scholarly journals Hypertriglyceridemia causing continuous renal replacement therapy dysfunction in a patient with end-stage liver disease

2018 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
DC McLaughlin ◽  
DC Fang ◽  
BA Nolot ◽  
PK Guru
Keyword(s):  
Liver Disease ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Comparative effectiveness of liver transplant strategies for end-stage liver disease patients on renal replacement therapy

2014 ◽  
Vol 20 (9) ◽  
pp. 1034-1044 ◽  
Author(s):  
Yaojen Chang ◽  
Lorenzo Gallon ◽  
Colleen Jay ◽  
Kirti Shetty ◽  
Bing Ho ◽  
...  
Keyword(s):  
Liver Disease ◽  
Renal Replacement Therapy ◽  
Liver Transplant ◽  
Replacement Therapy ◽  
Comparative Effectiveness ◽  
End Stage Liver Disease ◽  
End Stage

Predictors of Hypophosphatemia and Outcomes during Continuous Renal Replacement Therapy

2020 ◽  
Vol 49 (6) ◽  
pp. 700-707 ◽  
Author(s):  
Rachel Jenkins Hendrix ◽  
M. Colleen Hastings ◽  
Michael Samarin ◽  
Joanna Q. Hudson
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Patient Outcomes ◽  
Kidney Injury ◽  
Discharge Duration ◽  
Poor Outcomes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Mean Time

<b><i>Introduction:</i></b> Hypophosphatemia occurs in up to 80% of patients undergoing continuous renal replacement therapy (CRRT) and has been associated with poor outcomes. Whether preemptive phosphate supplementation is warranted in select patients has not been adequately explored. This single-center, retrospective cohort study evaluates predictors of hypophosphatemia and characterizes treatment approaches in adult patients undergoing at least 12 h of CRRT. <b><i>Methods:</i></b> Patients were divided into 2 groups based on the presence or absence of hypophosphatemia as defined by serum phosphorus &#x3c;2.5 mg/dL. Select laboratory values at baseline and during CRRT, medications and nutritional sources affecting phosphorus, and CRRT parameters were compared. Patient outcomes including resolution of acute kidney injury (AKI), freedom from renal replacement therapy at hospital discharge, duration of intensive care unit (ICU) and hospital stay, duration of mechanical ventilation, and ICU mortality were evaluated. <b><i>Results:</i></b> Seventy-two patients were included. The group was 43% female and 51% African American. CRRT was ordered for AKI in 83% and for end-stage renal disease in 15%. Hypophosphatemia occurred in 45 patients (63%). Mean time to development of hypophosphatemia was 34 ± 22 h. Patients who developed hypophosphatemia received a longer duration of CRRT (<i>p</i> = 0.001), were more likely to have a diet ordered (<i>p</i> = 0.005), less likely to have received calcium infusions (<i>p</i> = 0.045), and had lower phosphorus (<i>p</i> = 0.017) and potassium levels (<i>p</i> = 0.038) and higher calcium levels at baseline (<i>p</i> = 0.048). Development of hypophosphatemia was associated with an increased duration of ICU stay (<i>p</i> = 0.014) but not with the other patient outcomes evaluated. Twenty-seven of the 45 patients (60%) who developed hypophosphatemia received phosphorus supplementation with near equal use of intravenous, oral, and combination routes. Only 17 patients (38%) achieved resolution of hypophosphatemia while on CRRT. <b><i>Conclusion:</i></b> Hypophosphatemia is common, difficult to correct, and contributes to longer ICU stays in patients requiring CRRT. A preemptive approach to address hypophosphatemia including aggressive supplementation strategies to correct phosphorus is warranted in patients requiring CRRT.

Renal Replacement Therapy in End-Stage Renal Disease Patients with Chronic Liver Disease and Ascites: Role of Peritoneal Dialysis

2008 ◽  
Vol 28 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Kunal Chaudhary ◽  
Ramesh Khanna
Keyword(s):  
Liver Disease ◽  
Renal Replacement Therapy ◽  
Renal Disease ◽  
Replacement Therapy ◽  
Chronic Liver Disease ◽  
End Stage Renal Disease ◽  
Chronic Liver ◽  
Risk Of Bleeding ◽  
Stage Renal Disease ◽  
End Stage

Chronic liver disease and cirrhosis account for several thousand deaths in the United States and often these patients have renal disease that progresses to end-stage renal disease (ESRD), necessitating renal replacement therapy. These patients provide significant challenges to their physicians, especially in the management of their ESRD with dialysis. ESRD patients with chronic liver disease and ascites are more difficult to manage on hemodialysis (HD) due to their hemodynamic status and risk of bleeding. Peritoneal dialysis (PD) offers them a viable alternative, along with a stable hemodynamic status and a lower risk of bleeding. The overall morbidity and mortality as well as the risk of peritonitis appear to be almost similar between cirrhotic and non-cirrhotic PD patients. In the absence of clinical trials comparing HD versus PD in such a population, and despite the limited clinical observations, the authors support PD as a viable and effective form of renal replacement therapy for patients with ESRD and associated chronic liver disease with cirrhosis and ascites.

Continuous renal replacement therapy (CRRT) in patients with liver disease: Is circuit life different?

2009 ◽  
Vol 51 (3) ◽  
pp. 504-509 ◽  
Author(s):  
Banwari Agarwal ◽  
Steve Shaw ◽  
Manu Shankar Hari ◽  
Andrew K. Burroughs ◽  
Andrew Davenport
Keyword(s):  
Liver Disease ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy
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