Elevated serum Cystatin C at continuous renal replacement therapy initiation predicts lack of renal recovery

2013 ◽  
Vol 79 (05) ◽  
pp. 356-361 ◽  
Author(s):  
Zhongheng Zhang ◽  
Hongying Ni ◽  
Baolong Lu ◽  
Ni Jin
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Cystatin C ◽  
Elevated Serum ◽  
Renal Recovery ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Therapy Initiation ◽  
Renal Replacement Therapy Initiation

Platelet Decreases following Continuous Renal Replacement Therapy Initiation as a Novel Risk Factor for Renal Nonrecovery

2021 ◽  
pp. 1-8
Author(s):  
Benjamin R. Griffin ◽  
Patrick Ten Eyck ◽  
Sarah Faubel ◽  
Diana Jalal ◽  
Martin Gallagher ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Clinical Effect ◽  
Secondary Analysis ◽  
Renal Recovery ◽  
Cut Points ◽  
Randomized Evaluation ◽  
Therapy Initiation ◽  
Renal Replacement Therapy Initiation

<b><i>Background:</i></b> Continuous renal replacement therapy (CRRT) is a form of dialysis used in critically ill patients, and has recently been associated with renal nonrecovery. Decreases in platelets following CRRT initiation are common and are associated with mortality, but associations with renal recovery are unclear. Our objective was to determine if platelet nadir or the degree of platelet decrease following CRRT initiation was associated with renal nonrecovery. <b><i>Methods:</i></b> This is a secondary analysis of the Randomized Evaluation of Normal versus Augmented Level (RENAL) trial. Primary predictors were platelet nadir discretized by median value and percent platelet decrease following CRRT initiation, with cut points evaluated by decile from 30 to 60%. The 2 primary outcomes were time to RRT-independence and RRT-free days. Secondary outcomes were 28-day mortality, 90-day mortality, intensive care unit (ICU)-free, and hospital-free days. <b><i>Results:</i></b> Time to RRT independence censored for death was achieved less frequently in patients with low platelet nadir (hazard ratio [HR] 0.77, confidence interval [CI] 0.66–0.91) and in those with &#x3e;50% platelet decrease (HR 0.84, CI 0.72–0.97). RRT-free days were lower in both low platelet nadir (odds ratio [OR] 0.94, CI 0.90–0.97) and &#x3e;50% platelet decrease (OR 0.91, CI 0.88–0.95). These groups also had higher rates of 28- and 90-day mortality and fewer ICU-free and hospital-free days. Thrombocytopenia at CRRT initiation was also associated with renal nonrecovery, although the clinical effect was small. <b><i>Conclusions:</i></b> Platelet nadir &#x3c;100 × 10<sup>3</sup>/µL and platelet decrease by &#x3e;50% following CRRT initiation were both associated with lower rates of renal recovery. Further research is needed to evaluate mechanisms-linking platelet changes and renal nonrecovery in CRRT.

scholarly journals IMPACT OF TIMING OF RENAL REPLACEMENT THERAPY INITIATION ON OUTCOME OF ACUTE KIDNEY INJURY IN SEPTIC PATIENTS

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S213-18
Author(s):  
Muhammad Nasir ◽  
Madiha Hashmi ◽  
Muhammad Sohaib ◽  
Zahoor Ahmed ◽  
Muhammad Salman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Blood Urea Nitrogen ◽  
Kidney Injury ◽  
Urea Nitrogen ◽  
Therapy Initiation ◽  
Renal Replacement Therapy Initiation ◽  
Late Group

Objective: To identify whether the timing of initiation of continuous renal replacement therapy affects outcome in septic patients with acute kidney injury in term of 28 days mortality. Study Design: Cross sectional analytical study. Place and Duration of Study: This research was conducted at department of Anaesthesiology and critical careunit of the Aga Khan University Hospital, Karachi, from Oct 2018 to Jun 2019. Methodology: The study reviewed all adult patients aged >18 years who developed acute kidney injury afterseptic shock and required continuous renal replacement therapy in surgical intensive care unit. Considering thevalue of blood urea nitrogen, patients were classified into two groups. One was in early group that‟s was defined as blood urea nitrogen value of <100 mg/dl just before continuous renal replacement therapy initiation while the patients who have blood urea nitrogen value of ≥100 mg/dl just prior to continuous renal replacement therapy initiation were classified as late group. Kaplan-Meier survival analysis was performed and median survival was computed. Results: Forty patients were included for analysis. There were thirty patients (75%) in early group in whomcontinuous renal replacement therapy was started with mean blood urea nitrogen of 66 ± 20.2 mg/dL and 10(25%) patients were in late group with mean blood urea nitrogen of 137 ± 28.4 mg/dL. The overall survival ratesin both groups were 49.6%, and 10.4% at 10 and 25 days, respectively. Median survival time was not statisticallysignificant between early and late continuous renal replacement...........

Early postoperative serum Cystatin C predicts renal replacement therapy following cardiac surgery

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
AH Kiessling ◽  
J Dietz ◽  
C Reyher ◽  
UA Stock ◽  
A Beiras-Fernandez ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Cystatin C ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Postoperative Serum
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