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Continuous renal replacement therapy

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https://www.readbyqxmd.com/read/28220472/renal-denervation-for-resistant-hypertension
#1
REVIEW
Giuseppe Coppolino, Anna Pisano, Laura Rivoli, Davide Bolignano
BACKGROUND: Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#2
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28219057/preventing-continuous-renal-replacement-therapy-induced-hypophosphatemia-an-extended-clinical-experience-with-a-phosphate-containing-solution-in-the-setting-of-regional-citrate-anticoagulation
#3
Valentina Pistolesi, Laura Zeppilli, Francesca Polistena, Maria Itala Sacco, Alessandro Pierucci, Luigi Tritapepe, Giuseppe Regolisti, Enrico Fiaccadori, Santo Morabito
AIMS: To evaluate the efficacy and safety of a commercially available phosphate-containing solution for continuous renal replacement therapy (CRRT) in preventing CRRT-related hypophosphatemia. METHODS: In heart surgery patients undergoing continuous veno-venous haemodiafiltration (CVVHDF) with regional citrate anticoagulation (RCA), we combined an 18 mmol/l citrate solution with a phosphate-containing (1.2 mmol/l) dialysate/replacement fluid evaluating the incidence of hypophosphatemia and the need for parenteral phosphorus supplementation...
February 21, 2017: Blood Purification
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#4
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28212688/incidence-and-survival-of-end-stage-kidney-disease-due-to-polycystic-kidney-disease-in-australia-and-new-zealand-1963-2014
#5
Mangalee R Fernando, Hannah Dent, Stephen P McDonald, Gopala K Rangan
BACKGROUND: The aim of this study was to determine whether the incidence and survival of patients with end-stage kidney disease (ESKD) due to polycystic kidney disease (PKD) has changed in Australia and New Zealand. METHODS: Data for all PKD patients who developed ESKD and commenced renal replacement therapy (RRT) was assessed using the Australia and New Zealand Dialysis and Transplant Registry from 1963 to 2014. RESULTS: A total 4678 patients with ESKD due to PKD received RRT during the study period...
February 17, 2017: Population Health Metrics
https://www.readbyqxmd.com/read/28203407/thoracoabdominal-aortic-replacement-for-crawford-extent-ii-aneurysm-after-thoracic-endovascular-aortic-repair
#6
Haiou Hu, Tie Zheng, Junming Zhu, Yongmin Liu, Ruidong Qi, Lizhong Sun
BACKGROUND: The surgical treatment of Crawford extent II aneurysms after thoracic endovascular aortic repair (TEVAR) remains challenging, because of the need to remove the failed endograft and the complexity of the aortic reconstruction. We retrospectively reviewed our experience with surgical management of Crawford extent II aneurysms after TEVAR using thoracoabdominal aortic replacement (TAAR). METHODS: Eleven patients (10 males, 1 female) with Crawford extent II aneurysm after TEVAR were treated with TAAR between August 2012 and May 2015...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28202121/-oliguria-and-acute-renal-dysfunction-in-a-six-month-old-infant
#7
Ya-Jie Cui, Chun-Lan Song, Yi-Bing Cheng
The infant (a girl aged 6 months) was admitted to the hospital because of oliguria and acute renal dysfunction. The laboratory examination results showed serious metabolic acidosis and increased blood urea nitrogen and serum creatinine levels. The patient continued to be anuric after 10 days of treatment with continuous renal replacement therapy (CRRT). she died a day later. The family history showed that the patient's sister died of acute renal failure 6 months after birth. The genomic sequencing results showed AGXT mutation in the patient and confirmed the diagnosis of primary hyperoxaluria type 1 (PH1)...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28197045/experiences-with-continuous-venovenous-hemofiltration-using-18mmol-l-predilution-citrate-anticoagulation-and-a-phosphate-containing-replacement-solution
#8
Yuen Henry Jeffrey, Shum Hoi-Ping, Anne Leung Kit Hung, Lam Chung-Ling, Yan Wing-Wa, Lai King-Yiu
CONTEXT: Regional citrate anticoagulation for continuous renal replacement therapy is associated with a longer filter-life, less bleeding events and improved mortality. Problems associated with using Prismocitrate 10/2 solution in continuous renal replacement therapy, include hypomagnesemia, hypophosphatemia and the need for additional bicarbonate infusion. AIMS: This study uses the new Prismocitrate 18/0 solution for improved buffer balance and Phoxilium solution for a more favourable electrolyte profile...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28196107/fluid-overload-and-survival-in-critically-ill-patients-with-acute-kidney-injury-receiving-continuous-renal-replacement-therapy
#9
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Eun Young Seong, Ihm Soo Kwak, Sang Heon Song
BACKGROUND: Fluid overload is known to be associated with increased mortality in patients with acute kidney injury (AKI) who are critically ill. In this study, we intended to uncover whether the adverse effect of fluid overload on survival could be applied to all of the patients with AKI who received continuous renal replacement therapy (CRRT). METHODS: We analyzed 341 patients with AKI who received CRRT in our intensive care units. The presence of fluid overload was defined as a minimum 10% increase in body weight from the baseline...
2017: PloS One
https://www.readbyqxmd.com/read/28188168/metformin-associated-lactic-acidosis-treated-with-continuous-renal-replacement-therapy
#10
Akihide Nakamura, Kei Suzuki, Hiroshi Imai, Naoyuki Katayama
Metformin-associated lactic acidosis (MALA) is a rare but life-threatening complication. We report a case of MALA in a man aged 71 years who was treated with continuous renal replacement therapy (CRRT). The patient was brought to the hospital for prolonged and gradual worsening gastrointestinal symptoms. Although he received intravenous treatment, he developed catecholamine-resistant shock, and blood gas analysis revealed lactic acidosis. Bicarbonate and antibiotics for possible sepsis were initiated, but with no clear benefit...
February 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28184340/biomarkers-predicting-survival-of-sepsis-patients-treated-with-continuous-renal-replacement-therapy
#11
Jeong Ho Lee, Ha Yeon Kim, Eun Hui Bae, Soo Wan Kim, Seong Kwon Ma
The present study investigated the prognostic factors predicting survival of patients with sepsis and acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT). This retrospective observational study included 165 sepsis patients treated with CRRT. The patients were divided into two groups; the survivor group (n=73, 44.2%) vs. the nonsurvivor group (n=92, 55.8%). AKI was defined by the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines. We analyzed medical histories, clinical characteristics and laboratory findings of the enrolled patients when they started CRRT...
January 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/28173756/a-clinical-score-to-predict-mortality-in-septic-acute-kidney-injury-patients-requiring-continuous-renal-replacement-therapy-the-helenicc-score
#12
Rogério da Hora Passos, João Gabriel Rosa Ramos, Evandro Jose Bulhoes Mendonça, Eva Alves Miranda, Fábio Ricardo Dantas Dutra, Maria Fernanda R Coelho, Andrea C Pedroza, Luis Claudio L Correia, Paulo Benigno Pena Batista, Etienne Macedo, Margarida M D Dutra
BACKGROUND: This study aimed to identify predictors of early (7-day) mortality in patients with septic acute kidney injury (AKI) who required continuous renal replacement therapy (CRRT). METHODS: Prospective cohort of 186 septic AKI patients undergoing CRRT at a tertiary hospital, from October 2005 to November 2010. RESULTS: After multivariate adjustment, five variables were associated to early mortality: norepinephrine utilization, liver failure, medical condition, lactate level, and pre-dialysis creatinine level...
February 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28164512/critical-deviations-of-ionized-calcium-measurements-when-using-blood-gas-analyzers-to-monitor-citrate-dialysis
#13
Thorsten Feldkamp, Norbert Weiler, Michael Marx, Peter B Luppa, Ralf Junker
BACKGROUND: During the course of acute kidney injury (AKI) patients may require renal replacement therapy (RRT). The preferred therapeutic measure for such patients is continuous RRT (CRRT). Anticoagulation is required to prevent clotting of the extracorporeal circuit. The actual KDIGO guidelines recommend citrate as the first line anticoagulant. METHODS: Citrate dose infused into the extracorporeal circuit should achieve an extracorporeal calcium concentration of 0...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28158991/peritonitis-outcomes-in-patients-with-hiv-and-end-stage-renal-failure-on-peritoneal-dialysis-a-prospective-cohort-study
#14
Kwazi C Z Ndlovu, Wilbert Sibanda, Alain Assounga
BACKGROUND: Few studies have investigated the management of human immunodeficiency virus (HIV)-associated end-stage renal failure particularly in low-resource settings with limited access to renal replacement therapy. We aimed to evaluate the effects of HIV infection on continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis outcomes and technique failure in highly active antiretroviral therapy (HAART)-treated HIV-positive CAPD populations. METHODS: We conducted a single-center prospective cohort study of consecutive incident CAPD patients recruited from two hospitals in Durban, South Africa from September 2012-February 2015...
February 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28157807/factors-associated-with-mortality-in-continuous-renal-replacement-therapy-for-pediatric-patients-with-acute-kidney-injury
#15
Seung Jun Choi, Eun-Ju Ha, Won Kyoung Jhang, Seong Jong Park
OBJECTIVES: To analyze the epidemiology of pediatric acute kidney injury requiring continuous renal replacement therapy and identify prognostic factors affecting mortality rates. DESIGN: Retrospective analysis. SETTING: PICU of a tertiary medical center. PATIENTS: One hundred-twenty three children diagnosed with acute kidney injury requiring continuous renal replacement therapy. INTERVENTIONS: None...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28157799/factors-associated-with-mortality-in-pediatric-acute-kidney-injury-treated-with-continuous-renal-replacement-therapy-more-questions-than-answers
#16
Priya Prabhakaran, Robert P Richter, Nancy M Tofil
No abstract text is available yet for this article.
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28149027/sustained-low-efficiency-dialysis-in-septic-shock-hemodynamic-tolerability-and-efficacy
#17
Shakti Bedanta Mishra, Ratender Kumar Singh, Arvind Kumar Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
AIM OF THE STUDY: Acute kidney injury (AKI) in septic shock has poor outcomes. Sustained low-efficiency dialysis (SLED) is increasingly replacing continuous renal replacement therapy as the preferred modality in Intensive Care Units (ICUs). However, the essential aspects of hemodynamic tolerability and efficacy of SLED in septic shock AKI has been minimally studied. PATIENTS AND METHODS: We describe hemodynamic tolerability using modified vasopressor index (VI) and vasopressor dependency (VD) and efficacy using a combination of Kt/v, correction of acidosis, electrolyte, and fluid overload...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#18
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28134404/-takotsubo-cardiomyopathy-recurrence-in-patient-with-chronic-kidney-disease-case-report-and-literature-review
#19
Francesco Caccetta, Maurizio Caroppo, Fernando Musio, Anna Mudoni, Antonella Accogli, Maria Dolores Zacheo, Domenica Burzo, Rolando Mangia, Michele Accogli, Vitale Nuzzo
Takotsubo cardiomyopathy (CT) is a syndrome characterized by an acute and transient left ventricular dysfunction, electrocardiographic abnormalities suggestive of acute coronary syndrome, chest pain and/or dyspnea, left ventricular mid-apical segments akinesia and normal coronary angiography. It is mainly observed in postmenopausal women after an intense physical or mental stress. The course is usually favourable but sometimes severe complications occur. The recurrence rate is 2-10%. We present the case of a recurrence of CT in a female, 79 years old, with hypertension, diabetes, chronic kidney disease (CKD) stage 3 who was admitted to the emergency room for dyspnea and vomiting...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28128881/the-effect-of-sustained-low-efficient-dialysis-versus-continuous-renal-replacement-therapy-on-renal-recovery-after-acute-kidney-injury-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#20
REVIEW
Bernadett Kovacs, Katrina J Sullivan, Swapnil Hiremath, Rakesh V Patel
Acute kidney injury (AKI) is a significant contributing factor to the morbidity and mortality of critically ill adults, yet there remains controversy on the optimal renal replacement therapy mode for these patients. The aim of our systematic review was to determine the effect of sustained low-efficiency dialysis or continuous renal replacement therapy on patient outcomes in critically ill patients with AKI. A systematic search of Medline, Embase, CINAHL, and the Cochrane Library was conducted in February 2015...
January 27, 2017: Nephrology
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