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Peritoneal, Hemodialysis, CRRT

Nattachai Srisawat, Nattaya Sintawichai, Win Kulvichit, Nuttha Lumlertgul, Patita Sitticharoenchai, Nicha Thamrongsat, Sadudee Peerapornratana
PURPOSE: In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand. MATERIALS AND METHODS: Questionnaires were distributed to 160 physicians involved in the intensive care between January and December 2014 across Thailand. Distribution was done through an online survey platform or telephone interview...
April 11, 2018: Journal of Critical Care
Felipe Cavagnaro Santa María, Jorge Roque Espinosa, Pamela Guerra Hernández
INTRODUCTION: Neonatal hyperammonemia secondary due to inborn errors of metabolism is a rare condition with a high rate of neurological sequelae and mortality. Initial medical management is often insufficient to stop the progressive increase of ammonia, with the consequent deterioration of the patient. For this reason, depurative techniques have been implemented, including peritoneal dialysis, intermittent hemodialysis and continuous renal replacement therapy (CRRT). OBJECTIVE: To describe our experience with continuous extracorporeal dialysis in severely ill neonates with hyperammonemia...
February 2018: Revista Chilena de Pediatría
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Ajay Jaryal, Sanjay Vikrant
OBJECTIVE: The objective of the following study was to assess the outcome of continuous renal replacement therapy (CRRT) and acute peritoneal dialysis (PD) in dialysis-requiring renal failure in patients with hemodynamic instability. MATERIALS AND METHODS: A retrospective analysis of all the patients who received CRRT and acute PD over a period of 1 year at our institute, a tertiary care center, was done for diagnosis, type of renal replacement therapy (RRT), and survival outcome...
June 2017: Indian Journal of Critical Care Medicine
Claudio Ronco
In 1977 Peter Kramer performed the first CAVH (continuous arteriovenous hemofiltration) treatment in Gottingen, Germany. CAVH soon became a reliable alternative to hemo- or peritoneal dialysis in critically ill patients. The limitations of CAVH spurred new research and the discovery of new treatments such as CVVH and CVVHD (continuous veno-venous hemofiltration and continuous veno-venous hemodialysis). The alliance with industry led to development of new specialized equipment with improved accuracy and performance in delivering continuous renal replacement therapies (CRRTs)...
May 31, 2017: International Journal of Artificial Organs
Rupesh Raina, Abigail M Chauvin, Timothy Bunchman, David Askenazi, Akash Deep, Michael J Ensley, Vinod Krishnappa, Sidharth Kumar Sethi
HYPOTHESIS: Acute kidney injury (AKI) is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD) and hemodialysis (HD). It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability...
2017: PloS One
Fang Wang, Daqing Hong, Yafang Wang, Yunlin Feng, Li Wang, Li Yang
BACKGROUND: Renal replacement therapy (RRT) is important to support critically ill patients with acute kidney injury (AKI). This study, a part of a nation-wide survey for AKI conducted by the ISN AKF 0 by 25 China Consortium, aims to study the current RRT practical situation and problems in China. METHODS: The current study is a part of a nation-wide survey for AKI conducted by ISN AKF 0 by 25 China Consortium. The survey included 44 sites all over the country, including 22 academic hospitals in big cities and 22 local hospitals in smaller cities or rural areas...
May 4, 2017: BMC Nephrology
Josée Bouchard, Valery Lavergne, Darren M Roberts, Monique Cormier, Genevieve Morissette, Marc Ghannoum
Background: Extracorporeal treatments (ECTRs) are used for different conditions, including replacement of organ function and poisoning. Current recommendations for ECTRs in various poisonings suggest that intermittent haemodialysis (IHD) is the most efficient technique. However, the practicality of these recommendations is poorly defined in view of limited information on availability and cost worldwide. Methods: A survey invitation to an Internet-based questionnaire was emailed between January 2014 and March 2015 to members of international societies to determine the availability, time to initiation and cost of ECTRs (including filters, dialysate, catheter, anticoagulant and nursing/physician salary)...
April 1, 2017: Nephrology, Dialysis, Transplantation
Hildy Schell-Chaple
Continuous renal replacement therapy (CRRT) was introduced more than 40 years ago as a renal support option for critically ill patients who had contraindications to intermittent hemodialysis and peritoneal dialysis. Despite being the most common renal support therapy used in intensive care units today, the tremendous variability in CRRT management challenges the interpretation of findings from CRRT outcome studies. The lack of standardization in practice and training of clinicians along with the high risk of CRRT-related adverse events has been the impetus for the recent expert consensus work on identifying quality indicators for CRRT programs...
2017: AACN Advanced Critical Care
Narongsak Watcharotone, Wiwat Sayumpoorujinant, Udomsak Udompon, Napat Leeaphorn, Talerngsak Kanjanabuch
OBJECTIVE: The mortality rate of acute kidney injury (AKI) patients is high despite of new advanced continuous renal replacement therapy (CRRT), which has widely become the treatment of choice in patients who are hemodynamically unstable. Nevertheless, the effectiveness of CRRT in improving the survival outcome is still unclear. Therefore, many centers still use intermittent peritoneal dialysis (IPD) or intermittent hemodialysis (IHD) in hospital where CRRT is unavailable. The present study was carried out to evaluate outcome of AKI patients who were treated with IHD and IPD in Saraburi Hospital...
September 2011: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Naheed Ansari
Peritoneal dialysis (PD) was the first modality used for renal replacement therapy (RRT) of patients with acute kidney injury (AKI) because of its inherent advantages as compared to Hemodialysis. It provides the nephrologist with nonvascular alternative for renal replacement therapy. It is an inexpensive modality in developing countries and does not require highly trained staff or a complex apparatus. Systemic anticoagulation is not needed, and it can be easily initiated. It can be used as continuous or intermittent procedure and, due to slow fluid and solute removal, helps maintain hemodynamic stability especially in patients admitted to the intensive care unit...
2011: International Journal of Nephrology
Matthew L Paden, Barry L Warshaw, Micheal L Heard, James D Fortenberry
OBJECTIVE: To assess the outcome of pediatric patients supported by concomitant extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). DESIGN, SETTING, AND PATIENTS: Acute kidney injury is associated with mortality in ECMO patients. CRRT in patients on ECMO provides an efficient and potentially beneficial method of acute kidney injury management. Concern that concomitant CRRT use increases the risk of developing anuria and chronic renal failure limits its use in some centers...
March 2011: Pediatric Critical Care Medicine
Petar Kes, Nikolina Basić Jukić
Acute kidney injury (AKI) is a common clinical syndrome with a broad aetiological profile. It complicates about 5% of hospital admissions and 30% of admissions to intensive care units (ICU). During last 20 years has been a significant change in the spectrum of severe AKI such that it is no longer mostly a single organ phenomenon but rather a complex multisystem clinical problem. Despite great advances in renal replacement technique (RRT), mortality from AKI, when part of MOF, remains over 50%. The changing nature of AKI requires a new approach using the new advanced technology...
April 2010: Bosnian Journal of Basic Medical Sciences
Melvin Bonilla-Félix
Acute kidney injury (AKI) is a common complication in pediatric and neonatal intensive care units (ICUs). Renal replacement therapy (RRT) is frequently needed in children in whom supportive therapy is not enough to satisfy metabolic demands or to provide adequate nutrition in cases of oliguric kidney failure. The decision to begin dialysis should not be delayed, because experience in infants shows that the shorter the time from the ischemic insult to the beginning of dialysis, the higher the survival rate. The use of continuous RRT (CRRT) in pediatric patients in the ICU has almost tripled; at the same time, the use of peritoneal dialysis (PD) and intermittent hemodialysis has markedly declined...
February 2009: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Petar Kes, N Basić Jukić
Acute kidney injury (AKI) is encountered in a variety of settings (e.g., hospitalized and outpatient, non-intensive and intensive care unit patients, pediatric, adult, and elderly), with varied clinical manifestations ranging from a minimal elevation of serum creatinine (SCr) to anuric renal failure and/or multi organ failure (MOF), and a wide variation in causes, risk factors and comorbiditis. There is no hard and fast rule as to when renal replacement therapy (RRT) should be initiated, but is clearly not sensible to wait until an obvious uremic complication arises...
December 2008: Prilozi
Robert Perkins, James Simon, Arun Jayakumar, Robert Neff, Irving Cohen, Erin Bohen, James Oliver, Kevin Kumke, Steven Older, Jeremy Perkins, Kurt Grathwohl, Christina Yuan, Kevin Abbott
Experience with delivery of renal replacement therapy (RRT) in support of combat operations by the U.S. military has not been reported since the 1970s. We describe the tri-service military medical experience with RRT in support of Operation Iraqi Freedom. Through December 31, 2006, RRT was provided to 12 individuals inside the theater of operations. Navy medical personnel provided RRT to three patients (two U.S. active duty service members and one host nation individual) aboard the USNS Comfort, a mobile level 4 hospital...
November 2008: Military Medicine
Jale Bengi Celik, Ahmet Topal, Elmas Kartal, Alper Yosunkaya
BACKGROUND: A short time ago, commercially available diafiltration and replacement fluids could be found o n the hospital in Turkey. Instead, peritoneal dialysis solution (PDS) for continue veno-venous hemodiafiltration (CVVHDF) therapy and normal saline as replacement fluid are used. In this retrospective study, we investigated the effects of PDS and bicarbonate-buffered hemofiltration solution (Bic-HFS). METHODS: We did a retrospective chart review of 24 patients treated with continue renal replacement therapy (CRRT) between January 2004 and February 2008...
2008: Renal Failure
Andrew Davenport
Over the last three decades the treatment options for patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) have expanded from basic acute peritoneal dialysis and intermittent hemodialysis (IHD), to now include a variety of continuous modalities (CRRT), ranging from hemofiltration, dialysis and/or hemodiafiltration, and a variety of hybrid therapies, variously described as extended daily dialysis and/or hemodiafiltration, with the possibility of additional adjunct therapies encompassing plasma separation and adsorption techniques...
July 2008: Saudi Journal of Kidney Diseases and Transplantation
M Z Souqiyyeh, F A Shaheen, A A Al-Khader
To evaluate the approach of physicians to the diagnosis and management of acute renal failure (ARF) in the Kingdom of Saudi Arabia, a questionnaire was mailed to nephrologists, physicians attending to renal failure patients, specialists working in intensive care unit (ICU) and the general physicians in 110 hospitals, which have either an ICU or a dialysis unit. The questions were related to the areas of evaluation, conservative management, dialysis therapy, and prognosis of ARF. There were 135 responses from 76 hospitals (69%); 37 of small size (< 150 beds), 21 of medium size (151-400 beds), and 18 of large size (401-1200 beds)...
July 1998: Saudi Journal of Kidney Diseases and Transplantation
D P Gabriel, J T Caramori, L C Martim, P Barretti, A L Balbi
There is no consensus in the literature on the best renal replacement therapy (RRT) in acute kidney injury (AKI), with both hemodialysis (HD) and peritoneal dialysis (PD) being used as AKI therapy. However, there are concerns about the inadequacy of PD as well as about the intermittency of HD complicated by hemodynamic instability. Recently, continuous replacement renal therapy (CRRT) have become the most commonly used dialysis method for AKI around the world. A prospective randomized controlled trial was performed to compare the effect of high volume peritoneal dialysis (HVPD) with daily hemodialysis (DHD) on AKI patient survival...
April 2008: Kidney International. Supplement
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