Super High-Flux Continuous Venovenous Hemodialysis Using Regional Citrate Anticoagulation: Long-Term Stability of Middle Molecule Clearance
| Autor: | Martin Siebeck, Thomas Dimski, Detlef Kindgen-Milles, Timo Brandenburger, Torsten Slowinski |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
biology business.industry medicine.medical_treatment Standard treatment 030232 urology & nephrology Acute kidney injury Serum albumin Urology Hemodynamics 030208 emergency & critical care medicine Hematology Urine medicine.disease 03 medical and health sciences 0302 clinical medicine Nephrology Hemofiltration medicine biology.protein Renal replacement therapy Prospective cohort study business |
| Zdroj: | Therapeutic Apheresis and Dialysis. 22:355-364 |
| ISSN: | 1744-9979 |
| Popis: | Continuous renal replacement therapy is a standard treatment in critically ill patients with acute kidney injury. All CRRT techniques provide a high low-molecular weight clearance but even with hemofiltration, clearance of middle molecules is low. We investigated whether a new super high-flux hemofilter provides effective and sustained middle molecule clearance during citrate-anticoagulated continuous venovenous hemodialysis for up to 72 h. We included 14 critically ill patients with AKI-KDIGO-III in a prospective observational trial. We measured/calculated blood and urine concentrations, clearances and sieving coefficients of eight molecules with molecular weights from 60 to 66 kDa, hemodynamic parameters and SAPS-II scores. All filters were patent at 72 h. Clearance and sieving coefficients of small solutes were high and sustained over time, those for larger solutes decreased over 72 h but remained high enough to decrease blood concentrations of solutes up to 25 kDa. Albumin serum levels remained unaffected. Catecholamine doses and SAPS-II scores decreased significantly. This new hemofilter may improve blood purification in critically ill patients with AKI. |
| Databáze: | OpenAIRE |
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