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Sustained low-efficiency dialysis

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https://www.readbyqxmd.com/read/28700186/-the-treatment-of-aki-in-nephrology-hospitalization-the-sle-hdf-15-litres-in-10-hours
#1
REVIEW
Marcello Napoli, Maria Luisa Lefons, Giovanni Sandri, Efisio Sozzo, Carmela Ambrosino
The AKI in intensive care has been widely treated by international and national guidelines. The treatment of AKI in patients not requiring admission in Intensive Care Unit, but often hospitalized in Nephrology Unit, it is showed of less relevance. For over 5 years we have used for the treatment of AKI of patients admitted in Nephrology Unit an intermittent slow technique, implemented in approximately 600 patients with AKI for a total of about 3000 treatments. In this study we report the clinical results obtained in 100 consecutive patients referred to our Nephrology Unit from 1st January 2014...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#2
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28584428/a-pilot-randomized-controlled-trial-of-comparison-between-extended-daily-hemodialysis-and-continuous-veno-venous-hemodialysis-in-patients-of-acute-kidney-injury-with-septic-shock
#3
Shakti Bedanta Mishra, Afzal Azim, Narayan Prasad, Ratendra Kumar Singh, Banani Poddar, Mohan Gurjar, Arvind Kumar Baronia
AIM OF STUDY: Acute kidney injury (AKI) is common in patients of septic shock. There is sparse data comparing sustained low-efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT) in patients with septic shock. MATERIALS AND METHODS: This is a prospective randomized study in a 12-bedded medical intensive care unit. After clearance from institute's ethics committee and obtaining informed consent from the relatives, sixty adult patients with septic shock who were to undergo dialysis for AKI were included in the study...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28525779/systematic-review-and-meta-analysis-of-renal-replacement-therapy-modalities-for-acute-kidney-injury-in-the-intensive-care-unit
#4
Danielle M Nash, Sebastian Przech, Ron Wald, Daria O'Reilly
PURPOSE: To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). MATERIALS AND METHODS: We completed a systematic review and meta-analysis of studies published in 2015 or earlier using MEDLINE®, EMBASE®, Cochrane databases and grey literature. Eligible studies included randomized clinical trials (RCTs) or prospective cohort studies comparing outcomes of mortality, dialysis dependence or length of stay among critically ill adults receiving CRRT, IHD or SLED to treat AKI...
May 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28223003/treatment-of-metformin-intoxication-complicated-by-lactic-acidosis-and-acute-kidney-injury-the-role-of-prolonged-intermittent-hemodialysis
#5
Giuseppe Regolisti, Riccardo Antoniotti, Filippo Fani, Paolo Greco, Enrico Fiaccadori
Metformin intoxication with lactic acidosis, a potentially lethal condition, may develop in diabetic patients when the drug dose is inappropriate and/or its clearance is reduced. Diagnosis and therapy may be delayed due to nonspecific symptoms at presentation, with severe anion gap metabolic acidosis and elevated serum creatinine values being the most prominent laboratory findings. Confirmation requires measurement of serum metformin by high-performance liquid chromatography-tandem mass spectrometry, but this technique is available only at specialized institutions and cannot be relied on as a guide to immediate treatment...
February 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28175308/population-pharmacokinetics-and-dosing-simulations-of-ceftazidime-in-critically-ill-patients-receiving-sustained-low-efficiency-dialysis
#6
Christina König, Stephan Braune, Jason A Roberts, Axel Nierhaus, Oliver M Steinmetz, Michael Baehr, Otto R Frey, Claudia Langebrake, Stefan Kluge
Objectives: To describe the population PKs of ceftazidime in critically ill patients receiving sustained low-efficiency dialysis (SLED). Patients and methods: This study was performed in ICUs of a university hospital. We collected blood samples during three consecutive days of SLED sessions in patients receiving ceftazidime. Concentration versus time curves were analysed using a population PKs approach with Pmetrics ® . Monte Carlo simulation for the first 24 h including a 6 h SLED session was performed with the final model...
May 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28149027/sustained-low-efficiency-dialysis-in-septic-shock-hemodynamic-tolerability-and-efficacy
#7
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/28134407/-metformin-associated-lactic-acidosis-and-acute-kidney-injury
#8
Paolo Greco, Giuseppe Regolisti, Riccardo Antoniotti, Caterina Maccari, Elisabetta Parenti, Silvia Corrado, Enrico Fiaccadori
Metformin is recommended as the treatment of choice in patients with type 2 diabetes mellitus because of its efficacy, general tolerability and low cost. Recent guidelines have extended the use of metformin to patients with Chronic Kidney Disease (CKD) up to stage III. However, in the recent literature, cases of MALA (metformin-associated lactic acidosis) are increasingly reported. MALA is the most dangerous side effect of the drug, with an incidence rate of 2-9 cases per 100000 person-years of exposure. We report on two patients with accidental metformin overdose, severe lactic acidosis and acute kidney injury...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28128881/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
#9
REVIEW
Bernadett Kovacs, Katrina J Sullivan, Swapnil Hiremath, Rakesh V Patel
Critically ill adults with acute kidney injury (AKI) experience considerable morbidity and mortality. Controversy remains regarding the optimal renal replacement intervention for these patients. Our systematic review aimed to determine the effect(s) of sustained low-efficiency dialysis (SLED) compared with continuous renal replacement (CRRT) therapy on relevant patient outcomes. A systematic search of Medline, Embase, CINAHL and the Cochrane Library was conducted. Identified citations were screened independently in duplicate for relevance, and the methodological quality of included studies was evaluated...
May 2017: Nephrology
https://www.readbyqxmd.com/read/27683090/a-population-pharmacokinetic-model-to-predict-oxypurinol-exposure-in-patients-on-haemodialysis
#10
Daniel Fb Wright, Matthew P Doogue, Murray L Barclay, Peter T Chapman, Nicholas B Cross, John H Irvine, Lisa K Stamp
PURPOSE: The aims of this study were to characterise the population pharmacokinetics of oxypurinol in patients receiving haemodialysis and to compare oxypurinol exposure in dialysis and non-dialysis patients. METHODS: Oxypurinol plasma concentrations from 6 gout people receiving haemodialysis and 19 people with gout not receiving dialysis were used to develop a population pharmacokinetic model in NONMEM. Deterministic simulations were used to predict the steady-state area under the oxypurinol plasma concentration time curve over 1 week (AUC7days)...
January 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27487001/hemodiafiltration-decreases-serum-levels-of-inflammatory-mediators-in-severe-leptospirosis-a-prospective-study
#11
Sérgio Aparecido Cleto, Camila Eleutério Rodrigues, Ceila Maria Malaque, Jaques Sztajnbok, Antônio Carlos Seguro, Lúcia Andrade
BACKGROUND: Leptospirosis is a health problem worldwide. Its most severe form is a classic model of sepsis, provoking acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI), with associated mortality that remains unacceptably high. We previously demonstrated that early initiation of sustained low-efficiency dialysis (SLED) followed by daily SLED significantly decreases mortality. However, the mode of clearance can also affect dialysis patient outcomes. Therefore, the objective of this study was to compare the effects of SLED with traditional (diffusive) clearance, via hemodialysis, and SLED with convective clearance, via hemodiafiltration (SLEDf), in patients with severe leptospirosis...
2016: PloS One
https://www.readbyqxmd.com/read/27449661/comparison-of-urine-output-among-patients-treated-with-more-intensive-versus-less-intensive-rrt-results-from-the-acute-renal-failure-trial-network-study
#12
Finnian R Mc Causland, Josephine Asafu-Adjei, Rebecca A Betensky, Paul M Palevsky, Sushrut S Waikar
BACKGROUND AND OBJECTIVES: Intensive RRT may have adverse effects that account for the absence of benefit observed in randomized trials of more intensive versus less intensive RRT. We wished to determine the association of more intensive RRT with changes in urine output as a marker of worsening residual renal function in critically ill patients with severe AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Acute Renal Failure Trial Network Study (n=1124) was a multicenter trial that randomized critically ill patients requiring initiation of RRT to more intensive (hemodialysis or sustained low-efficiency dialysis six times per week or continuous venovenous hemodiafiltration at 35 ml/kg per hour) versus less intensive (hemodialysis or sustained low-efficiency dialysis three times per week or continuous venovenous hemodiafiltration at 20 ml/kg per hour) RRT...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27088612/transpulmonary-thermodilution-tptd-before-during-and-after-sustained-low-efficiency-dialysis-sled-a-prospective-study-on-feasibility-of-tptd-and-prediction-of-successful-fluid-removal
#13
Wolfgang Huber, Stephan Fuchs, Andreas Minning, Claudius Küchle, Marlena Braun, Analena Beitz, Caroline Schultheiss, Sebastian Mair, Veit Phillip, Sebastian Schmid, Roland M Schmid, Tobias Lahmer
BACKGROUND: Acute kidney injury (AKI) is common in critically ill patients. AKI requires renal replacement therapy (RRT) in up to 10% of patients. Particularly during connection and fluid removal, RRT frequently impairs haemodyamics which impedes recovery from AKI. Therefore, "acute" connection with prefilled tubing and prolonged periods of RRT including sustained low efficiency dialysis (SLED) has been suggested. Furthermore, advanced haemodynamic monitoring using trans-pulmonary thermodilution (TPTD) and pulse contour analysis (PCA) might help to define appropriate fluid removal goals...
2016: PloS One
https://www.readbyqxmd.com/read/27047998/continuous-renal-replacement-therapy-crrt-practices-in-canadian-hospitals-where-are-we-now
#14
Frances Fothergill Bourbonnais, Sharon Slivar, Sue Malone Tucker
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients. Renal replacement therapy is prescribed for as many as 70% of critically ill patients in AKI and may be provided in the form of intermittent or continuous dialysis including intermittent hemodialysis, sustained low-efficiency dialysis, and continuous renal replacement therapy (CR RT). CRRT is commonly used for unstable critically ill patients, as it involves a slow continuous process. The nursing work involved with CR RT is highly complex and the learning requirements are challenging; therefore, it is important to identify nursing practices...
2016: Canadian Journal of Critical Care Nursing
https://www.readbyqxmd.com/read/27041995/naringenin-loaded-solid-lipid-nanoparticles-preparation-controlled-delivery-cellular-uptake-and-pulmonary-pharmacokinetics
#15
Peng Ji, Tong Yu, Ying Liu, Jie Jiang, Jie Xu, Ying Zhao, Yanna Hao, Yang Qiu, Wenming Zhao, Chao Wu
Naringenin (NRG), a flavonoid compound, had been reported to exhibit extensive pharmacological effects, but its water solubility and oral bioavailability are only~46±6 µg/mL and 5.8%, respectively. The purpose of this study is to design and develop NRG-loaded solid lipid nanoparticles (NRG-SLNs) to provide prolonged and sustained drug release, with improved stability, involving nontoxic nanocarriers, and increase the bioavailability by means of pulmonary administration. Initially, a group contribution method was used to screen the best solid lipid matrix for the preparation of SLNs...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27018501/disulfide-linked-amphiphilic-polymer-docetaxel-conjugates-assembled-redox-sensitive-micelles-for-efficient-antitumor-drug-delivery
#16
Pei Zhang, Huiyuan Zhang, Wenxiu He, Dujuan Zhao, Aixin Song, Yuxia Luan
Here, we prepared novel redox-sensitive drug delivery system based on copolymer-drug conjugates methoxy poly(ethylene glycol)-poly(γ-benzyl l-glutamate)-disulfide-docetaxel (mPEG-PBLG-SS-DTX) to realize the desirable cancer therapy. First, copolymers of methoxy poly(ethylene glycol)-poly(γ-benzyl l-glutamate) (mPEG-PBLGs) with different molecular weight (mPEG2000-PBLG1750 and mPEG5000-PBLG1750) were synthesized via the ring open polymerization (ROP) of 5-benzyl-l-glutamate-N-carboxyanhydride (γ-Bzl-l-Glu-NCA) initiated by monoamino-terminated mPEG (mPEG-NH2)...
May 9, 2016: Biomacromolecules
https://www.readbyqxmd.com/read/26499505/survey-of-pharmacists%C3%A2-antibiotic-dosing-recommendations-for-sustained-low-efficiency-dialysis
#17
Jian P Mei, Azadeh Ali-Moghaddam, Bruce A Mueller
BACKGROUND: The use of hybrid renal replacement therapies like sustained low efficiency dialysis (SLED) is increasing in ICUs worldwide. However, pharmacokinetic studies designed to inform therapeutic antibiotic dosing in critically ill patients receiving SLED are limited. SLED operational characteristics vary across institutions. Pharmacists in institutions that utilize SLED are challenged to recommend therapeutic doses for antibiotics. OBJECTIVE: To characterize pharmacist-recommended antibiotic regimens for SLED...
February 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/26475843/spatial-analysis-of-case-mix-and-dialysis-modality-associations
#18
Tamar Phirtskhalaishvili, Florian Bayer, Stephane Edet, Isabelle Bongiovanni, Julien Hogan, Cécile Couchoud
UNLABELLED:BACKGROUND: Health-care systems must attempt to provide appropriate, high-quality, and economically sustainable care that meets the needs and choices of patients with end-stage renal disease (ESRD). France offers 9 different modalities of dialysis, each characterized by dialysis technique, the extent of professional assistance, and the treatment site. The aim of this study was 1) to describe the various dialysis modalities in France and the patient characteristics associated with each of them, and 2) to analyze their regional patterns to identify possible unexpected associations between case-mixes and dialysis modalities...
May 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/26431064/transferrin-receptor-targeted-vitamin-e-tpgs-micelles-for-brain-cancer-therapy-preparation-characterization-and-brain-distribution-in-rats
#19
Sonali, Poornima Agrawal, Rahul Pratap Singh, Chellappa V Rajesh, Sanjay Singh, Mahalingam R Vijayakumar, Bajrangprasad L Pandey, Madaswamy Sona Muthu
The effective treatment of brain cancer is hindered by the poor transport across the blood-brain barrier (BBB) and the low penetration across the blood-tumor barrier (BTB). The objective of this work was to formulate transferrin-conjugated docetaxel (DTX)-loaded d-alpha-tocopheryl polyethylene glycol 1000 succinate (vitamin E TPGS or TPGS) micelles for targeted brain cancer therapy. The micelles with and without transferrin conjugation were prepared by the solvent casting method and characterized for their particle size, polydispersity, drug encapsulation efficiency, drug loading, in vitro release study and brain distribution study...
June 2016: Drug Delivery
https://www.readbyqxmd.com/read/26372512/micronutrient-and-amino-acid-losses-in-acute-renal-replacement-therapy
#20
REVIEW
Weng C Oh, David S Gardner, Mark A J Devonald
PURPOSE OF REVIEW: A wide range of renal replacement therapies is now available to support patients with acute kidney injury. These treatments utilize diffusion, convection or a combination of these mechanisms to remove metabolic waste products from the bloodstream. It is inevitable that physiologically important substances including micronutrients will also be removed. Here we review current knowledge of the extent of micronutrient loss, how it varies between treatment modalities and its clinical significance...
November 2015: Current Opinion in Clinical Nutrition and Metabolic Care
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