P0236 / #989: EARLY HIGH-VOLUME CONTINUOUS VENOVENOUS HEMODIAFILTRATION ON A PATIENT WITH REFRACTORY SEPTIC SHOCK AND ACUTE KIDNEY INJURY: A SINGLE CASE REPORT.

This is a case report of a girl with glutaric acidemia type I (GA-I) who experienced rhabdomyolysis and acute kidney injury (AKI). Her first acute metabolic crisis occurred at the age of 5 months, which mainly manifested as irritable crying, poor appetite, and hyperlactatemia. Mutation analysis showed 2 pathogenic mutations in the glutaryl-CoA dehydrogenase (GCDH) gene, which were c.383G>A (p.R128Q) and c.873delC (p.N291Kfs*41), the latter of which is a novel frameshift mutation of GA-I. She had a febrile illness at the age of 12 months, followed by AKI and severe rhabdomyolysis. Four days of continuous venovenous hemodiafiltration (CVVHDF) helped to overcome this acute decompensation. This case report describes a novel mutation in the GCDH gene, that is, c.873delC (p.N291Kfs*41). Also, it highlights the fact that patients with GA-I have a high risk of rhabdomyolysis and AKI, which may be induced by febrile diseases and hyperosmotic dehydration; CVVHDF can help to overcome this acute decompensation.

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High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial

Intensive Care Medicine ◽

10.1007/s00134-013-2967-z ◽

2013 ◽

Vol 39 (9) ◽

pp. 1535-1546 ◽

Cited By ~ 188

Author(s):

Olivier Joannes-Boyau ◽

Patrick M. Honoré ◽

Paul Perez ◽

Sean M. Bagshaw ◽

Hubert Grand ◽

...

Keyword(s):

Septic Shock ◽

Acute Kidney Injury ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Kidney Injury ◽

High Volume ◽

Volume Versus ◽

Randomized Controlled

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Evaluation of the Effectiveness of Continuous Venovenous Hemodiafiltration Appli̇ed With Oxiris and AN69 Membranes in Patients With Septic Shock-Related Acute Kidney Injury

10.21203/rs.2.21569/v1 ◽

2020 ◽

Author(s):

Cem Kıvılcım Kaçar ◽

Osman Uzundere ◽

Enver Yüksel ◽

Deniz Kandemir ◽

Esra Akiz Bıçak ◽

...

Keyword(s):

Septic Shock ◽

Acute Kidney Injury ◽

Infusion Rate ◽

Kidney Injury ◽

The Other ◽

Noradrenaline Infusion ◽

Continuous Venovenous Hemodiafiltration ◽

Significant Difference ◽

Group 2 ◽

Group 1

Abstract Background and objectives: AN69 and Oxiris are filters used in continuous renal replacement therapy. In this study, we aimed to research the effects of these filters on blood cell counts, blood biochemistry, inflammation indicators, clinical status and mortality of patients diagnosed with septic shock-related acute kidney injury. Method: Between March 2019 and October 2019, 42 adult patients (Group 1: Oxiris (n = 21) or Group 2: AN69 (n=21)) with septic shock-related acute kidney injury and received continuous venovenous hemodiafiltration (CVVHDF) in the intensive care unit were included in the study and their results were prospectively observed and compared. The data at the begining of CVVHDF (pre-CVVHDF) and 24 hours after the onset of CVVHDF (post-CVVHDF) were recorded.Results: In the comparison of the pre- and post-CVVHDF values in Group 1, there was a statistically significant decrease detected in the procalcitonin (p = 0.04) and noradrenaline infusion rate (p = 0.02) levels. In terms of the other data there was no statistically significant difference between pre- and post-CVVHDF values in Group 1. In the comparison of the pre- and post-CVVHDF values in Group 2, there was a statistically significant decrease detected in the urea (p = 0.04), platelet count (p = 0.02) and procalcitonin (p = 0.002) levels. There was no statistically significant difference between pre- and post-CVVHDF values in terms of the other data in Group 2. There was no statistically significant difference between the groups in terms of mortality. Conclusions: CVVHDF with Oxiris filter causes a statistically significant decrease in noradrenaline infusion rate. Therefore, we think that the use of CVVHDF with Oxiris filter applied for septic shock-related acute kidney injury will save us time and increase the improvement in the treatment.

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