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Hemoadsorption in acute pediatric carbamazepine intoxication: a case report and systematic review of extracorporeal therapies.

BACKGROUND: Severe carbamazepine intoxication in children may cause coma, seizures, respiratory failure, and hemodynamic instability. When g … ntilation (48%) and inotropic-vasopressor support (22%). Hemodialysis (56%), continuous veno-venous hemodiafiltration (26%), charcoal hemoperfusion (22%), therapeutic plasma exchange (19%), continuous veno-venous hemodialysis (7%), and continuous veno-venous hemofiltration (4%) were used. Documented time to normalization ranged from 4.5 to 84 h. Serum carbamazepine …

Continuous Renal Replacement Therapy for Patients With Sepsis in a Low-Resource Medical Intensive Care Unit (MICU): Incidence, Risk Factors, and Outcomes.

Introduction Sepsis is one of the leading causes of ICU admissions, with a substantial proportion of patients developing sepsis-associated a … nd vasopressor therapy were predominantly used among nonsurvivors (p< 0.001). Continuous Venovenous Hemodiafiltration (CVVHDF) was the CRRT modality used for all patients (three patients used a combination of continuous and intermittent techniques), and hemoadsorption filters were used in 38 patients. The preferential indications for CVVHDF included anuria and prof …

Effects of Expanded Hemodialysis with Medium Cut-Off Membranes on Maintenance Hemodialysis Patients: A Review.

Kidney failure is associated with high morbidity and mortality. Hemodialysis, the most prevalent modality of renal replacement therapy, uses the principle of semipermeable membranes to remove solutes and water in the plasma of patients with kidney failure. With the evolution of hemodialysis technology over the last half century, the clearance of small water-soluble molecules in such patients is adequate. However, middle molecules uremic toxins are still retained in the plasma and cause cardiovascular events, anemia, and malnutrition, which significantly contribute to poor quality of life and h

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… In hemodiafiltration (HDF) mode, which combines convection and diffusion, molecules up to 30 kDa are efficiently removed [ 16 ]. … High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients. J. Am. Soc. Nephrol. 2013;24:487–497. doi: 10.1681/ASN.2012080875. 19. Ronco C. Hemodiafiltration: Evolution of a technique towards better dialysis care. Contrib. …

Renal replacement therapy in cancer patients with acute kidney injury (Review).

Cancer patients are at high risk for developing acute kidney injury (AKI), which is associated with increased morbidity and mortality in these patients. Despite the progress made in understanding the pathogenic mechanisms and etiology of AKI in these patients, the main prevention consists of avoiding medication and nephrotoxic agents such as non-steroidal anti-inflammatory drugs, contrast agents used in medical imaging and modulation of chemotherapy regimens; when prophylactic measures are overcome and renal impairment becomes unresponsive to treatment, renal replacement therapy (RRT) is requi

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… Thus, a study was published in 2011( 51 ) comparing the efficacy of online hemodiafiltration with high-flow hemodialysis in patients with multiple myeloma and AKI. … Given the high cost of MCO filters, online hemodiafiltration is reserved for a limited number of sessions for certain types of patients, such as those with multiple myeloma. 8. …

[Analysis of the current application status of blood purification therapy in critically ill children].

OBJECTIVE: To analyze the clinical features, treatment mode selection, factors influencing prognosis and current clinical application of con … 4.1% (95/395)] in order of frequency. The predominant CBP treatment mode was continuous veno-venous hemodiafiltration [CVVHDF; 60.8% (240/395), followed by hemoperfusion [HP; 15.7% (62/395)], therapeutic plasma exchange [TPE; 9.1% (36/395)], and hybrid blood purification treatment [HBPT; 14.4% (57/395)]. The right internal jugular vein was the main vascular access …

Biochemical and Clinical Impact of Organic Uremic Retention Solutes: A Comprehensive Update.

In this narrative review, the biological/biochemical impact (toxicity) of a large array of known individual uremic retention solutes and groups of solutes is summarized. We classified these compounds along their physico-chemical characteristics as small water-soluble compounds or groups, protein bound compounds and middle molecules. All but one solute (glomerulopressin) affected at least one mechanism with the potential to contribute to the uremic syndrome. In general, several mechanisms were influenced for each individual solute or group of solutes, with some impacting up to 7 different biolo

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… Removal can be further increased by adding convection (hemodiafiltration) [ 339 , 340 , 341 ] but also by extending the length of dialysis [ 342 ]. … A strong decline in pre-dialysis β 2 -microglobulin was obtained when several of these features were combined in extended daily hemodiafiltration [ 343 ]. …

Biocompatibility in hemodialysis: artificial membrane and human blood interactions.

Hemodialysis, a cornerstone therapy for chronic kidney disease, represented a crucial advance in the evolution of artificial organs. While its success is largely due to its efficiency in removing uremic toxins, an equally important challenge is to uphold the primum non nocere principle by minimizing the harmful effects of membrane-blood interactions. This review examines the complex mechanisms and key interactions underlying membrane biocompatibility, including complement activation, inflammation, and coagulation disturbances, paving the way for their clinical implications. We also summarize r

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… When high blood flow cannot be achieved, predilution hemodiafiltration is used, which dilutes the blood before it enters the dialyzer, reducing viscosity and internal pressure. …

Derivation and elimination of uremic toxins from kidney-gut axis.

Uremic toxins are chemicals, organic or inorganic, that accumulate in the body fluids of individuals with acute or chronic kidney disease and impaired renal function. More than 130 uremic solutions are included in the most comprehensive reviews to date by the European Uremic Toxins Work Group, and novel investigations are ongoing to increase this number. Although approaches to remove uremic toxins have emerged, recalcitrant toxins that injure the human body remain a difficult problem. Herein, we review the derivation and elimination of uremic toxins, outline kidney-gut axis function and relati

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… Hemodiafiltration: clinical evidence and remaining questions. Kidney Int. 77 (7), 581–587. 10.1038/ki.2009.541 Block G. A., Wheeler D. C., Persky M. S., et al. (2012). Effects of phosphate binders in moderate CKD. J. Am. Soc. … Quality of life of hemodialysis patients in Central and Southern Italy: cross-sectional comparison between Hemodiafiltration with endogenous reinfusion (HFR) and Bicarbonate Hemodialysis. …

Clinical effects of continuous veno-venous hemofiltration combined with hemoperfusion for the treatment of multiple myeloma complicated with acute kidney injury.

ObjectiveTo evaluate the clinical efficacy of continuous veno-venous hemofiltration (CVVH) combined with hemoperfusion for the treatment of multiple myeloma (MM) complicated with acute kidney injury (AKI).MethodsMedical records of 73 patients with MM complicated with AKI admitted to the First People's Hospital of Huzhou from January 2019 to January 2021 were retrospectively analyzed. According to the treatment records, 35 patients received simple chemotherapy (control group), and 38 patients received CVVH combined with HP on the basis of chemotherapy (observation group). We compared the clinic

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… Hemodiafiltration with ultrafiltrate regeneration reduces free light chains without albumin loss in multiple myeloma patients. BMC Nephrol. 2020;21(1):227. doi: 10.1186/s12882-020-01885-8. doi: 10.1186/s12882-020-01885-8. 17. Bai M, Yu Y, Huang C, Liu Y, Zhou M, Li Y, et al. … Serum Free Light Chains Removal by HFR Hemodiafiltration in Patients with Multiple Myeloma and Acute Kidney Injury: A Case Series. Kidney Blood Press Res. 2018;43(4):1263–1272. doi: 10.1159/000492408. doi: 10.1159/000492408. 21. Jin Lixiu, Li Haifeng, Zong Yongzhong, Pan Yumei. …

The Coexistence of Multiple Myeloma-associated Amyloid Light-chain Amyloidosis and Fabry Disease in a Hemodialysis Patient.

Fabry disease (FD) is an inherited lysosomal disorder caused by an X-linked α-galactosidase A deficiency. We report the case of a 50-year-old male FD patient on hemodialysis who presented with macroglossia-related speaking difficulty and gastrointestinal symptoms. An endoscopic analysis revealed multiple gastric ulcers, and a histological examination led to a diagnosis of amyloid light-chain amyloidosis. Serum free light-chain and bone marrow analyses detected multiple myeloma (MM). Treatment with bortezomib and dexamethasone significantly improved the patient's symptoms. This is the first cas

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… Notably, neither HD nor hemodiafiltration has been shown to affect the serum FLC concentration or κ/λ ratio in patients with end-stage renal disease ( 14 ), indicating that these parameters are convenient, sensitive, and specific to MM, even in patients with HD. …

Serum free light chain level at diagnosis in myeloma cast nephropathy-a multicentre study.

Myeloma cast nephropathy (MCN) is a common cause of severe renal impairment in multiple myeloma (MM). The level of free light chain (FLC) that causes MCN varies substantially and there is uncertainty about the threshold level that should be used to inform clinical practice. In a multicentre cohort study of 103 patients with a diagnosis of MM and biopsy-confirmed MCN made between 2002-2014, we report prospectively measured levels of serum FLC at diagnosis obtained using a single nephelometric assay (Freelite®) and we explore the relationship between serum FLC level at diagnosis with renal outco

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… Pasquali S A novel option for reducing free light chains in myeloma kidney: supra-hemodiafiltration with endogenous reinfusion (HFR) J. Nephrol. 2015 28 251 254 10.1007/s40620-014-0130-8 25149172 32. … Susantitaphong P Tiranathanagul K Eiam-Ong S Extended high cutoff on-line hemodiafiltration is superior to extended high cutoff hemodialysis in removal of free light chain immunoglobulin of myeloma cast nephropathy Artif. Organs 2012 36 845 846 10.1111/j.1525-1594.2012.01442.x 22497276 38. …

Bilateral Amyloid Arthropathy of the Hip Joint Presented with Pathologic Fracture in a Hemodialysis Patient: A Case Report.

Pathological hip fractures are associated with substantial morbidity and functional decline. We report a rare case of localized dialysis-related amyloidosis involving both hip joints. A 48-year-old man undergoing long-term hemodialysis presented with atraumatic right hip pain. Radiographs and magnetic resonance imaging revealed a pathological subcapital fracture of the right femoral neck and extensive bilateral femoral neck osteolysis, with amyloid deposition showing low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Given the severe bone erosion and im

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… Hemodiafiltration is another modality that effectively increases beta-2 microglobulin clearance by combining both dialysis and filtration. Furthermore, research is actively underway to develop novel therapeutic agents that inhibit the aggregation of beta-2 microglobulin proteins 18 ) . …

The Use of Extracorporeal Organ Support Therapies for Acute Kidney Injury in Cancer Patients.

Acute kidney injury (AKI) is a frequent and serious complication in patients with cancer, associated not only with increased morbidity and mortality, but also with the interruption or modification of anticancer therapy. In critically ill patients with cancer, AKI arises from a complex interplay of cancer-related, treatment-related, and patient-related factors, with many patients requiring renal replacement therapy (RRT) and admission to the intensive care unit (ICU). This narrative review summarizes the etiology of AKI in patients with cancer and discusses the role of extracorporeal organ supp

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… CRRT can be delivered as continuous veno-venous hemofiltration (CVVH), hemodialysis (CVVHD) or hemodiafiltration (CVVHDF), and the choice is guided by the clinical goal: convective modalities such as CVVH are favoured in shock and fluid overload, whereas CVVHD or CVVHDF, which add a diffusive component … Calmette–Guerin CAR-T Chimeric Antigen Receptor—T cell CLL Chronic Lymphocytic Leukaemia CLS Capillary Leak Syndrome CRRT Continuous Renal Replacement Therapy CRS Cytokine Release Syndrome CVVH Continuous Veno-Venous Hemofiltration CVVHD Continuous Veno-Venous Hemodialysis CVVHDF Continuous Veno-Venous Hemodiafiltration …

Krukenberg's Spindle-Like Corneal Changes in a Patient With Prolonged ICU Admission: A Case Report.

Krukenberg's spindles are vertical, spindle-shaped pigment deposits on the posterior cornea and are primarily associated with pigment dispersion syndrome (PDS). We present a case of Krukenberg's spindle-like corneal changes in a 39-year-old male patient following prolonged ICU management for thyroid storm complicated by infective endocarditis. The patient's complex ICU course included mechanical ventilation, veno-arterial extracorporeal membrane oxygenation (VA-ECMO), and multiple medications. Ophthalmological examination revealed bilateral, brownish, linear changes in the central corneal stro

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… Following a tracheostomy, he required ongoing respiratory management and continuous hemodiafiltration (CHDF). …

Proteomic analysis of plasma proteins of high-flux haemodialysis and on-line haemodiafiltration patients reveals differences in transthyretin levels related with anaemia.

A large proportion of end-stage renal disease (ESRD) patients under long-term haemodialysis, have persistent anaemia and require high doses of recombinant human erythropoietin (rhEPO). However, the underlying mechanisms of renal anaemia have not been fully elucidated in these patients. In this study, we will be focusing on anaemia and plasma proteins in ESRD patients on high-flux haemodialysis (HF) and on-line haemodiafiltration (HDF), to investigate using two proteomic approaches if patients undergoing these treatments develop differences in their plasma protein composition and how this could

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… A comparison of on-line hemodiafiltration and high-flux hemodialysis: a prospective clinical study. J. Am. Soc. Nephrol. 2000;11:2344–2350. doi: 10.1681/ASN.V11122344. 4. Locatelli F, et al. … Mortality risk in patients on hemodiafiltration versus hemodialysis: a 'real-world' comparison from the DOPPS. Nephrol. Dial Transplant. 2018;33:683–689. doi: 10.1093/ndt/gfx277. 5. Nangaku M, Eckardt KU. Pathogenesis of renal anemia. Semin. …

Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions.

Clinically, it is highly challenging to promote recovery in patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF). Despite recent advances in understanding the underlying mechanisms of ALF and ACLF, standard medical therapy remains the primary therapeutic approach. Liver transplantation (LT) is considered the last option, and in several cases, it is the only intervention that can be lifesaving. Unfortunately, this intervention is limited by organ donation shortage or exclusion criteria such that not all patients in need can receive a transplant. Another option is to

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… and outcomes of acute kidney injury in patients with acute liver failure Clin Gastroenterol Hepatol 2015 13 352 359 25019700 10.1016/j.cgh.2014.07.011 PMC4937794 8 Redant S Beretta-Piccoli X Mugisha A Attou R Kaefer K De Bels D Tolwani A Honoré PM Hyperammonemia, the Last Indication of High-Volume Hemodiafiltration … 1377 1387 22534247 10.1097/ALN.0b013e318256f0c0 26 Canaud B Recent advances in dialysis membranes Curr Opin Nephrol Hypertens 2021 30 613 622 34475335 10.1097/MNH.0000000000000744 27 Ahrenholz PG Winkler RE Michelsen A Lang DA Bowry SK Dialysis membrane-dependent removal of middle molecules during hemodiafiltration …

Твердая неэптическая гипераммония, связанная с уреаплазмой парвума и инфекциями гомини Микопласмы в двойном иммунозапугивании женщины, представляющей как предполагаемый перитональный карциноматоз.

Острая гипераммония, не связанная с гепатической гипераммонией, является редким, но потенциально опасным для жизни заболеванием у пациентов, страдающих иммунокомпромиссной болезнью. Виды Ureaplasma и Mycoplasma являются быстродействующими врожденными организмами, которые генерируют аммиак и могут вызывать распространенную культурно-отрицательную инфекцию. Мы сообщаем о случае 63-year-old Женщина, получающая двойную биологическую терапию, оклелизумаб от множественных склерозов и секукинуумаб от псориаза, которая имела историю стерильности пюрии и симптомов мочи ниже. В течение двух месяцев ее с

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… Continuous veno-venous hemodiafiltration was delivered using regional citrate anticoagulation, an Ultraflux AV1000S hemofilter on a Fresenius multiFiltrate PRO platform, a blood-flow rate of 80 mL/min, and a prescribed effluent dose of 25-50 mL/kg/h. …

Acute kidney injury in critically ill cancer patients: an update.

Patients with cancer represent a growing group among actual ICU admissions (up to 20 %). Due to their increased susceptibility to infectious and noninfectious complications related to the underlying cancer itself or its treatment, these patients frequently develop acute kidney injury (AKI). A wide variety of definitions for AKI are still used in the cancer literature, despite existing guidelines on definitions and staging of AKI. Alternative diagnostic investigations such as Cystatin C and urinary biomarkers are discussed briefly. This review summarizes the literature between 2010 and 2015 on

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… Table 1 Summary of publications between 2010 and 2015 on critically ill cancer patients with AKI AKI acute kidney injury, AKIN Acute Kidney Injury Network, ca pts cancer patients, chemo chemotherapy, CRRT , continuous renal replacement therapy, CVVHDF continuous venovenous hemodiafiltration, CVVHF continuous … Continuous veno-venous hemodiafiltration for the treatment of spontaneous tumor lysis syndrome complicated by acute renal failure and severe hyperuricemia. Clin Nephrol. 2000;54:59–63. 66. Hutchison CA, Heyne N, Airia P, Schindler R, Zickler D, Cook M, et al. …

Beta-2 microglobulin and all-cause mortality in the era of high-flux hemodialysis: results from the Dialysis Outcomes and Practice Patterns Study.

BackgroundBeta-2 microglobulin (β2M) accumulates in hemodialysis (HD) patients, but its consequences are controversial, particularly in the current era of high-flux dialyzers. High-flux HD treatment improves β2M removal, yet β2M and other middle molecules may still contribute to adverse events. We investigated patient factors associated with serum β2M, evaluated trends in β2M levels and in hospitalizations due to dialysis-related amyloidosis (DRA), and estimated the effect of β2M on mortality.MethodsWe studied European and Japanese participants in the Dialysis Outcomes and Practice Patterns St

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… We fit models using all patients and in prespecified subgroups based on region, residual urine volume (≥200 or <200 mL/day) and dialysis modality [hemodiafiltration (HDF) or HD]. …

Hyperammonemia: An Unusual Cause of Encephalopathy in Multiple Myeloma.

Multiple myeloma (MM) is a malignancy of plasma cells that commonly presents with kidney dysfunction, hypercalcemia, bone pain, and anemia. Although many patients exhibit these symptoms, other, less obvious presentations can complicate the prognosis. In this case report, we describe a 65-year-old African American female with known IgG Kappa MM, who initially presented with back pain - a common symptom associated with bone involvement in MM. However, during her hospital stay, she developed a profoundly altered mental status, which was later linked to elevated ammonia levels. Hyperammonemia is a

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… The patient was trialed on continuous venovenous hemodiafiltration that only resulted in a minimal reduction in ammonia from 128 umol/L to 125 umol/L (Figure 8 , days 13-14). She was then switched to intermittent hemodialysis with an unsuccessful attempt to reduce bicarbonate. …