scholarly journals The Role of Renal Replacement Therapy in the Management of Pharmacologic Poisonings

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Aibek E. Mirrakhimov ◽  
Aram Barbaryan ◽  
Adam Gray ◽  
Taha Ayach
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Volume Of Distribution ◽  
Water Soluble ◽  
Search Terms ◽  
Low Degree ◽  
Lithium Poisoning ◽  
Life Threatening ◽  
Acid Toxicity

Pharmacologic toxicities are common and range from mild to life-threatening. The aim of this study is to review and update the data on the role of renal replacement therapy (RRT) in the management of various pharmacologic poisonings. We aim to provide a focused review on the role of RRT in the management of pharmacological toxicities. Relevant publications were searched in MEDLINE with the following search terms alone or in combination: pharmacologic toxicity, hemodialysis, hemofiltration, renal replacement therapy, toxicology, poisonings, critical illness, and intensive care. The studies showed that a pharmacologic substance should meet several prerequisites to be deemed dialyzable. These variables include having a low molecular weight (<500 Da) and low degree of protein binding (<80%), being water-soluble, and having a low volume of distribution (<1 L/kg). RRT should be strongly considered in critically ill patients presenting with toxic alcohol ingestion, salicylate overdose, severe valproic acid toxicity, metformin overdose, and lithium poisoning. The role of RRT in other pharmacologic toxicities is less certain and should be considered on a case-by-case basis.

The role of arterio-venous fistula in formation of pulmonary hypertension in patients on renal replacement therapy. A Review

2019 ◽  
Vol 21 (1) ◽  
pp. 19-31
Author(s):  
R.T. Ishakov ◽  
◽  
E.M. Zeltyn-Abramov ◽  
N.G. Potheshkina ◽  
N.I. Belavina ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Venous Fistula

THE ROLE OF SLOW LOW EFFICIENCY DIALYSIS (SLED) IN RENAL REPLACEMENT THERAPY

2019 ◽  
Vol 72 (11) ◽  
Author(s):  
Małgorzata Kościelska ◽  
Paweł Żebrowski ◽  
Jolanta Małyszko
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Low Efficiency

scholarly journals Continuous renal replacement therapy rescued life-threatening capillary leak syndrome in an extremely-low-birth-weight premature: a case report

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Li-Fen Yang ◽  
Jia-Chang Ding ◽  
Ling-Ping Zhu ◽  
Li-Xia Li ◽  
Meng-Qi Duan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Renal Replacement Therapy ◽  
Low Birth Weight ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Therapeutic Option ◽  
Capillary Leak Syndrome ◽  
Extremely Low Birth Weight ◽  
Capillary Leak ◽  
Life Threatening

Abstract Background Capillary leak syndrome (CLS) is a rare disease characterized by profound vascular leakage and presents as a classic triad of hypotension, hypoalbuminemia and hemoconcentration. Severe CLS is mostly induced by sepsis and generally life-threatening in newborns, especially in premature infants. Continuous renal replacement therapy (CRRT) plays an important role of supportive treatment for severe CLS. Unfortunately, CRRT in preterm infants has rarely been well defined. Case presentation We report the case of a 11-day-old girl with CLS caused by sepsis, who was delivered by spontaneous vaginal delivery (SVD) at gestational age of 25 weeks and 4 days, and a birth weight of 0.89 Kilograms(kg). The infant received powerful management consisting of united antibiotics, mechanical ventilation, intravenous albumin and hydroxyethyl starch infusion, vasoactive agents, small doses of glucocorticoids and other supportive treatments. However, the condition rapidly worsened with systemic edema, hypotension, pulmonary exudation, hypoxemia and anuria in about 40 h. Finally, we made great efforts to perform CRRT for her. Fortunately, the condition improved after 82 h’ CRRT, and the newborn was rescued and gradually recovered. Conclusion CRRT is an effective rescue therapeutic option for severe CLS and can be successfully applied even in extremely-low-birth-weight premature.

scholarly journals Role of acute phase proteins in diagnosis of uremic pancreatitis and destructive pancreatitis in patients receiving renal replacement therapy (programmed hemodialysis)

2021 ◽  
Vol 38 (5) ◽  
pp. 115-122
Author(s):  
Kazim G. Gasanov ◽  
Viktor A. Zurnadzhyants ◽  
Eldar A. Kchibekov ◽  
M. I. Shikhragimov
Keyword(s):  
Renal Replacement Therapy ◽  
Serum Concentration ◽  
Blood Serum ◽  
Replacement Therapy ◽  
Acute Phase Proteins ◽  
Control Group ◽  
Serum Concentrations ◽  
High Concentration ◽  
Surgical Unit

Objective. To determine the blood serum 2-microglobulin and 2-macroglobulin concentration in patients undergoing renal replacement therapy (programmed hemodialysis) for the diagnosis of uremic pancreatitis and / or destructive pancreatitis. Materials and methods. The study involved 52 patients admitted to the Surgical Unit of Astrakhan "RZhD-Medicine" Hospital and City Clinical Hospital № 3. The blood serum 2-microglobulin and 2-macroglobulin concentration was analyzed in patients admitted on an emergency basis with suspicion of uremic pancreatitis and destructive pancreatitis, who receive renal replacement therapy (programmed hemodialysis). The control group included 50 outpatients undergoing renal replacement therapy (programmed hemodialysis). The study did not include patients with suspected pancreatitis who were not receiving renal replacement therapy. The period of the study is 20192021. Results. The concentration of blood serum 2-microglobulin is statistically higher than normal in all patients, who had received renal replacement therapy (programmed hemodialysis) in anamnesis. The most statistically high concentration of 2-microglobulin was revealed while studying patients with uremic pancreatitis (n = 34), and was (30.0 2.75 mg/l) compared with the blood serum concentration in patients with destructive pancreatitis (8 0.51 mg / l). The concentration of 2-macroglobulin was statistically lower in destructive pancreatitis (n = 18) and was 615 161 mg/l compared with uremic pancreatitis (980 216 mg/l). In the control group of outpatients (n = 50) receiving renal replacement therapy (programmed hemodialysis), no statistically significant blood serum concentrations of 2-microglobulin and 2-macroglobulin were found. Conclusions. A clear dependence of the concentration of 2-microglobulin and 2-macroglobulin on the severity of uremic pancreatitis and destructive pancreatitis was established. Statistically high values of 2-microglobulin concentrations were obtained in patients with uremic pancreatitis, and the 2-macroglobulin level was statistically low in destructive pancreatitis.

Management of hypercalcaemic crisis in adults: Current role of renal replacement therapy

2018 ◽  
Vol 36 (6) ◽  
pp. 1053-1056 ◽  
Author(s):  
Yassamine Bentata ◽  
H. El Maghraoui ◽  
M. Benabdelhak ◽  
I. Haddiya
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Current Role ◽  
Hypercalcaemic Crisis

scholarly journals Finding the Dose for Ceftolozane-Tazobactam in Critically Ill Children with and without Acute Kidney Injury

Antibiotics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 887
Author(s):  
Laura Butragueño-Laiseca ◽  
Iñaki F. Troconiz ◽  
Santiago Grau ◽  
Nuria Campillo ◽  
Xandra García ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Renal Impairment ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Severe Renal Impairment ◽  
Kidney Injury ◽  
Volume Of Distribution ◽  
Critically Ill Children ◽  
Multi Drug Resistance ◽  
Time Curve

Background: Ceftolozane-tazobactam is a new antibiotic against multidrug-resistant pathogens such as Pseudomonas aeruginosas. Ceftolozane-tazobactam dosage is still uncertain in children, especially in those with renal impairment or undergoing continuous renal replacement therapy (CRRT). Methods: Evaluation of different ceftolozane-tazobactam dosing regimens in three critically ill children. Ceftolozane pharmacokinetics (PK) were characterized by obtaining the patient’s specific parameters by Bayesian estimation based on a population PK model. The clearance (CL) in patient C undergoing CRRT was estimated using the prefilter, postfilter, and ultrafiltrate concentrations simultaneously. Variables such as blood, dialysate, replacement, and ultrafiltrate flow rates, and hematocrit were integrated in the model. All PK analyses were performed using NONMEM v.7.4. Results: Patient A (8 months of age, 8.7 kg) with normal renal function received 40 mg/kg every 6 h: renal clearance (CLR) was 0.88 L/h; volume of distribution (Vd) Vd1 = 3.45 L, Vd2 = 0.942 L; terminal halflife (t1/2,β) = 3.51 h, dosing interval area under the drug concentration vs. time curve at steady-state (AUCτ,SS) 397.73 mg × h × L−1. Patient B (19 months of age, 11 kg) with eGFR of 22 mL/min/1.73 m2 received 36 mg/kg every 8 h: CLR = 0.27 L/h; Vd1 = 1.13 L; Vd2 = 1.36; t1/2,β = 6.62 h; AUCSS 1481.48 mg × h × L−1. Patient C (9 months of age, 5.8 kg), with severe renal impairment undergoing CRRT received 30 mg/kg every 8 h: renal replacement therapy clearance (CLRRT) 0.39 L/h; Vd1 = 0.74 L; Vd2= 1.17; t 1/2,β = 3.51 h; AUCτ,SS 448.72 mg × h × L−1. No adverse effects attributable to antibiotic treatment were observed. Conclusions: Our results suggest that a dose of 35 mg/kg every 8 h can be appropriate in critically ill septic children with multi-drug resistance Pseudomonas aeruginosa infections. A lower dose of 10 mg/kg every 8 h could be considered for children with severe AKI. For patients with CRRT and a high effluent rate, a dose of 30 mg/kg every 8 h can be considered.

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