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Claudio Ronco

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https://www.readbyqxmd.com/read/27867598/timing-of-rrt-initiation-in-critically-ill-patients-time-for-precision-medicine
#1
EDITORIAL
Eric Kipnis, Francesco Garzotto, Claudio Ronco
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27863290/cardiorenal-acute-kidney-injury-epidemiology-presentation-causes-pathophysiology-and-treatment
#2
REVIEW
Luca Di Lullo, Antonio Bellasi, Domenico Russo, Mario Cozzolino, Claudio Ronco
Cardiovascular disease and major cardiovascular events represent main cause of death in both acute and chronic kidney disease patients. Kidney and heart failure are common and frequently co-exist; this organ - organ interaction, also called organ cross-talk led to well-known definition of cardiorenal syndrome (CRS). Here we'll describe cardiovascular involvement in patients with acute kidney injury (AKI). Also known as type-3 CRS or acute reno-cardiac CRS, it occurs when AKI contributes and/or precipitates development of acute cardiac injury...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27846630/a-first-evaluation-of-omni%C3%A2-a-new-device-for-continuous-renal-replacement-therapy
#3
Pierre Schläpfer, Jean-Daniel Durovray, Valery Plouhinec, Cristiano Chiappa, Rinaldo Bellomo, Antoine Schneider
BACKGROUND: Omni® (B. Braun, Germany) is a new-generation, continuous renal replacement therapy (CRRT) machine designed to improve user interface, minimize downtime and optimize renal dose delivery. It was never tested in humans. METHODS: We used Omni® to provide CRRT in 10 critically ill patients. We collected therapy data, metabolic parameters and evaluated user's satisfaction with a survey. RESULTS: CRRT was delivered using Omni® in CVVH-heparin (6 patients) and CVVHD-citrate (4 patients) modes for a total duration of 617...
November 16, 2016: Blood Purification
https://www.readbyqxmd.com/read/27748946/data-analytics-for-continuous-renal-replacement-therapy-historical-limitations-and-recent-technology-advances
#4
William R Clark, Francesco Garzotto, Mauro Neri, Anna Lorenzin, Marta Zaccaria, Claudio Ronco
PURPOSE: Dialysis is a highly quantitative therapy involving large volumes of both clinical and technical data. While automated data collection has been implemented for chronic dialysis, this has not been done for acute kidney injury patients treated with continuous renal replacement therapy (CRRT). METHODS: After a brief review of the fundamental aspects of electronic medical records (EMRs), a new tool designed to provide clinicians with individualized CRRT treatment data is analyzed, with emphasis on its quality assurance capabilities...
October 10, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27736815/acute-kidney-injury-electronic-alert-for-nephrologist-reactive-versus-proactive
#5
Kianoush Kashani, Claudio Ronco
Acute kidney injury (AKI) is a common complication of acute illnesses with significant impact on the mortality and morbidity. Early recognition of AKI allows clinicians to provide prophylactic interventions and to improve the outcomes of this deadly syndrome. Growing utilization and capabilities of electronic health records allow AKI risk stratification and early recognition with a potential effect on the processes of care and outcomes. We evaluate the current level of evidence on the impact of the AKI e-alert on the processes of care and outcomes...
October 14, 2016: Blood Purification
https://www.readbyqxmd.com/read/27719682/nomenclature-for-renal-replacement-therapy-in-acute-kidney-injury-basic-principles
#6
Mauro Neri, Gianluca Villa, Francesco Garzotto, Sean Bagshaw, Rinaldo Bellomo, Jorge Cerda, Fiorenza Ferrari, Silvia Guggia, Michael Joannidis, John Kellum, Jeong Chul Kim, Ravindra L Mehta, Zaccaria Ricci, Alberto Trevisani, Silvio Marafon, William R Clark, Jean-Louis Vincent, Claudio Ronco
This article reports the conclusions of a consensus expert conference on the basic principles and nomenclature of renal replacement therapy (RRT) currently utilized to manage acute kidney injury (AKI). This multidisciplinary consensus conference discusses common definitions, components, techniques, and operations of the machines and platforms used to deliver extracorporeal therapies, utilizing a "machine-centric" rather than a "patient-centric" approach. We provide a detailed description of the performance characteristics of membranes, filters, transmembrane transport of solutes and fluid, flows, and methods of measurement of delivered treatment, focusing on continuous renal replacement therapies (CRRT) which are utilized in the management of critically ill patients with AKI...
October 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27719676/nomenclature-for-renal-replacement-therapy-and-blood-purification-techniques-in-critically-ill-patients-practical-applications
#7
Gianluca Villa, Mauro Neri, Rinaldo Bellomo, Jorge Cerda, A Raffaele De Gaudio, Silvia De Rosa, Francesco Garzotto, Patrick M Honore, John Kellum, Anna Lorenzin, Didier Payen, Zaccaria Ricci, Sara Samoni, Jean-Louis Vincent, Julia Wendon, Marta Zaccaria, Claudio Ronco
This article reports the conclusions of the second part of a consensus expert conference on the nomenclature of renal replacement therapy (RRT) techniques currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients. A multidisciplinary approach was taken to achieve harmonization of definitions, components, techniques, and operations of the extracorporeal therapies. The article describes the RRT techniques in detail with the relevant technology, procedures, and phases of treatment and key aspects of volume management/fluid balance in critically ill patients...
October 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27703388/cost-effectiveness-analysis-of-online-hemodiafiltration-versus-high-flux-hemodialysis
#8
Francesco Ramponi, Claudio Ronco, Giacomo Mason, Enrico Rettore, Daniele Marcelli, Francesca Martino, Mauro Neri, Alejandro Martin-Malo, Bernard Canaud, Francesco Locatelli
BACKGROUND: Clinical studies suggest that hemodiafiltration (HDF) may lead to better clinical outcomes than high-flux hemodialysis (HF-HD), but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD. METHODS: The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1) estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2) simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3) application of state-specific health-related quality of life coefficients and differential costs derived from the literature...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27701376/predictors-of-rapid-disease-progression-in-autosomal-dominant-polycystic-kidney-disease
#9
Valentina Corradi, Fiorella Gastaldon, Carlotta Caprara, Anna Giuliani, Francesca Martino, Fiorenza Ferrari, Claudio Ronco
INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic diseases with a reported prevalence of 1:400 to 1:1000. Since the intact kidneys can compensate for the loss of glomerular filtration in ADPKD patients, renal insufficiency usually remains undetected until almost the fourth decade of life. Hereafter, reliable diagnostic and prognostic biomarkers to identify ADPKD progression are urgently needed. Several studies and systematic reviews tried to identify markers or predictors of rapid disease progression of ADPKD...
October 4, 2016: Minerva Medica
https://www.readbyqxmd.com/read/27694753/the-influence-of-hemodialysis-on-t-regulatory-cells-a-meta-analysis-and-systematic-review
#10
Carlotta Caprara, Gilbert R Kinsey, Valentina Corradi, Wenjun Xin, Jennie Z Ma, Elisa Scalzotto, Francesca K Martino, Mark D Okusa, Federico Nalesso, Fiorenza Ferrari, Mitchell Rosner, Claudio Ronco
AIMS: The study aimed to determine whether the available literature supports a positive or negative influence of dialysis on regulatory T-cells (Tregs). METHODS: We performed a systematic search and a meta-analysis. Mean differences in Tregs number of chronic kidney disease stages G5 on dialysis patients (CKD G5D) and healthy controls (HCs) were compared. Random effects model was applied. The software used was general package for meta-analysis (version 4.3-0, depends R (≥2...
October 1, 2016: Blood Purification
https://www.readbyqxmd.com/read/27663297/precision-and-improving-outcomes-in-acute-kidney-injury-personalizing-the-approach
#11
Lui G Forni, Lakhmir Chawla, Claudio Ronco
It is now well over a decade since attempts at harmonization of acute renal failure into a definable entity termed acute kidney injury. This has led to several landmark studies outlining the epidemiology of acute kidney injury, particularly in the critically ill, as well as providing insights into the long-term effects of the syndrome. Despite the introduction of consensus definitions and improvement in recognition, this has not been translated into outcome benefits as yet. The introduction of novel biomarkers associated with renal damage was primarily aimed at aiding early recognition of acute kidney injury...
September 13, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27577054/glomerular-and-tubular-kidney-stress-test-new-tools-for-a-deeper-evaluation-of-kidney-function
#12
Claudio Ronco, Lakhmir S Chawla
Kidney function has been traditionally identified with glomerular filtration rate (GFR). However, the kidney has multiple functions beyond filtration and a careful evaluation of its whole spectrum of activities should be carried out. Furthermore, the kidney presents a functional reserve capacity both at glomerular and tubular level. In presence of appropriate stimuli, patients with intact nephron mass can increase their GFR and tubular secretion. The difference between maximal capacity and baseline function represents the renal functional reserve (RFR)...
August 30, 2016: Nephron
https://www.readbyqxmd.com/read/27562336/precision-fluid-management-in-continuous-renal-replacement-therapy
#13
Raghavan Murugan, Eric Hoste, Ravindra L Mehta, Sara Samoni, Xiaoqiang Ding, Mitchell H Rosner, John A Kellum, Claudio Ronco
Fluid management during continuous renal replacement therapy (CRRT) in critically ill patients is a dynamic process that encompasses 3 inter-related goals: maintenance of the patency of the CRRT circuit, maintenance of plasma electrolyte and acid-base homeostasis and regulation of patient fluid balance. In this article, we report the consensus recommendations of the 2016 Acute Disease Quality Initiative XVII conference on 'Precision Fluid Management in CRRT'. We discuss the principles of fluid management, describe various prescription methods to achieve circuit integrity and introduce the concept of integrated fluid balance for tailoring fluid balance to the needs of the individual patient...
2016: Blood Purification
https://www.readbyqxmd.com/read/27562206/role-of-technology-for-the-management-of-aki-in-critically-ill-patients-from-adoptive-technology-to-precision-continuous-renal-replacement-therapy
#14
J Cerdá, I Baldwin, P M Honore, G Villa, John A Kellum, Claudio Ronco
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research...
2016: Blood Purification
https://www.readbyqxmd.com/read/27562079/precision-continuous-renal-replacement-therapy-and-solute-control
#15
Sean M Bagshaw, Madarasu Rajasekara Chakravarthi, Zaccaria Ricci, Ashita Tolwani, M Neri, S De Rosa, John A Kellum, Claudio Ronco
Continuous renal replacement therapy (CRRT) remains the dominant form of renal support among critically ill patients worldwide. Current clinical practice on CRRT prescription mostly relies on high quality studies suggesting no impact of CRRT dose on critically ill patients' outcomes. Recent clinical practice guidelines have been developed based on these studies recommending a static prescribed CRRT dose of 20-25 ml/kg/h. There is a rationale for renewed attention to CRRT prescription/practice based on the concept of dynamic solute control adapted to the changing clinical needs of critically ill patients...
2016: Blood Purification
https://www.readbyqxmd.com/read/27561956/patient-selection-and-timing-of-continuous-renal-replacement-therapy
#16
Marlies Ostermann, Michael Joannidis, Antonello Pani, Matteo Floris, Silvia De Rosa, John A Kellum, Claudio Ronco
When and in whom to initiate continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) remains a highly controversial topic with large practice variation around the world. Even within countries, practice variation exists and recommendations for clinical practice are not specific. In this article, we report the consensus recommendations for timing and patient selection for CRRT - the results of the 2016 Acute Disease Quality Initiative XVII conference on 'precision CRRT'. We suggest that these recommendations could serve to develop the best clinical practice and standards of care for use of CRRT in patients with AKI...
2016: Blood Purification
https://www.readbyqxmd.com/read/27561818/the-17th-acute-disease-quality-initiative-international-consensus-conference-introducing-precision-renal-replacement-therapy
#17
John A Kellum, Claudio Ronco
No abstract text is available yet for this article.
2016: Blood Purification
https://www.readbyqxmd.com/read/27522219/a-protective-kidney-lung-approach-to-improve-outcomes-in-mechanically-ventilated-patients
#18
Faeq Husain-Syed, Horst-Walter Birk, Werner Seeger, Claudio Ronco
There is increasing evidence that deleterious interactions between the lung and the kidney may be partly responsible for the multiorgan failure and high mortality seen in patients with acute respiratory distress syndrome. Lung protective strategies can reduce many of the adverse mechanistic and biological effects of mechanical ventilation. However, the key modifiable mediators are yet to be defined for the titration of balance between protective ventilation settings and distant organ function. Disparate but complementary mechanisms that may be involved in acute lung-kidney interactions will be discussed...
2016: Blood Purification
https://www.readbyqxmd.com/read/27502196/polymyxin-b-hemoperfusion-in-septic-patients-analysis-of-a-multicenter-registry
#19
Salvatore Lucio Cutuli, Antonio Artigas, Roberto Fumagalli, Gianpaola Monti, Vito Marco Ranieri, Claudio Ronco, Massimo Antonelli
BACKGROUND: In 2010, the EUPHAS 2 collaborative group created a registry with the purpose of recording data from critically ill patients suffering from severe sepsis and septic shock treated with polymyxin-B hemoperfusion (PMX-HP) for endotoxin removal. The aim of the registry was to verify the application of PMX-HP in the daily clinical practice. METHODS: The EUPHAS 2 registry involved 57 centers between January 2010 and December 2014, collecting retrospective data of 357 patients (297 in Europe and 60 in Asia) suffering from severe sepsis and septic shock caused by proved or suspected infection related to Gram negative bacteria...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27487355/copeptin-levels-and-kidney-function-in-adpkd-case-control-study
#20
Valentina Corradi, Francesca Martino, Fiorella Gastaldon, Elisa Scalzotto, Carlotta Caprara, Antonio Fortunato, Giulia Pinaffo, Cristina Marchetti, Francesca Fabbi, Davide Giavarina, Fiorenza Ferrari, Mitchell H Rosner, Claudio Ronco
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Studies have suggested a possible prognostic role of copeptin in determining the rate of progressive kidney function decline in ADPKD patients. However, it remains unresolved whether the changes in copeptin levels are specific for ADPKD or merely reflect a decline in glomerular filtration rate (GFR) regardless of the etiology of chronic kidney disease (CKD). METHODS: We performed a case-control study in ADPKD and non-ADPKD (control) patients...
September 2016: Clinical Nephrology
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