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Peritoneal, Hemodialysis, CRRT

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
I-Feng Sun, Su-Shin Lee, Sin-Daw Lin, Chung-Sheng Lai
Acute renal failure (ARF) is a very common condition that may occur in patients with major burn injuries. The majority of burn patients with ARF have a high mortality rate, ranging from 73% to 100%. There are several ways to treat ARF in burn patients, including peritoneal dialysis (PD), intermittent hemodialysis, and continuous renal replacement therapy (CRRT). CRRT is generally used in patients in whom intermittent hemodialysis has failed to control hypovolemia, as well as in patients who cannot tolerate intermittent hemodialysis...
July 2007: Kaohsiung Journal of Medical Sciences
Sylwester Prokurat, Ryszard Grenda, Jacek Rubik, Piotr Kaliciński, Marek Migdał, Anna Husar, Maciej Pyzlak, Jakub Klimkiewicz
Continuous renal replacement therapy (CRRT) has became a modality of choice in chidren with acute renal failure (ARF), especially in cases of multiorgan failure (MOF) and in hemodynamically unstable patients in whom regular hemodialysis is difficult to reform. Newborns and infants with contraindications to peritoneal dialysis are another group of patients treated with CRRT. Retrospective analysis of CRRT therapy in 112 patients treated with (CVVHD, CVVH, CVVHDF, SCUF-continuous veno-venous hemodialysis/hemofiltration/ hemodiafiltration/ultrafiltration) between 2000-2005 is presented...
2006: Przegla̧d Lekarski
S M Dirkes
Acute renal failure (ARF) is a common complication of critically ill patients in today's intensive care units. Intermittent renal replacement therapy for these types of patients may be limited or ineffective due to the critical nature of their illness. Volume overload and hemodynamic instability are complications that may not be treated adequately with conventional forms of dialysis, such as hemodialysis or peritoneal dialysis. Continuous renal replacement therapy (CRRT) is rapidly gaining ground as the treatment of choice for ARF in the intensive care unit (ICU) due to its slow, gentle nature of water and solute removal Critical care nurses are responsible for monitoring this therapy, but a collaborative effort with nephrology nurses' expertise and background in dialysis therapies is a key ingredient in implementation of a successful CRRT program...
December 2000: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Leslie P Wong, Molly P Blackley, Kenneth A Andreoni, Hyunsook Chin, Ronald J Falk, Philip J Klemmer
BACKGROUND: Acute renal failure (ARF) in the setting of end-stage liver disease has a dismal prognosis without liver transplantation. Renal replacement therapy (RRT) is a common bridge to liver transplant despite a paucity of supportive data. We investigated our single-center patient population to determine efficacy of RRT in liver transplant candidates with ARF. METHODS: We identified 102 liver transplant candidates receiving RRT for ARF between April 30, 1999 and January 31, 2004...
July 2005: Kidney International
Michael A Veltri, Alicia M Neu, Barbara A Fivush, Rulan S Parekh, Susan L Furth
Chronic renal failure is, fortunately, an unusual occurrence in children; however, many children with various underlying illnesses develop acute renal failure, and transiently require renal replacement therapy - peritoneal dialysis, intermittent hemodialysis (IHD), or continuous renal replacement therapy (CRRT). As children with acute and chronic renal failure often have multiple comorbid conditions requiring drug therapy, generalists, intensivists, nephrologists, and pharmacists need to be aware of the issues surrounding the management of drug therapy in pediatric patients undergoing renal replacement therapy...
2004: Paediatric Drugs
C Baroni, R Tarchini
During the thirty years from its birth, the activity of the Department of Nephrology and Dialysis at the Carlo Poma Hospital in Mantova has witnessed the progressive increase in the number of kidney patients (300/year), uraemic patients in RRT, both peritoneal and extracorporeal (>220 patients) and kidney transplants (84). During the same period there has also been an increase in the following activities: from kidney biopsy by echocolordoppler for glomerular illness to metabolic studies for the prevention of kidney stones, therapy and follow-up for hypertension during pregnancy to echo-studies of the renal vascular bed, long-term follow-up of kidney transplant patients to territorial distribution of 4 limited-care dialysis facilities...
May 2003: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Josée Thériault, Mohsen Agharazzi, Marc Dumont, Vincent Pichette, Denis Ouimet, Martine Leblanc
AIMS: Our objectives were to review the characteristics of patients who developed atheroembolic renal disease requiring dialysis as well as their renal function recovery and survival rates. METHODS: All cases of atheroembolic disease with renal failure severe enough to require dialysis were reviewed from January 1984 to December 2000 in two centers. The diagnosis of atheroemboli was based on clinical presentation and/or biopsy. Acute renal failure was defined as a serum creatinine >200 micromol/l if normal at baseline or doubling from baseline if chronic renal failure, whereas renal function recovery was the ability to discontinue renal replacement therapy for >or=3 months...
2003: Nephron. Clinical Practice
Nele Van de Noortgate, Francis Verbeke, Annemieke Dhondt, Francis Colardijn, Wim Van Biesen, Raymond Vanholder, Norbert Lameire
In this article the different dialysis strategies in the management of acute renal failure (ARF) in the elderly are discussed. Although peritoneal dialysis (PD) offers some theoretical advantages, there are several medical and technical reasons why it is currently less frequently used. The choice between intermittent hemodialysis (HD) and continuous renal replacement therapy (CRRT) is determined by a number of considerations, the most important ones being hemodynamic stability, the need for hyperalimentation and/or ultrafiltration, and the local experience with one or both techniques...
March 2002: Seminars in Dialysis
A Hyman, D C Mendelssohn
BACKGROUND: Although there is a very high mortality rate (>50%) with acute renal failure (ARF) in the intensive care unit (ICU), there is no general consensus on the best dialysis treatment for this condition. METHODS: We surveyed by mail questionnaire, all adult academic and community registered Canadian nephrology centers that offer treatment for ARF. RESULTS: The overall response rate was 59% (53/90). Comparing current dialysis methods with those utilized 5 years ago, the largest increase was in continuous renal replacement therapies (CRRT) (26 vs...
January 2002: American Journal of Nephrology
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