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Continuous renal replacement

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https://www.readbyqxmd.com/read/28326146/effects-of-continuous-and-intermittent-renal-replacement-therapies-among-adult-patients-with-acute-kidney-injury
#1
Tonio Schoenfelder, Xiaoyu Chen, Hans-Holger Bleß
Background: Dialysis-dependent acute kidney injury (AKI) can be treated using continuous (CRRT) or intermittent renal replacement therapies (IRRT). Although some studies suggest that CRRT may have advantages over IRRT, study findings are inconsistent. This study assessed differences between CRRT and IRRT regarding important clinical outcomes (such as mortality and renal recovery) and cost-effectiveness. Additionally, ethical aspects that are linked to renal replacement therapies in the intensive care setting are considered...
2017: GMS Health Technology Assessment
https://www.readbyqxmd.com/read/28320333/delta-neutrophil-index-is-an-independent-predictor-of-mortality-in-septic-acute-kidney-injury-patients-treated-with-continuous-renal-replacement-therapy
#2
In Mi Han, Chang-Yun Yoon, Dong Ho Shin, Youn Kyung Kee, Seung Gyu Han, Young Eun Kwon, Kyoung Sook Park, Mi Jung Lee, Hyung Jung Oh, Jung Tak Park, Seung Hyeok Han, Shin-Wook Kang, Tae-Hyun Yoo
BACKGROUND: Delta neutrophil index (DNI), representing an elevated fraction of circulating immature granulocytes in acute infection, has been reported as a useful marker for predicting mortality in patients with sepsis. The aim of this study was to evaluate the prognostic value of DNI in predicting mortality in septic acute kidney injury (S-AKI) patients treated with continuous renal replacement therapy (CRRT). METHOD: This is a retrospective analysis of consecutively CRRT treated patients...
March 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28315623/a-case-report-of-cholinergic-crisis-evolved-from-myasthenia-gravis-due-to-the-tumor-in-trigone-of-bladder
#3
(no author information available yet)
Cholinergic crisis has rarely been reported as a complication of myasthenia gravis, wherein it mainly occurs as a result of the improper accumulation of anticholinesterase agents. In this report, we present one such case. The nature of the patient's clinical manifestations suggested that the main reason for the cholinergic crisis was the abnormal accumulation of pyridostigmine bromide due to renal failure, which was secondary to a tumor in trigeon of bladder. To the best of our knowledge, this is the first report of myasthenia gravis leading to cholinergic crisis caused by acute postrenal renal failure arising from the bladder neoplasm...
November 19, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28298669/veno-venous-extracorporeal-membrane-oxygenation-for-continuous-renal-replacement-in-a-neonate-with-propionic-acidemia
#4
Jeffrey W Gander, Erika T Rhone, William G Wilson, John P Barcia, Melissa J Sacco
The usual indications for extra corporeal membrane oxygenation (ECMO) are for respiratory or cardiac failure. Although continuous renal replacement therapy (CRRT) is frequently used when patients are on ECMO, the need for CRRT as the primary indication for ECMO is rare. A case of a neonate placed onto veno-venous ECMO for the use of CRRT to treat hyperammonemia from propionic acidemia is presented.
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28295984/safety-of-arteriovenous-fistulae-and-grafts-for-continuous-renal-replacement-therapy-the-michigan-experience
#5
Anas Al Rifai, Nidhi Sukul, Robert Wonnacott, Michael Heung
INTRODUCTION: Arteriovenous fistula or graft (AVF/AVG) use is widely considered contraindicated for continuous renal replacement therapy (CRRT), yet insertion of hemodialysis (HD) catheters can carry high complication risk in critically ill end-stage renal disease (ESRD) patients. METHODS: Single-center analysis of 48 consecutive hospitalized ESRD patients on maintenance HD who underwent CRRT using AVF/AVG from 2012 to 2013. Primary outcome was access-related complications...
March 13, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28295601/idiopathic-hyperammonemia-after-solid-organ-transplantation-primarily-a-lung-problem-a-single-center-experience-and-systematic-review
#6
Dustin Krutsinger, Alejandro Pezzulo, Amy E Blevins, Robert M Reed, Michael Voigt, Michael Eberlein
BACKGROUND: Idiopathic hyperammonemia syndrome (IHS) is an uncommon, often deadly complication of solid organ transplantation. IHS cases in solid organ transplantation seem to occur predominantly in lung transplant (LTx) recipients. However to the best of our knowledge the occurrence of IHS has not been systematically evaluated. We set out to identify all reported cases of IHS following non-liver solid organ transplantations. METHODS: Retrospective review of our institutional experience and systematic review of the literature...
March 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28293378/hepatorenal-syndrome-update-on-diagnosis-and-therapy
#7
EDITORIAL
Juan G Acevedo, Matthew E Cramp
Hepatorenal syndrome (HRS) is a manifestation of extreme circulatory dysfunction and entails high morbidity and mortality. A new definition has been recently recommended by the International Club of Ascites, according to which HRS diagnosis relies in serum creatinine changes instead that on a fixed high value. Moreover, new data on urinary biomarkers has been recently published. In this sense, the use of urinary neutrophil gelatinase-associated lipocalin seems useful to identify patients with acute tubular necrosis and should be employed in the diagnostic algorithm...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28291652/cost-effectiveness-of-hospital-treatment-and-outcomes-of-acute-methanol-poisoning-during-the-czech-republic-mass-poisoning-outbreak
#8
Jan Rulisek, Martin Balik, Ferdinand Polak, Petr Waldauf, Daniela Pelclova, Jan Belohlavek, Sergey Zakharov
PURPOSE: During an outbreak of mass methanol poisoning in the Czech Republic in 2012-2014, we compared the total hospital costs and one-year medical costs in the patients treated with different antidotes (fomepizole versus ethanol) and modalities of hemodialysis (intermittent hemodialysis, IHD, versus continuous renal replacement therapy, CRRT). METHODS: Cross-sectional study in 106 patients with confirmed diagnosis treated in 30 ICU settings. For each patient, the following data were analyzed: admission laboratory data, GCS, PSS, ICU length of stay, organ failures, treatment, outcome, and total hospital costs...
March 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28289816/current-state-of-the-art-for-renal-replacement-therapy-in-critically-ill-patients-with-acute-kidney-injury
#9
REVIEW
Sean M Bagshaw, Michael Darmon, Marlies Ostermann, Fredric O Finkelstein, Ron Wald, Ashita J Tolwani, Stuart L Goldstein, David J Gattas, Shigehiko Uchino, Eric A Hoste, Stephane Gaudry
Acute kidney injury (AKI) is associated with incremental risk for death and chronic kidney disease and represents a mounting clinical challenge for healthcare professionals. Renal replacement therapy (RRT) use in ICU settings is rising, likely in response to similar trends in AKI, taken together with an ageing population burdened by high prevalence of multi-morbidity and high illness acuity. Numerous features of RRT prescription and delivery are not standardized, nor are they supported from high-quality evidence derived from randomized trials...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28286115/association-between-augmented-renal-clearance-and-clinical-outcomes-in-patients-receiving-%C3%AE-lactam-antibiotic-therapy-by-continuous-or-intermittent-infusion-a-nested-cohort-study-of-the-bling-ii-randomised-placebo-controlled-clinical-trial
#10
Andrew A Udy, Joel M Dulhunty, Jason A Roberts, Joshua S Davis, Steven A R Webb, Rinaldo Bellomo, Charles Gomersall, Charudatt Shirwadkar, Glenn M Eastwood, John Myburgh, David L Paterson, Therese Starr, Sanjoy K Paul, Jeffrey Lipman
Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded...
March 9, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28284300/renal-replacement-therapy-in-acute-kidney-injury-controversies-and-consensus
#11
REVIEW
Michael Heung, Lenar Yessayan
Acute kidney injury (AKI) is a common complication among critically ill patents, and 5% of intensive care unit (ICU) patients require initiation of renal replacement therapy (RRT). In recent years, clinical trials have provided evidence-based guidance for some important aspects of RRT management in patients with AKI, such as dialysis dosing and approaches to anticoagulation in patients undergoing continuous RRT. However, there remain many areas of uncertainty, and delivery of RRT in the ICU requires clinical judgment, flexibility, and an understanding of dialysis principles...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28280397/pharmacokinetics-and-outcome-of-tazobactam-piperacillin-in-japanese-patients-undergoing-low-flow-continuous-renal-replacement-therapy-dosage-considerations
#12
Hanako Kohama, Takeshi Ide, Kazuro Ikawa, Norifumi Morikawa, Shinichi Nishi
BACKGROUND: Tazobactam/piperacillin (TAZ/PIPC), which is often combined with continuous renal replacement therapy (CRRT), induces renal excretion and is thought to have a high component removal rate for blood purification. CRRT procedures vary depending on the country, region, and institution. It is not clear whether the dose of TAZ/PIPC for use in Japan can be determined based on studies conducted in other countries. Therefore, in this study, we examined the suitability of recommended dose in Japan...
2017: Clinical Pharmacology: Advances and Applications
https://www.readbyqxmd.com/read/28255493/treatment-of-complete-anal-stricture-after-diverting-colostomy-for-fournier-s-gangrene
#13
Kenji Okumura, Tadao Kubota, Kazuhiro Nishida, Alan Kawarai Lefor, Ken Mizokami
Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier's gangrene and treated with debridement and diverting colostomy...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28254857/continuous-renal-replacement-therapy-case-vignettes
#14
Charlotte Garwood, Cass Piper Sandoval, Robert Wonnacott, Craig Sadler, Susan Dirkes
The most common indication for continuous renal replacement therapy (CRRT) in critically ill patients is acute kidney injury with hemodynamic instability. Typically, the patient has metabolic disturbances and potential or actual fluid overload that require intervention. Certain critical care diagnoses and/or conditions or therapies present unique CRRT management approaches. Case vignettes are used to present the unique management of CRRT in critically ill patients with rhabdomyolysis, heart failure, and respiratory failure requiring extracorporeal membrane oxygenation...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28254856/considerations-for-medication-management-and-anticoagulation-during-continuous-renal-replacement-therapy
#15
Ashley Thompson, Fanny Li, A Kendall Gross
Providing safe and high-quality care to critically ill patients receiving continuous renal replacement therapy (CRRT) includes adequate drug dosing and evaluation of patients' response to medications during therapy. Pharmacokinetic drug studies in acute kidney injury and CRRT are limited, considering the number of medications used in critical care. Therefore, it is important to understand the basic principles of drug clearance during CRRT by evaluating drug properties, CRRT modalities, and how they affect medication clearance...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28254855/training-and-maintaining-developing-a-successful-and-dynamic-continuous-renal-replacement-therapy-program
#16
Heather Przybyl, Jill Evans, Laurie Haley, Jodi Bisek, Emily Beck
Continuous renal replacement therapy (CRRT) is commonly used to support critically ill patients with acute kidney injury or chronic renal disease whose condition is too unstable for them to tolerate intermittent hemodialysis. Current publications related to CRRT programs in the United States and Canada note key themes related to the development and maintenance of CRRT training programs. A successful CRRT training program should consider and incorporate adult learning principles whenever possible. A variety of teaching methods to deliver information to nurses, including online learning modules, didactic lecture, return demonstration, and high-fidelity patient simulation are key to training programs for this high-risk complex therapy...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28254854/continuous-renal-replacement-therapy-update-an-emphasis-on-safe-and-high-quality-care
#17
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
https://www.readbyqxmd.com/read/28254853/continuous-renal-replacement-therapies-raising-the-bar-for-quality-care
#18
Hildy Schell-Chaple
No abstract text is available yet for this article.
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/28253564/incorporating-neutrophil-to-lymphocyte-ratio-and-platelet-to-lymphocyte-ratio-in-place-of-neutrophil-count-and-platelet-count-improves-prognostic-accuracy-of-the-international-metastatic-renal-cell-carcinoma-database-consortium-model
#19
Pawel Chrom, Rafal Stec, Lubomir Bodnar, Cezary Szczylik
Purpose: The study investigated whether a replacement of neutrophil count and platelet count by neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) within the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model would improve its prognostic accuracy. Materials and Methods: This retrospective analysis included consecutive patients with metastatic renal cell carcinoma treated with first-line tyrosine kinase inhibitors...
March 3, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28247082/membrane-pressures-predict-clotting-of-pediatric-continuous-renal-replacement-therapy-circuits
#20
Aadil Kakajiwala, Thomas Jemielita, John Z Hughes, Kimberly Windt, Michelle Denburg, Stuart L Goldstein, Benjamin Laskin
BACKGROUND: Clotting of continuous renal replacement therapy (CRRT) circuits leads to inadequate clearance, decreased ultrafiltration, and increased resource use. We identified factors associated with premature clotting of circuits during CRRT in children. METHODS: In a retrospective cohort of 26 children (median age 11.8 years) receiving 79 CRRT circuits (51 heparin, 22 citrate, 6 using no anticoagulation), we captured hourly pressure, flow, and fluid removal rates along with all activated clotting time (ACT) and circuit ionized calcium measurements...
March 1, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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