Medium cut-off dialyzers in a large population of hemodialysis patients in Colombia: COREXH registry.

Expanded hemodialysis (HDx) provides increased clearance of conventional and large middle molecules through innovative medium cutoff (MCO) membranes. However, there is a paucity of real-world data regarding the benefits and safety of HDx. This large observational study evaluated outcomes among patients in Colombia undergoing HDx at a extended dialysis clinical services provider. This was a prospective single cohort study of prevalent patients who were treated with HDx; baseline information was collected from the most recent data before patients were started on HDx. Patients were followed prospectively for 1 year for changes in serum albumin and other laboratory parameters compared with the baseline. Survival, hospitalization and safety were assessed from the start of HDx. A total of 1000 patients were invited to enroll; 992 patients met the inclusion criteria for data analysis and 638 patients completed the year of follow-up. Seventy-four (8%) patients died during 866 patient-years (PY) of follow-up; the mortality rate was 8.54 deaths/100 PY (95% confidence interval [CI], 6.8-10.7). There were 673 hospitalization events with a rate of 0.79 events/PY (95% CI, 0.73-0.85) with 6.91 hospital days/PY (95% CI, 6.74-7.09). The observed variability from baseline and maximum average change in mean serum albumin levels were -1.8% and -3.5%, respectively. No adverse events were related to the MCO membrane. HDx using an MCO membrane maintains stable serum albumin levels and is safe in terms of nonoccurrence of dialyzer related adverse events.

Characterization of molecular properties of wheat starch from three different types of breads using asymmetric flow field-flow fractionation (AF4).

In this study, molecular properties of wheat starch from three different types of breads were analyzed using asymmetric flow field-flow (AF4) connected to multi-angle light scattering (MALS) and differential refractive index (dRI) detectors. This analysis allowed the determination of molecular properties, i.e. molar mass (M), root-mean-square radius (rrms), apparent density (ρapp) and conformation. Complementary analyses, such as resistant starch and amylose content, were also performed. The results show that wheat starch extracted from breads can have different properties reflected in changes in M, rrms and ρapp. In addition, the results suggest that some of the changes in molecular properties may be related to the presence of resistant starch.

Remote Patient Monitoring Program in Automated Peritoneal Dialysis: Impact on Hospitalizations.

Background:Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients' adherence to prescriptions is a limitation with potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy.Methods:A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days.Results:After propensity score matching, APD therapy with RPM (n = 63) compared with APD-without RPM (n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio [IRR] of 0.61 [95% confidence interval (CI) 0.39 - 0.95]; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 [95% CI 0.23 - 0.92]; p = 0.028).Conclusions:The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.

Physicochemical and structural properties of starch from five Andean crops grown in Bolivia.

Three Andean grains - amaranth (Amaranthus caudatus), quinoa (Chenopodium quinoa), canihua (Chenopodium pallidicaulle) - and two Andean roots starches - achira (Canna indica), maca (Lepidium meyenii) - were studied. Physicochemical properties such as granule size, crystallinity, pasting properties among other as well as structural properties such as root-mean-square radius (rrms), weight-average molar mass (Mw) and apparent density (ρapp) were analyzed in order to evaluate the relation between them. Grains were similar in most of their characteristics as roots in their i.e. granule size, shape, type of crystallinity, Mw and rrms varied according to botanical source. The starch granules from grains were in a narrow diameter range (0.5 to 2 µm) and displayed A-type X-ray diffraction pattern (XRD). Roots starch had a wide granule diameter range (1 to 100 µm) and displayed a B-type XRD. The amylose content varied between 0 and 48% where amaranth had the lowest value and achira had the highest. Furthermore, quinoa and canihua starches had very low breakdown in pasting properties, indicating high stability during cooking. A model is proposed that relates pasting properties i.e. peak viscosity and final viscosity with ρapp, gelatinization enthalpy, granule size and amylose content.

Characterization of a water soluble, hyperbranched arabinogalactan from yacon (Smallanthus sonchifolius) roots.

Yacon (Smallanthus sonchifolius Poepp. & Endl.) roots are largely grown in Andean countries and have attracted recent interest due to their antioxidant and prebiotic effects. Yacon is typically consumed as a fruit due to its sweet taste and juiciness. The macromolecular properties of an aqueous extract of yacon are investigated using asymmetric flow field-flow fractionation (AF4) coupled to UV, multiangle light scattering (MALS) and differential refractive index (dRI) detection. The method allows for determination of molar mass and size over the size distribution. Three major populations were found of which one strongly dominates in concentration. Through collection of fractions from AF4, carbohydrate composition and glycosidic linkage analysis for the dominating population was performed. The results show that the dominating population consists of a highly branched arabinogalactan (type 2) with a molar mass of approximately 1-2·105g/mol, a hydrodynamic radius of approximately 6-10nm and a relatively high apparent density (approx. 70-150kg/m3).