Sustained low-efficiency dialysis for metformin-associated lactic acidosis in patients with acute kidney injury

2018 ◽  
Vol 32 (2) ◽  
pp. 297-306 ◽  
Author(s):  
Paolo Greco ◽  
Giuseppe Regolisti ◽  
Umberto Maggiore ◽  
Elena Ferioli ◽  
Filippo Fani ◽  
...  
Renal Failure ◽  
2012 ◽  
Vol 34 (10) ◽  
pp. 1238-1243 ◽  
Author(s):  
Emerson Q. Lima ◽  
Ricardo G. Silva ◽  
Endrigo L.S. Donadi ◽  
Alex B. Fernandes ◽  
Jeferson R. Zanon ◽  
...  

2020 ◽  
Author(s):  
Ankit Patel ◽  
Kenneth B Christopher

Renal replacement therapy (RRT) can be used to support patient’s kidney function in cases of acute kidney injury (AKI). However, timing, modality, and dosing of RRT continue to remain in question. Recent studies have begun to provide data to help guide clinicians on when to initiate RRT, what form of RRT to use ranging from continuous venovenous hemofiltration (VVH) to intermittent hemodialysis, and the impact of high versus low-intensity dosing. Additionally, the risks associated with temporary vascular access with regard to thrombosis and infection, the impact of high efficiency and flux versus low efficiency and flux membranes, and options for anticoagulation in RRT for AKI are also discussed. This review contains 75 references.  Key words: acute kidney injury, chronic kidney disease, continuous venovenous hemofiltration, continuous venovenous hemodialysis, renal replacement therapy, venovenous hemofiltration, 


2019 ◽  
Vol 58 (5) ◽  
pp. 375-382 ◽  
Author(s):  
Anthony Corchia ◽  
Alain Wynckel ◽  
Julien Journet ◽  
Julie Moussi Frances ◽  
Nihel Skandrani ◽  
...  

Pharmacy ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Paula Brown ◽  
Marisa Battistella

The use of sustained low-efficiency dialysis (SLED) as a renal replacement modality has increased in critically ill patients with both acute kidney injury (AKI) and hemodynamic instability. Unfortunately, there is a paucity of data regarding the appropriate dosing of medications for patients undergoing SLED. Dose adjustment in SLED often requires interpretation of pharmacodynamics and pharmacokinetic factors and extrapolation based on dosing recommendations from other modes of renal replacement therapy (RRT). This review summarizes published trials of antimicrobial dose adjustment in SLED and discusses pharmacokinetic considerations specific to medication dosing in SLED. Preliminary recommendation is provided on selection of appropriate dosing for medications where published literature is unavailable.


2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Maxime Cambournac ◽  
Isabelle Goy-Thollot ◽  
Julien Guillaumin ◽  
Jean-Yves Ayoub ◽  
Céline Pouzot-Nevoret ◽  
...  

2008 ◽  
Vol 69 (01) ◽  
pp. 40-46 ◽  
Author(s):  
B.G. Holt ◽  
J.J. White ◽  
A. Kuthiala ◽  
P. Fall ◽  
H.M. Szerlip

2017 ◽  
Vol 42 (1) ◽  
pp. 14-20
Author(s):  
Kaniz Fatema ◽  
Mohammad Omar Faruq

Acute kidney injury (AKI) is a risk factor for increased mortality in critically ill patients. Sustained low efficiency dialysis (SLED) is a new approach in renal replacement therapy (RRT) and it combines the advantages of continuous renal replacement therapy (CRRT) and intermittent haemodialysis (HD). The study was aimed to evaluate the outcome of the hae-modynamically unstable patients with AKI in Bangladesh who were treated with SLED. So far this is the first reported study on SLED in intensive care unit (ICU) in Bangladesh. This quasi-experimental study was conducted in a 10-bed adult ICU of a tertiary care hospital in Bangladesh from June 2012 to May 2013. A total of 153 sessions of SLED were performed on 43 AKI patients. Mean age of the patients was 60.12 ± 15.57 years with male preponder-ance (67.4% were male). Mean APACHE II score was 26.88 ± 6.25. Fourteen patients (32.55%) had de novo AKI. Twenty nine patients (67.4%) had chronic kidney disease (CKD) with baseline mean serum creatinine 2.56 mg/dl, but did not require any RRT before admis-sion in ICU. After giving SLED, AKI of the study patients were completely resolved in 27.9%. Some forty two percent patients became dialysis dependant and 30.23% patients died. Patients who had AKI on CKD became dialysis dependant more often than the patients with de novo AKI (p <0.01). Mortality rate was significantly higher in patients who were on inotrope support (p= 0.017). Otherwise, there was no relation of 28 day mortality with age, prior renal function and mechanical ventilator requirement (p>0.05). Thus, SLED is an excellent renal replacement therapy for the haemodynamically unstable AKI patients of ICU. It is also cost-effective compared to CRRT.


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