scholarly journals Continuous Renal Replacement Therapy with the Adsorbing Filter oXiris in Septic Patients: A Case Series

2019 ◽  
Vol 47 (Suppl. 3) ◽  
pp. 54-58 ◽  
Author(s):  
Franco Turani ◽  
Riccardo Barchetta ◽  
Mauro Falco ◽  
Silvia Busatti ◽  
Luca Weltert
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Medical Records ◽  
Time Course ◽  
Case Series ◽  
Kidney Injury ◽  
Immunological Response ◽  
Respiratory Parameters ◽  
Endotoxin Activity

Background: Extracorporeal treatment may be useful during sepsis, but definitive recommendations are lacking. Aim of this study is to review retrospectively the medical records of septic patients submitted to continuous renal replacement therapy (CRRT) with the adsorbing membrane oXiris and evaluate (1) the safety of the device, (2) the cardiorenal response, and (3) the immunological response. Materials and Methods: The medical records of 60 septic patients submitted to CRRT with the membrane oXiris from April 2011 to December 2018 have been reviewed. The adsorbing membrane oXiris® (Baxter, IL, USA) was used through a Prisma plataform (Prismaflex – Baxter, IL, USA). At basal time (T0), at 24 h (T1), and at the end of the treatment (T2) were analyzed the clinical data, the cytokines, and the time course of endotoxin. Results: Sixty patients were included in the study. In total, 85% of patients had acute kidney injury (AKI). Every CRRT treatment was of 72 ± 13 h, with the consumption of 3.2 ± 1 filters. No AE events were reported. The main cardiorenal and respiratory parameters improved with a decrease of the noradrenaline dosage. Cytokines, procalcitonin, and endotoxin activity assay decreased too. SOFA total improved from 12.4 ± 2 to 9 ± 2. Conclusion: In sepsis/septic shock patients with AKI, CRRT with the adsorbing membrane oXiris may be safe and improves the cardiorenal – function and the clinical condition. The effect on cytokines and endotoxin may explain in part these results. A RCT is warranted to confirm these data.

scholarly journals Continuous Renal Replacement Therapy among Patients with COVID-19 and Acute Kidney Injury

2021 ◽  
pp. 1-8
Author(s):  
Ryann Sohaney ◽  
Salma Shaikhouni ◽  
John Travis Ludwig ◽  
Anca Tilea ◽  
Markus Bitzer ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Fluid Balance ◽  
Repeated Measures ◽  
Kidney Injury ◽  
Regional Citrate Anticoagulation ◽  
Respiratory Parameters ◽  
The Relationship

<b><i>Background and Objectives:</i></b> Acute kidney injury (AKI) is a common complication among patients with COVID-19 and acute respiratory distress syndrome. Reports suggest that COVID-19 confers a pro-thrombotic state, which presents challenges in maintaining hemofilter patency and delivering continuous renal replacement therapy (CRRT). We present our initial experience with CRRT in critically ill patients with COVID-19, emphasizing circuit patency and the association between fluid balance during CRRT and respiratory parameters. <b><i>Design, Setting, Participants, and Measurements:</i></b> Retrospective chart review of 32 consecutive patients with COVID-19 and AKI managed with continuous venovenous hemodiafiltration with regional citrate anticoagulation (CVVHDF-RCA) according to the University of Michigan protocol. Primary outcome was mean CRRT circuit life per patient during the first 7 days of CRRT. We used simple linear regression to assess the relationship between patient characteristics and filter life. We also explored the relationship between fluid balance on CRRT and respiratory parameters using repeated measures modeling. <b><i>Results:</i></b> Patients’ mean age was 54.8 years and majority were Black (75%). Comorbidities included hypertension (90.6%), obesity (70.9%) diabetes (56.2%), and chronic kidney disease (40.6%). Median CRRT circuit life was 53.5 [interquartile range 39.1–77.6] hours. There was no association between circuit life and inflammatory or pro-thrombotic laboratory values (ferritin <i>p</i> = 0.92, C-reactive protein <i>p</i> = 0.29, D-dimer <i>p</i> = 0.24), or with systemic anticoagulation (<i>p</i> = 0.37). Net daily fluid removal during the first 7 days of CRRT was not associated with daily (closest recorded values to 20:00) PaO<sub>2</sub>/FIO<sub>2</sub> ratio (<i>p</i> = 0.21) or positive end-expiratory pressure requirements (<i>p</i> = 0.47). <b><i>Conclusions:</i></b> We achieved adequate CRRT circuit life in COVID-19 patients using an established CVVHDF-RCA protocol. During the first 7 days of CRRT therapy, cumulative fluid balance was not associated with improvements in respiratory parameters, even after accounting for baseline fluid balance.

High Cut-Off Renal Replacement Therapy for Removal of Myoglobin in Severe Rhabdomyolysis and Acute Kidney Injury: A Case Series

Nephron ◽  
2013 ◽  
Vol 121 (3-4) ◽  
pp. c159-c164 ◽  
Author(s):  
Nils Heyne ◽  
Martina Guthoff ◽  
Julia Krieger ◽  
Michael Haap ◽  
Hans-Ulrich Häring
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Case Series ◽  
Kidney Injury

scholarly journals The Effect of Specialized Continuous Renal Replacement Therapy Team in Acute Kidney Injury Patients Treatment

2015 ◽  
Vol 56 (3) ◽  
pp. 658 ◽  
Author(s):  
Youn Kyung Kee ◽  
Eun Jin Kim ◽  
Kyoung Sook Park ◽  
Seung Gyu Han ◽  
In Mee Han ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Therapy Team
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