simulation results were compared with the experimental measurements and they showed close agreement

Optimum sensitive area of surface acoustic wave resonator chemical and bio-sensors

A model is developed to map the variation of sensitivity of a surface acoustic wave (SAW) resonator sensor over its surface, in order to find the region with maximum sensitivity. The model is based on a combined coupling of modes (COM) and periodic Green's function analysis. In order to extend the analysis to layered media, a new efficient technique is introduced to account for the mechanical interactions with buried electrodes. Using this technique the sensitivity calculations are found to be in good agreement with measurements. It is also shown that whilst changes in other parameters influence the sensitivity, it is the velocity change which most strongly determines the overall frequency change

Hydrogen sensing properties of Pt/lanthanum oxide-molybdenum oxide nanoplatelet/SiC based Schottky diode

An investigation of the electrical and hydrogen sensing properties of a novel Schottky diode based on a nanostructured lanthanum oxide-molybdenum oxide compound is presented herein. Molybdenum oxide (MoO3) nanoplatelets were grown on SiC substrates via thermal evaporation which was then subsequently coated with lanthanum oxide (La2O3) by RF sputtering. The current-voltage characteristics and hydrogen sensing performance (change in barrier height and sensitivity as well as the dynamic response) were examined from 25 to 300°C. At 180°C, a voltage shift of 2.23V was measured from the sensor while exposed to 1% hydrogen gas under a 100 μA constant reverse bias current. The results indicate that the presence of a La2O3 thin layer substantially improves the hydrogen sensitivity of the MoO3 nanoplatelets