Equilibrium dialysis with HPLC detection to measure substrate binding affinity of a non-heme iron halogenase.

Determination of substrate binding affinity (Kd) is critical to understanding enzyme function. An extensive number of methods have been developed and employed to study ligand/substrate binding, but the best approach depends greatly on the substrate and the enzyme in question. Below we describe how to measure the Kd of BesD, a non-heme iron halogenase, for its native substrate lysine using equilibrium dialysis coupled with High Performance Liquid Chromatography (HPLC) for subsequent detection. This method can be performed in anaerobic glove bag settings. It requires readily available HPLC instrumentation for ligand quantitation and is adaptable to meet the needs of a variety of substrate affinity measurements.

Rational regulation of post-electrodialysis electrochromic anion exchange membranes via TiO2@Ag synergistically strengthens visible-light photocatalytic anti-contamination activity.

Membrane-contamination during electrodialysis (ED) process is still a non-negligible challenge, while irreversible consumption and unsustainability have become the main bottlenecks limiting the improvement of anion exchange membranes (AEMs) anti-contamination activity. Here, we introduce a novel approach to design AEMs by chemically assembling 4-pyndinepropanol with bromomethylated poly(2,6-dimethyl-1,4-phenylene oxide) (BPPO) in an electrochromic-inspired process. Subsequently, the co-mingled TiO2@Ag nanosheet with the casting-solution were sprayed onto the surface of the substrate membrane to create a micrometer-thick interfacial layer. The addition of Ag nanoparticles (NPs) enhances the active sites of TiO2, resulting in stronger local surface plasmon resonance (LSPR) effects and reducing its energy band gap limitation (From 3.11 to 2.63 eV). Post-electrodialysis electrochromic AEMs incorporating TiO2@Ag exhibit synergistic enhancement of sunlight absorption, effectively suppressing photogenerated carrier binding and promoting migration. These resultant-membranes demonstrate significantly improved bacterial inhibition properties (42.0-fold increase for E. coli) and degradation activity (7.59-fold increase for rhodamine B) compared to pure TiO2 membranes. Importantly, they maintain photocatalytic activity without compromising salt-separation performance or stability, as the spraying process utilizes the same substrate materials. This approach to rational design and regulation of anti-contamination AEMs offers new insights into the collaborative synergy of color-changing and photocatalytic materials.

Leveraging organic acids in bipolar membrane electrodialysis (BPMED) can enhance ammonia recovery from scrubber effluents.

While air stripping combined with acid scrubbing remains a competitive technology for the removal and recovery of ammonia from wastewater streams, its use of strong acids is concerning. Organic acids offer promising alternatives to strong acids like sulphuric acid, but their application remains limited due to high cost. This study proposes an integration of air stripping and organic acid scrubbing with bipolar membrane electrodialysis (BPMED) to regenerate the organic acids. We compared the energy consumption and current efficiency of BPMED in recovering dissolved ammonia and regenerating sulphuric, citric, and maleic acids from synthetic scrubber effluents. Current efficiency was lower when regenerating sulphuric acid (22 %) compared to citric (47 %) and maleic acid (37 %), attributable to the competitive proton transport over ammonium across the cation exchange membrane. Organic salts functioned as buffers, reducing the concentration of free protons, resulting in higher ammonium removal efficiencies with citrate (75 %) and malate (68 %), compared to sulphate (29 %). Consequently, the energy consumption of the BPMED decreased by 54 % and 35 % while regenerating citric and maleic acids, respectively, compared to sulfuric acid. Membrane characterisation experiments showed that the electrical conductivity ranking, ammonium citrate > ammonium malate > ammonium sulphate, was mirrored by the energy consumption (kWh/kg-N recovered) ranking, ammonium sulphate (15.6) < ammonium malate (10.2) < ammonium citrate (7.2), while the permselectivity ranking, ammonium sulphate > ammonium citrate > ammonium malate, aligned with calculated charge densities. This work demonstrates the potential of combining organic acid scrubbers with BPMED for ammonium recovery from wastewater effluents with minimum chemical input.

Selective electrodialysis for nutrient recovery and pharmaceutical removal from liquid digestate: Pilot-scale investigation and potential fertilizer production.

The present research employs a pilot-scale selective electrodialysis system to treat liquid digestate, fractionating nutrient ions and exploring fertilizer creation via ammonia stripping and phosphorus precipitation, while studying pharmaceutical transport behavior and examining membrane fouling. The influence of diverse potentials was studied in simulated and real digestate, with 30 V application proven more efficient overall. Applying consecutive runs resulted in products that were 7.9, 7.4, 1.7, 5.3, and 6 times more concentrated compared to the feed solution for NH4+, K+, PO43-, Ca2+, and Mg2+, respectively. Pharmaceuticals analysis showed that ciprofloxacin was completely retained in the liquid digestate, while ibuprofen was detected in the anionic product. Diclofenac was initially present in the digestate but was undetectable in the final products, suggesting it adhered to the membrane. Membranes showed inorganic and organic fouling. The monovalent cation exchange membrane had severe salt scaling, showing calcium and magnesium deposits, and fewer functional groups.

Dialysis rolled scaffold bioreactor allows extended production of monoclonal antibody with reduced media use.

Rapidly expanding biopharmaceutical market demands more cost-effective platforms to produce protein therapeutics. To this end, novel approaches, such as perfusion culture or concentrated fed-batch, have been explored for higher yields and lower manufacturing costs. Although these new approaches produced promising results, but their wide-spread use in the industry is still limited. In this study, a dialysis rolled scaffold bioreactor was presented for long-term production of monoclonal antibodies with reduced media consumption. Media dialysis can selectively remove cellular bio-wastes without losing cells or produced recombinant proteins. The dialysis process was streamlined to significantly improve its efficiency. Then, extended culture of recombinant CHO cells for 41 days was successfully demonstrated with consistent production rate and minimal media consumption. The unique configuration of the developed bioreactor allows efficient dialysis for media management, as well as rapid media exchange to harvest produced recombinant proteins before they degrade. Taken together, it was envisioned that the developed bioreactor will enable cost-effective and long-term large-scale culture of various cells for biopharmaceutical production.

Boosting nutrient recovery from AnMBR effluent by means of electrodialysis technology: Operating parameters assessing.

This work describes a comprehensive assessment of operating parameters of a bench-scale electrodialysis (ED) plant for nutrient concentration from an Anaerobic Membrane BioReactor (AnMBR) effluent. The ED bench-scale plant serves a dual purpose. Firstly, to generate a concentrated stream with a high nutrient content, and secondly, to produce high-quality reclaimed water in the diluted stream, both sourced from real wastewater coming from the effluent of an AnMBR. Two sets of experiments were conducted: 1) short-term experiments to study the effect of some parameters such as the applied current and the type of anionic exchange membrane (AEM), among others, and 2) a long-term experiment to verify the feasibility of the process using the selected parameters. The results showed that ED produced concentrated ammonium and phosphate streams using a 10-cell pair stack with 64 cm2 of unitary effective membrane area, working in galvanostatic mode at 0.24 A, and operating with an Acid-100-OT anionic exchange membrane. Concentrations up to 740 mg/L and 50 mg/L for NH4-N and PO4-P, respectively, were achieved in the concentrated stream along with removal efficiencies of 70% for ammonium and 60% for phosphate in the diluted stream. The average energy consumption was around 0.47 kWh·m-3.

Dialysis Monitoring of Ionic Strength and Denaturant Effects, and Their Reversibility, for Various Classes of Macromolecules.

Monitoring membrane-mediated dialysis in real time with static and dynamic light scattering revealed distinctive differences, including reversibility/irreversibility, in the effects of ionic strength (NaCl) and the denaturant guanidine-HCl (Gd) on a synthetic polyelectrolyte and several types of biomacromolecules: protein, polysaccharide, and polyampholyte. Dialysis cycles against aqueous NaCl and Gd, and reverse back to the original aqueous solution, were monitored. The behavior of Na-polystyrenesulfonate was reversible and yielded a detailed polymer physics description. The biomacromolecules additionally showed hydrogen-bonding/hydrophobic (HP) interactions. An interpretive model was developed that considers the interplay among polyelectrolyte, polyampholyte, and HP potential energies in determining the different associative, aggregative, and dissociative behaviors. NaCl isolated purely electrostatic effects, whereas Gd combined electrostatic and HP effects. Some macromolecules showed partially reversible behavior, and others were completely irreversible. The dialysis monitoring method should prove useful for investigating fundamental macromolecular and colloid properties and for drug formulation and stability optimization.

A New Method for Growth Factor Enrichment from Dairy Products by Electrodialysis with Filtration Membranes: The Major Impact of Raw Product Pretreatment.

This study is focused on fractionation of insulin-like growth factor I (IGF-I) and transforming growth factor-ß2 (TGF-ß2) using a new electro-based membrane process calledelectrodialysis with filtration membranes (EDFM). Before EDFM, different pretreatments were tested, and four pH conditions (4.25, 3.85, 3.45, and 3.05) were used during EDFM. It was demonstrated that a 1:1 dilution of defatted colostrum with deionized water to decrease mineral content followed by the preconcentration of GFs by UF is necessary and allow for these compounds to migrate to the recovery compartment during EDFM. MS analyses confirmed the migration, in low quantity, of only α-lactalbumin (α-la) and ß-lactoglobulin (ß-lg) from serocolostrum to the recovery compartment during EDFM. Consequently, the ratio of GFs to total protein in recovery compartment compared to that of feed serocolostrum solution was 60× higher at pH value 3.05, the optimal pH favoring the migration of IGF-I and TGF-ß2. Finally, these optimal conditions were tested on acid whey to also demonstrate the feasibility of the proposed process on one of the main by-products of the cheese industry; the ratio of GFs to total protein was 2.7× higher in recovery compartment than in feed acid whey solution, and only α-la migrated. The technology of GF enrichment for different dairy solutions by combining ultrafiltration and electrodialysis technologies was proposed for the first time.

Rapid and Online Microvolume Flow-Through Dialysis Probe for Sample Preparation in Veterinary Drug Residue Analysis.

A rapid and online microvolume flow-through dialysis probe designed for sample preparation in the analysis of veterinary drug residues is introduced. This study addresses the need for efficient and green sample preparation methods that reduce chemical waste and reagent use. The dialysis probe integrates with liquid chromatography and mass spectrometry (LC-MS) systems, facilitating automated, high-throughput analysis. The dialysis method utilizes minimal reagent volumes per sample, significantly reducing the generation of solvent waste compared to traditional sample preparation techniques. Several veterinary drugs were spiked into tissue homogenates and analyzed to validate the probe's efficacy. A diagnostic sensitivity of >97% and specificity of >95% were obtained for this performance evaluation. The results demonstrated the effective removal of cellular debris and particulates, ensuring sample integrity and preventing instrument clogging. The automated dialysis probe yielded recovery rates between 27 and 77% for multiple analytes, confirming its potential to streamline veterinary drug residue analysis, while adhering to green chemistry principles. The approach highlights substantial improvements in both environmental impact and operational efficiency, presenting a viable alternative to conventional sample preparation methods in regulatory and research applications.

Integration of anaerobic digestion and electrodialysis for methane yield promotion and in-situ ammonium recovery.

Ammonia inhibition is a common issue encountered in anaerobic digestion (AD) when treating nitrogen-rich substrates. This study proposed a novel approach, the electrodialysis-integrated AD (ADED) system, for in-situ recovery of ammonium (NH4+) while simultaneously enhancing AD performance. The ADED reactor was operated at two different NH4+-N concentrations (5,000 mg/L and 10,000 mg/L) to evaluate its performance against a conventional AD reactor. The results indicate that the ADED technology effectively reduced the NH4+-N concentration to below 2,000 mg/L, achieving this with a competitive energy consumption. Moreover, the ADED reactor demonstrated a 1.43-fold improvement in methane production when the influent NH4+-N was 5,000 mg/L, and it effectively prevented complete inhibition of methane production at the influent NH4+-N of 10,000 mg/L. The life cycle impact assessment reveals that ADED technology offers a more environmentally friendly alternative by recovering valuable fertilizer from the AD system.

Comparison of Commonly Used and New Methods to Determine Small Molecule Non-Specific Binding to Human Liver Microsomes.

Accurate measurement of non-specific binding of a drug candidate to human liver microsomes (HLM) can be critical for the accurate determination of key enzyme kinetic parameters such as Michaelis-Menton (Km), reversible inhibition (Ki), or inactivation (KI) constants. Several methods have been developed to determine non-specific binding of small molecules to HLM, such as rapid equilibrium dialysis (RED), ultrafiltration (UF), HLM bound to magnetizable beads (HLM-beads), ultracentrifugation (UC), the linear extrapolation stability assay (LESA), and the Transil™ system. Despite various differences in methodology between these methods, it is generally presumed that similar free fraction values (fu,mic) should be generated. To evaluate this hypothesis, a test set of 9 compounds were selected, representing low (high fu,mic value) and significant (low fu,mic value) HLM binding, respectively, across HLM concentrations tested in this manuscript. The fu,mic values were determined using a single compound concentration (1.0 µM) and three HLM concentrations (0.025, 0.50, and 1.0 mg/mL). When the HLM non-specific binding event is not extensive resulting in high fu,mic values, all methods generated similar fu,mic values. However, fu,mic values varied markedly across assay formats when high binding to HLM occurred, where fu,mic values differed by up to 33-fold depending on the method used. Potential causes for such discrepancies across the various methods employed, practical implications related to conduct the different assays, and implications to clinical drug-drug interaction (DDI) predictions are discussed.

A simple method to prepare anion exchange membrane by PVA/EVOH/MIDA for acid recovery by diffusion dialysis.

Given the substantial environmental pollution from industrial expansion, environmental protection has become particularly important. Nowadays, anion exchange membranes (AEMs) are widely used in wastewater treatment. With the use of polyvinyl alcohol (PVA), ethylene-vinyl alcohol (EVOH) copolymer, and methyl iminodiacetic acid (MIDA), a series of cross-linked AEMs were successfully prepared using the solvent casting technique, and the network structure was formed in the membranes due to the cross-linking reaction between PVA/EVOH and MIDA. Fourier transform infrared spectrometer, X-ray photoelectron spectroscopy, scanning electron microscopy, and transmission electron microscopy were used to analyze the prepared membranes. At the same time, its comprehensive properties which include water uptake, linear expansion rate, ion exchange capacity, thermal stability, chemical stability, and mechanical stability were thoroughly researched. In addition, diffusion dialysis performance in practical applications was also studied in detail. The acid dialysis coefficient (UH+) ranged from 10.2 to 35.6 × 10-3 m/h. Separation factor (S) value ranged from 25 to 38, which were all larger than that of the commercial membrane DF-120 (UH+: 8.5 × 10-3 m/h, S: 18.5). The prepared membranes had potential application value in acid recovery.

The effectiveness of a blended-learning training methodology on the dialysis nurse’s perception of competence. Quasi-experimental study / Efetividade de um programa de formação b-learning na perceção de competência do enfermeiro de diálise. Estudo quase-experimental

Introdução:Os enfermeiros que prestam cuidados à pessoa com doença renal crónica em hemodiálise devem ter formação específica em técnicas dialíticas. Assim, os Enfermeiros de Diálise deverão desenvolver competências específicas e diferenciadas ao longo do seu percurso profissional. O b-learning desempenha um papel fundamental na modernização do ensino, tornando-o mais acessível, flexível e adaptado às necessidades dos enfermeiros. Oferece oportunidades para melhorar a quali-dade da aprendizagem e promover a colaboração e a inovação no processo educativo.Objetivos:Os objetivos do estudo foram: avaliar a influência das variáveis sociodemográficas (idade e habilitações literárias) e da formação adquirida (frequência e duração) no perfil de competências e avaliar a eficácia de um programa de formação em técnicas de HD, na perceção de competência do Enfermeiro de Diálise. Material e Métodos:Estudo quase-experimental, pré e pós-teste, sem grupo controle. Resultados:A idade, a frequência e a duração da formação influenciam a perceção de competência do enfermeiro de diálise. Os participantes apresentaram uma melhoria significativa em alguns domínios da perceção de competência do Enfermeiro de Diálise após a implementação de um programa de formação em técnicas de HD. Conclusões:A existência de um programa de formação para Enfermeiros de Diálise, devidamente estruturado e padronizado, é uma mais-valia na aquisição, consolidação e atualização de conhecimentos. (AU)

Introduction: Nurses providing care to individuals with chronic kidney disease undergoing hemodialysis must have specific training in dialysis techniques. Therefore, Dialysis Nurses should develop specific and differentiated competencies throughout their professional career. Blended learning plays a fundamental role in modernizing education, making it more accessible, flexible, and tailored to the needs of nurses. It offers opportunities to improve the quality of learning and promote collaboration and innovation in the educational process. Objectives: The study’s objectives were to assess the influence of sociodemographic variables (age and education) and acquired training (frequency and duration) on the competence profile and to evaluate the effectiveness of a training program in HD techniques on the perception of competence of Dialysis Nurses. Material and Methods: Quasi-experimental, pre and post-test study without a control group. Results: Age, frequency, and duration of training influence dialysis nurses’ perceptions of competence. Participants showed a significant improvement in some domains of dialysis nurses’ perceptions of competence after the implementation of a training program in HD techniques. Conclusions: A properly structured and standardized training program for dialysis nurses is an asset in acquiring, consolidating, and updating knowledge. (AU)

Sex-related differences in pre-dialysis trajectories and dialysis initiation: A French nationwide retrospective study.

BACKGROUND: In the last two decades, sex and gender differences have been documented in chronic kidney disease (CKD) management, including access to renal replacement therapy and its outcomes. The objectives of this study were to 1) compare the pre-dialysis healthcare utilization in men and women, and 2) examine the sex-specific factors associated with emergency dialysis start. METHODS: Adult patients with CKD who started dialysis in France in 2015 were extracted from the Renal Epidemiology and Information Network registry. Patients were matched to the French National Health Data System database to extract healthcare utilization data for the 2 years before dialysis start. Frequencies and monthly rates of consultations and hospitalizations were compared between men and women. Logistic regression analyses were performed separately in the two groups. RESULTS: Among the 8856 patients included, 3161 (35.7%) were women. Median age (71 years) and estimated glomerular filtration rate (8.1 and 7.7 ml/min for men and women) were similar between groups at dialysis start. Monthly consultations rates with a general practitioner and nephrology-related care were similar between women and men. Some sex-specific differences were found: higher frequencies of consultations with a psychiatrist in women and more frequent hospitalizations for circulatory system diseases in men. Emergency dialysis start rate was 30% in both groups. Emergency dialysis start was associated with acute nephropathy, compared with slowly progressive nephropathy, in women but not in men (OR = 1.48, p<0.01 vs 1.15, p = 0.18). CONCLUSIONS: This study found similar quantitative pre-dialysis healthcare utilization in men and women. To better understand sex/gender differences in CKD care trajectories, future research should focus on patients with CKD who are unknown to nephrology services, on patients receiving conservative care and on the sex/gender-specific mechanisms underlying care decision-making.

Role of the Opinions of the Nephrologist and Structural Factors in Dialysis Modality Selection. Results of a Peritoneal Dialysis Study Group Questionnaire.

Background. The use of PD depends on economic, structural and organizational factors. The nephrologist's opinion is that peritoneal dialysis is less used than it shold be. In Italy, PD is not carried out in private Centers, but neither is it in around one third of Public Centers. The aim of this study was to investigate the opinions of nephrologists on PD in Public Centers only, thereby nullifying the influence of the economic factors. Materials and Methods. The investigation was carried out by means of an online questionnaire (Qs) via mail, and during meetings and Congresses in 2006-07. The Qs investigated the characteristics of the Centers, the nephrologists interviewed, and opinions on the various aspects of the choice of Renal Replacement Therapy Renal Replacement Therapy (RRT) (26 questions). Responses were received from 454 nephrologists in 270 public Centers. Among these, 205 centers (370 Qs) report PD (PD-YES), 36 (42 Qs) do not (PD-NO) and 29 (42 Qs) do not use it but send patients selected for PD to other Centers (PD-TRANSF). Results. The PD-NO and PD-TRANSF Centers are significantly smaller, with greater availability of beds. In the PD-YES Centers the presence of a pre-dialysis pathway, early referral and nurses dedicated solely to PD are associated with a higher use of PD. The nephrologists in the PD-NO Centers rate PD more negatively in terms of both clinical and non-clinical factors. The belief that more than 40% of patients can do either PD or HD differs among the nephrologists in the PD-YES (74.3%), PD-TRANSF (45.2%) and PD-NO (28.6%) Centers. Likewise, the belief that PD can be used as a first treatment in more than 30% of cases differs among the nephrologists in PD-YES (49.2%), PD-TRANSF (33.3%) and PD-NO (14.3%) Centers. Conclusions. The use of PD in Public Centers is conditioned by both structural and organizational factors, and by the opinions of nephrologists on the use and effectiveness of the technique.

Higher sclerostin is associated with pulmonary hypertension in pre-dialysis end-stage kidney disease patients: a cross-sectional prospective observational cohort study.

BACKGROUND: Pulmonary hypertension (PH) is a complication of chronic kidney disease (CKD) that contributes to mortality. Sclerostin, a SOST gene product that reduces osteoblastic bone formation by inhibiting Wnt/ß-catenin signaling, is involved in arterial stiffness and CKD-bone mineral disease, but scanty evidence to PH. This study explored the relationship between sclerostin and PH in CKD 5, pre-dialysis end-stage kidney disease (ESKD) patients. METHODS: This cross-sectional prospective observational cohort study included 44 pre-dialysis ESKD patients between May 2011 and May 2015. Circulating sclerostin levels were measured using an enzyme-linked immunosorbent assay. PH was defined as an estimated pulmonary artery systolic pressure > 35 mmHg on echocardiography. RESULTS: Patients with higher sclerostin levels ≥ 218.18pmol/L had echocardiographic structural cardiac abnormalities, especially PH (P < 0.01). On multivariate logistic analysis, sclerostin over 218.19pmol/L was significantly associated with PH (odds ratio [OR], 41.14; 95% confidence interval [CI], 4.53-373.89, P < 0.01), but multivariate Cox regression analysis showed the systemic vascular calcification score over 1 point (Hazard ratio [HR] 11.49 95% CI 2.48-53.14, P = 0.002) and PH ([HR] 5.47, 95% CI 1.30-23.06, P = 0.02) were risk factors for all-cause mortality in pre-dialysis ESKD patients. CONCLUSIONS: Serum sclerostin and PH have a positive correlation in predialysis ESKD patients. The higher systemic vascular calcification score and PH have an association to increase all-cause mortality in pre-dialysis ESKD patients.

Circulating osteoprotegerin levels and cardiovascular outcomes in patients with pre-dialysis chronic kidney disease: results from the KNOW-CKD study.

While the relationship between circulating osteoprotegerin (OPG) and cardiovascular events is well-established in the general population, its association with cardiovascular risks in chronic kidney disease (CKD) patients remains less robust. This study hypothesized that elevated circulating OPG levels might be associated with an increased risk of major adverse cardiac events (MACE) in CKD patients, a total of 2,109 patients with CKD stages 1 through pre-dialysis 5 from the KNOW-CKD cohort were categorized into quartiles based on serum OPG levels. The primary outcome of the study was 3-point MACE, defined as a composite of nonfatal myocardial infarction, nonfatal stroke, or cardiac death. The median follow-up duration was 7.9 years. The cumulative incidence of 3-point MACE significantly varied across serum OPG levels in Kaplan-Meier curve analysis (P < 0.001, log-rank test), with the highest incidence observed in the 4th quartile. Cox regression analysis indicated that, relative to the 1st quartile, the risk of 3-point MACE was significantly higher in the 3rd (adjusted hazard ratio 2.901, 95% confidence interval 1.009 to 8.341) and the 4th quartiles (adjusted hazard ratio 4.347, 95% confidence interval 1.410 to 13.395). In conclusion, elevated circulating OPG levels are associated with adverse cardiovascular outcomes in pre-dialysis CKD patients.

Haematological Indices and Iron Status in Pre-Dialysis Chronic Kidney Disease Patients.

BACKGROUND: Chronic kidney disease (CKD) is associated with haematological changes, the commonest being anaemia. The number and function of white blood cells (WBC) and platelets are equally affected. Iron deficiency is a common cause of anaemia in the CKD population and anaemia has been associated with reduced cardiac function, increased rates of hospitalization, morbidity and mortality. This study aimed to determine the haematological indices and iron status among pre-dialysis CKD patients. METHOD: A hospital-based cross-sectional study involving 95 predialysis CKD patients and 95 age- and sex-matched apparently healthy controls. Full blood count, peripheral blood film, serum ferritin, transferrin saturation, C-reactive protein (CRP), electrolytes, urea and creatinine, serum folate and vitamin B12 were done in all study participants. Comparisons were made between results obtained from participants in both groups. RESULT: The mean ages were 58.1 ± 14.9 years and 58.3 ± 15.0 years in the CKD group and controls, respectively. The male:female ratio was 1:0.9 in both groups. The prevalence of anaemia was 51.6% and 3% in patients with CKD and controls, respectively. There was no significant difference in the total WBC count, neutrophil and lymphocyte differentials, platelet count, serum vitamin B12 and folate in patients with CKD and controls. The prevalence of iron deficiency among patients with CKD was 32.6%, of which 62.5% were absolutely iron-deficient while 37.5% were functionally iron-deficient. The median ferritin and CRP were also higher in CKD. (p =0.001). CONCLUSION: Anaemia and iron deficiency are common in predialysis CKD patients. Early diagnosis and treatment are important to avoid the problems associated with them. MOTS-CLÉS: Maladie rénale chronique, Anémie, Carence en fer, Pré-dialyse.

Assessment of Dialysis Adequacy Using Small Solute Clearance Indices among Twice versus Thrice Weekly Maintenance Hemodialysis Patients in a Tertiary Care Hospital of Bangladesh.

This observational study was carried out in the Department of Nephrology, Mymensingh Medical College Hospital, Bangladesh from January 2020 to December 2020. A total of 179 patients were included in this study according to inclusion and exclusion criteria. Informed written consent was taken from each patient. All patients were underwent detail history taking, thorough physical examination and relevant investigations. Data collection was conducted through a structured questionnaire. Collected data were analyzed using the statistical software SPSS 23.0. Mean age ±SD of the study patients was 47.06±14.1 with a majority in age group 41-50 years. Male predominance was observed with a male: female ratio of 2.19:1 and 68.7% male patients. Level of pre-dialysis, post-dialysis urea in the study population was 123.77±26.86mg/dl, 50.27±15.70mg/dl respectively and mean ±SD of Urea Reduction Ratio (URR) in hemodialysis (target >65.0%) was 67.2±1.9. Most of the 8 hours (two times) per week hemolysis patients could not achieve the target value of dialysis adequacy parameters. On the other hand, maximum people in 12 hours (three times) per week hemodialysis group achieved the target value of dialysis adequacy parameters. It is important to calculate Kt/V or URR and individualize the dialysis doses for each patient.