{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T07:20:07Z","timestamp":1710487207242},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T00:00:00Z","timestamp":1623974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The dialysis disequilibrium syndrome (DDS) results from osmotic shifts between the blood and the brain compartments. Patients at risk for DDS include those with very elevated blood urea nitrogen, concomitant hypernatremia, metabolic acidosis, and low total body water volumes. By understanding the underlying pathophysiology and applying urea kinetic modeling, it is possible to avoid the occurrence of this disorder. A urea reduction ratio (URR) of no more than 40%\u201345% over 2\u2009h is recommended for the initial hemodialysis treatment. The relationship between the URR and Kt\/V is useful when trying to model the dialysis treatment to a specific URR target. A simplified relationship between Kt\/V and URR is provided by the equation: Kt\/V\u00a0=\u00a0\u2212ln (1\u2009\u2212\u2009URR). A URR of 40% is roughly equivalent to a Kt\/V of 0.5. The required dialyzer urea clearance to achieve this goal URR in a 120\u2010min treatment can simply be calculated by dividing half the patient's volume of distribution of urea by 120. The blood flow rate and dialyzer mass transfer coefficient (K<jats:sub>0<\/jats:sub>A) required to achieve this clearance can then be plotted on a nomogram. Other methods to reduce the risk of DDS are reviewed, including the use of continuous renal replacement therapy.<\/jats:p>","DOI":"10.1111\/hdi.12938","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T09:39:02Z","timestamp":1624009142000},"page":"424-432","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Half the V by 120: A practical approach to the prevention of the dialysis disequilibrium syndrome"],"prefix":"10.1111","volume":"25","author":[{"given":"Kareem H.","family":"Genena","sequence":"first","affiliation":[{"name":"Nephrology Division Baylor University Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahbaz","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Dallas Nephrology Associates  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harold M.","family":"Szerlip","sequence":"additional","affiliation":[{"name":"Nephrology Division Baylor University Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Dallas Nephrology Associates  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S165925"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1961.03620100011003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(62)91365-X"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sft087"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902413"},{"key":"e_1_2_6_7_1","first-page":"91","article-title":"Dialysis disequilibrium syndrome: a preventable fatal acute complication","volume":"71","author":"Mah DY","year":"2016","journal-title":"Med J Malaysia"},{"key":"e_1_2_6_8_1","first-page":"A2013","article-title":"An extreme case of dialysis disequilibrium syndrome leading to brain death | A58","volume":"195","author":"Dinh K","year":"2017","journal-title":"Crit Care Case Rep"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(96)90124-9"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1992.273"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5410.672"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1973.100"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200101253440404"},{"key":"e_1_2_6_14_1","first-page":"34","volume-title":"Handbook of dialysis","author":"Daugirdas JT","year":"2015"},{"key":"e_1_2_6_15_1","unstructured":"DepnerTA.Approach to hemodialysis kinetic modeling In: Henrich WL editors. 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