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Haemodiafiltration

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https://www.readbyqxmd.com/read/28689876/impact-of-renal-replacement-modalities-on-the-clearance-of-piperacillin-tazobactam-administered-via-continuous-infusion-in-critically-ill-patients
#1
Claire Roger, Menino O Cotta, Laurent Muller, Steven C Wallis, Jeffrey Lipman, Jean-Yves Lefrant, Jason A Roberts
This prospective pharmacokinetic study aimed to compare the clearance of piperacillin-tazobactam administered as a 24-h continuous infusion between continuous venovenous haemodiafiltration (CVVHDF) and continuous venovenous haemofiltration (CVVH) applied at equal dose in critically ill patients. A loading dose of 4.5 g of piperacillin-tazobactam followed by a continuous infusion (500 mg/h) was administered to patients randomized to receive CVVHDF or CVVH. Serial pre- and postfilter blood samples were drawn during an 8-h sampling interval...
July 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28666752/dosing-of-caspofungin-based-on-a-pharmacokinetic-pharmacodynamic-index-for-the-treatment-of-invasive-fungal-infections-in-critically-ill-patients-on-continuous-venovenous-haemodiafiltration
#2
Alejandro Pérez-Pitarch, Rafael Ferriols-Lisart, Gerardo Aguilar, Carlos Ezquer-Garín, F Javier Belda, Beatriz Guglieri-López
INTRODUCTION: The objective of this study was to evaluate the efficacy of different dosages of caspofungin in the treatment of invasive candidiasis and aspergillosis, in relation to the probability of pharmacokinetic/pharmacodynamic target attainment, using modelling and Monte Carlo simulations in critically ill adult patients on continuous haemodiafltration. METHODS: Critically ill adult patients on continuous venovenous haemodiafiltration treated with caspofungin were analysed...
June 27, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28584142/micafungin-plasma-levels-are-not-affected-by-continuous-renal-replacement-therapy-experience-in-critically-ill-patients
#3
M G Vossen, D Knafl, M Haidinger, R Lemmerer, M Unger, S Pferschy, W Lamm, A Maier-Salamon, W Jäger, F Thalhammer
Critically ill patients often experience acute kidney injury and the need for renal replacement therapy in the course of their treatment in an intensive care unit (ICU). These patients are at an increased risk for candidiasis. Although there have been several reports of micafungin disposition during renal replacement therapy, to this date there are no data describing the elimination of micafungin during high-dose continuous venovenous hemodiafiltration with modified AN69 membranes. The aim of this prospective open-label pharmacokinetic study was to assess whether micafungin plasma levels are affected by continuous hemodiafiltration in critical ill patients using the commonly employed AN69 membrane...
August 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28446488/eculizumab-in-a-child-with-atypical-haemolytic-uraemic-syndrome-and-haemophagocytic-lymphohistiocytosis-triggered-by-cytomegalovirus-infection
#4
Gloria M Fraga-Rodriguez, Sonia Brió-Sanagustin, Eulalia Turón-Viñas, Bradley P Dixon, Eduardo Carreras-González
We present the case of a 21-month-old girl with two rare and life-threatening conditions, atypical haemolytic uraemic syndrome (aHUS) and haemophagocytic lymphohistiocytosis (HLH), triggered by a cytomegalovirus (CMV) infection. Soon after admission, the girl became anuric and required continuous venovenous haemodiafiltration.Initial treatments included methylprednisolone, fibrinogen and plasma infusion (for HLH), plasmapheresis (for thrombotic microangiopathy), immunoglobulins (for inflammation), ganciclovir (for CMV infection) and the antibiotic cefotaxime...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28401301/enhancing-dialyser-clearance-from-target-to-development
#5
Kamonwan Tangvoraphonkchai, Andrew Davenport
Products of metabolism accumulate in kidney failure and potentially have toxic effects. Traditionally these uraemic toxins are classified as small, middle-sized and protein-bound toxins, and clearance during dialysis is affected by diffusion, convection and adsorption. As current dialysis practice effectively clears small solutes, increasing evidence supports a toxic effect for middle-sized and protein-bound toxins. Therefore, newer approaches to standard dialysis practice are required to look beyond urea clearance...
April 12, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28396747/optimization-of-anti-infective-dosing-regimens-during-online-haemodiafiltration
#6
Nynke G L Jager, Anthe S Zandvliet, Daniel J Touw, Erik L Penne
Online haemodiafiltration (HDF) is increasingly used in clinical practice as a routine intermittent dialysis modality. It is well known that renal impairment and renal replacement therapy can substantially affect the pharmacokinetic behaviour of several drugs. However, surprisingly few data are available on the need for specific dose adjustments during HDF. Due to convection, drug clearance may be increased during HDF as compared with standard haemodialysis. This may be of particular interest in patients undergoing anti-infective therapy, since under-dosing may compromise patient outcomes and promote the emergence of bacterial resistance...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28394304/the-diet-and-haemodialysis-dyad-three-eras-four-open-questions-and-four-paradoxes-a-narrative-review-towards-a-personalized-patient-centered-approach
#7
REVIEW
Giorgina Barbara Piccoli, Maria Rita Moio, Antioco Fois, Andreea Sofronie, Lurlinys Gendrot, Gianfranca Cabiddu, Claudia D'Alessandro, Adamasco Cupisti
The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients' lives. In the early years of dialysis, potassium was identified as "the killer", and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the "third era" finds us combating protein-energy wasting...
April 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28334722/even-a-moderate-fluid-removal-rate-during-individualised-haemodialysis-session-times-is-associated-with-decreased-patient-survival
#8
Charles Chazot, Cyril Vo-Van, Christie Lorriaux, Patrik Deleaval, Brice Mayor, Jean-Marc Hurot, Guillaume Jean
BACKGROUND: Several studies report that fluid removal rate (FRR) above 10-13 mL/h/kg is associated with increased mortality in haemodialysis (HD) patients. AIM: The aims of this study are to assess the influence of moderate FRR on survival in a cohort of prevalent dialysis patients with various dialysis session times and to challenge the FRR thresholds associated with increased mortality risk reported previously. METHODS: Interdialytic weight gain (IDWG) and FRR (calculated from ultrafiltration [UF], target weight, and session time prescriptions) were studied in 190 prevalent dialysis patients (female: 42%, mean age: 69...
2017: Blood Purification
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
#9
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
#10
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...
2017: Blood Purification
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#11
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28035589/caspofungin-population-pharmacokinetics-in-critically-ill-patients-undergoing-continuous-veno-venous-haemofiltration-or-haemodiafiltration
#12
Claire Roger, Steven C Wallis, Laurent Muller, Gilbert Saissi, Jeffrey Lipman, Roger J Brüggemann, Jean-Yves Lefrant, Jason A Roberts
BACKGROUND AND OBJECTIVE: Sepsis and continuous renal replacement therapy (CRRT) can both significantly affect antifungal pharmacokinetics. This study aimed to describe the pharmacokinetics of caspofungin in critically ill patients during different CRRT modes. METHODS: Patients receiving caspofungin and undergoing continuous veno-venous haemofiltration (CVVH) or haemodiafiltration (CVVHDF) were eligible to take part in the study. Blood samples were collected at seven sampling times during a dosing interval...
December 29, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28025382/mortality-reduction-by-post-dilution-online-haemodiafiltration-a-cause-specific-analysis
#13
Menso J Nubé, Sanne A E Peters, Peter J Blankestijn, Bernard Canaud, Andrew Davenport, Muriel P C Grooteman, Gulay Asci, Francesco Locatelli, Francisco Maduell, Marion Morena, Ercan Ok, Ferran Torres, Michiel L Bots
Background: From an individual participant data (IPD) meta-analysis from four randomized controlled trials comparing haemodialysis (HD) with post-dilution online-haemodiafiltration (ol-HDF), previously it appeared that HDF decreases all-cause mortality by 14% (95% confidence interval 25; 1) and fatal cardiovascular disease (CVD) by 23% (39; 3). Significant differences were not found for fatal infections and sudden death. So far, it is unclear, however, whether the reduced mortality risk of HDF is only due to a decrease in CVD events and if so, which CVD in particular is prevented, if compared with HD...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27980383/using-the-cytokinesis-block-micronucleus-cytome-assay-to-evaluate-chromosomal-dna-damage-in-chronic-renal-patients-undergoing-bicarbonate-haemodialysis-and-haemodiafiltration
#14
REVIEW
M Guido, A Zizza, M R Tumolo, G Stefanelli, M D'Alba, A Idolo, F Bagordo, F Serio, T Grassi, A DE Donno
INTRODUCTION: Chronic Renal Failure (CRF) patients are considered to show genomic instability and are associated with a high risk of both cardiovascular diseases and cancer. We explored DNA damage due to two dialysis treatments in 20 patients undergoing bicarbonate haemodialysis (BD), 20 undergoing haemodiafiltration (HDF) and 40 healthy subjects. METHODS: The cytokinesis-block micronucleus (MN) assay was performed on peripheral blood lymphocytes to evaluate genetic damage...
September 2016: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/27951560/new-dialysis-technology-and-biocompatible-materials
#15
Andrew Davenport
Although haemodialysis is an established treatment for patients with end-stage kidney disease, sustaining life for more than 2 million patients world-wide, the mortality of dialysis patients remains high and is greater than that for some of the more common solid organ cancers. As such, the question arises as to whether more efficient clearance of the waste products of metabolism which accumulate would improve outcomes. Recent reports of an association between improved patient survivals with higher-volume on-line haemodiafiltration exchanges would support this hypothesis...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27951544/haemodiafiltration-at-higher-volumes-and-patient-survival
#16
Francesco Locatelli, Lucia Del Vecchio, Vincenzo La Milia
Patient morbidity and mortality rates are still very high in standard low-flux haemodialysis (lf-HD). On-line haemodiafiltration (OL-HDF) is considered the most efficient dialysis technique, as clearances of small solutes, like urea, may be even higher than in lf-HD and clearances of middle solutes, like β2-microglobulin, are much higher than in lf-HD. OL-HDF has been suggested to reduce mortality compared to HD, possibly due to more effective removal of larger uraemic retention solutes and/or better fluid removal...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27783636/online-haemodiafiltration-improves-inflammatory-state-in-dialysis-patients-a-longitudinal-study
#17
Ines Rama, Ines Llaudó, Pere Fontova, Gema Cerezo, Carlos Soto, Casimiro Javierre, Miguel Hueso, Nuria Montero, Alberto Martínez-Castelao, Juan Torras, Josep M Grinyó, Josep M Cruzado, Nuria Lloberas
BACKGROUND: Patients undergoing conventional hemodialysis (C-HD) present a greater immuno-inflammatory state probably related to uremia, sympathetic nervous system (SNS) activation and /or membrane bioincompatibility, which could improve with a technique-switching to online hemodiafiltration (OL-HD). The antigen-independent pathway activation of this modified immunologic state turns dendritic cells (DC) into an accurate cell model to study these patients. The aim of this study is to further evaluate the immune-inflammatory state of patients in C-HD assessed by DC maturation...
2016: PloS One
https://www.readbyqxmd.com/read/27737645/haemodiafiltration-elicits-less-platelet-activation-compared-to-haemodialysis
#18
Gergely Becs, Renáta Hudák, Zsolt Fejes, Ildikó Beke Debreceni, Harjit Pal Bhattoa, József Balla, János Kappelmayer
BACKGROUND: Mortality in patients with end-stage renal disorders is often a consequence of cardiovascular complications. Renal replacement therapies may contribute to this morbidity by promoting cellular activation. In renal failure patients peripheral blood samples were investigated for platelet and endothelial cell activation markers to compare the effects of haemodiafiltration (HDF) and haemodialysis (HD). METHODS: Overall 28 patients were included in the study...
October 13, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27628437/population-pharmacokinetics-of-daptomycin-in-adult-patients-undergoing-continuous-renal-replacement-therapy
#19
Xiaoying Xu, Dmytro Khadzhynov, Harm Peters, Ricardo L Chaves, Kamal Hamed, Micha Levi, Natascia Corti
AIM: The objective of this population pharmacokinetic (PK) analysis was to provide guidance for the dosing interval of daptomycin in patients undergoing continuous renal replacement therapy (CRRT). METHODS: A previously published population PK model for daptomycin was updated with data from patients undergoing continuous veno-venous haemodialysis (CVVHD; n = 9) and continuous veno-venous haemodiafiltration (CVVHDF; n = 8). Model-based simulations were performed to compare the 24 h AUC, Cmax and Cmin of daptomycin following various dosing regimens (4, 6, 8, 10, and 12 mg kg(-1) every [Q] 24 h and Q48 h), with the safety and efficacy exposure references for Staphylococcus aureus bacteraemia/right-sided infective endocarditis...
March 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27590718/protein-bound-toxins-added-value-in-their-removal-with-high-convective-volumes
#20
Soraya Abad, Almudena Vega, Borja Quiroga, David Arroyo, Nayara Panizo, Javier Eduardo Reque, Juan Manuel López-Gómez
Chronic kidney disease is associated with an increased risk of cardiovascular events. In recent years, protein-bound toxins have become more important due to their association with increased morbidity and mortality, characterised by inadequate clearance during dialysis. The purpose of this study is to assess the influence of high convective volumes on postdilution online haemodiafiltration (OL-HDF) on the removal of medium-sized molecules, small molecules and protein-bound molecules. MATERIAL AND METHODS: In forty postdilutional OL-HDF sessions, the reduction rates of toxins of different molecular weights were measured in 13 patients, including protein-bound molecules such as p-cresyl sulphate, indoxyl sulphate and homocysteine...
November 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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