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AKI, Crrt, sled

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
Abhijat Kitchlu, Neill Adhikari, Karen E A Burns, Jan O Friedrich, Amit X Garg, David Klein, Robert M Richardson, Ron Wald
BACKGROUND: Sustained low efficiency dialysis (SLED) is increasingly used as a renal replacement modality in critically ill patients with acute kidney injury (AKI) and hemodynamic instability. SLED may reduce the hemodynamic perturbations of intermittent hemodialysis, while obviating the resource demands of CRRT. Although SLED is being increasingly used, few studies have evaluated its impact on clinical outcomes. METHODS: We conducted a cohort study comparing SLED (target 8 h/session, blood flow 200 mL/min, predominantly without anticoagulation) to CRRT in four ICUs at an academic medical centre...
August 4, 2015: BMC Nephrology
Heather E Fieghen, Jan O Friedrich, Karen E Burns, Rosane Nisenbaum, Neill K Adhikari, Michelle A Hladunewich, Stephen E Lapinsky, Robert M Richardson, Ron Wald
BACKGROUND: Minimization of hemodynamic instability during renal replacement therapy (RRT) in patients with acute kidney injury (AKI) is often challenging. We examined the relative hemodynamic tolerability of sustained low efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT) in critically ill patients with AKI. We also compared the feasibility of SLED administration with that of CRRT and intermittent hemodialysis (IHD). METHODS: This cohort study encompassed four critical care units within a single university-affiliated medical centre...
November 25, 2010: BMC Nephrology
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
S Morabito, V Pistolesi, L Cibelli, A Pierucci
In the last 10-15 years, user-friendly continuous renal replacement therapy (CRRT) machines have played a major role in increasing the popularity of these techniques in intensive care settings. At present it is not clear which modality of renal replacement therapy (RRT) is optimal for critically ill patients with acute kidney injury (AKI). The choice between different modalities should therefore not be based on unproven ''outcome'' advantages but on evaluation of the clinical picture and logistical circumstances...
January 2009: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Z Huang, J J Letteri, W R Clark, C Ronco, D Gao
Renal replacement therapy (RRT) is required in a significant percentage of patients developing acute kidney injury (AKI) in an intensive care unit (ICU) setting. One of the foremost objectives of continuous renal replacement therapy (CRRT) is the removal of excess fluid and blood solutes that are retained as a consequence of decreased or absent glomerular filtration. Because prescription of CRRT requires goals to be set with regard to the rate and extent of both solute and fluid removal, a thorough understanding of the mechanisms by which solute and fluid removal occurs during CRRT is necessary...
June 2008: International Journal of Artificial Organs
C Ronco
Selection of a dialysis modality for critically ill patients with acute kidney injury (AKI) continues to be a controversial topic. Available studies can be divided into: 1) randomized controlled trials assessing the effect of treatment dose on patient outcome; 2) randomized controlled outcome comparisons of CRRT and IRRT; and 3) observational outcome comparisons of CRRT and IRRT. Clinical outcome comparisons of CRRT and HD continue to be very problematic. With the availability of the recent CRRT dose/outcome data, the interpretation of CRRT vs HD trial data now becomes nearly impossible because of the low-dose "handicap" that has existed in all of the comparative trials in the CRRT arms...
February 2007: International Journal of Artificial Organs
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