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Expanded haemodialysis: news from the field.

Expanded haemodialysis (HDx) has emerged as a promising solution to improve haemodialysis effectiveness. A medium cut-off membrane allows the removal of a wider range of uraemic toxins. However, little is known about the potential interesting applications of HDx therapy. Feedback from the first routine use of HDx therapy under real-life conditions in European facilities was excellent for priming and rinse back. There was no adverse event after 5191 HDx treatments. Patients suffering from itching, restless legs syndrome, persistent asthenia or malnourishment could benefit from HDx therapy. More

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… High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients. J Am Soc Nephrol 2013; 24: 487–497 2. Kirsch AH, Lyko R, Nilsson L-G. et al. Performance of hemodialysis with novel medium cut-off dialyzers. Nephrol Dial Transplant 2017; 32: 165–172 3. …

Induction of CYP3A activity by dexamethasone may not be strong, even at high doses: insights from a case of tacrolimus co-administration.

BackgroundDexamethasone (DEX) induces CYP3A activity in a concentration-dependent manner. However, no study has examined changes in the blood concentration of CYP3A substrate drugs when DEX is administered at high doses. Herein, we present a case in which tacrolimus (TAC), a typical CYP3A substrate drug, was co-administered with a chemotherapy regimen that included high-dose DEX.Case presentationA 71-year-old woman underwent liver transplantation for hepatocellular carcinoma 18 years prior to her inclusion in this case study. She was receiving TAC orally at 2 mg/day and had a stable trough blo

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… She was managed in the intensive care unit with continuous hemodiafiltration (CHDF) and positive airway pressure (CPAP) for 2 weeks because of tumor collapse syndrome, left subdural hematoma, and acute kidney injury (AKI). Figure 1 illustrates the course of this case. …

Коронарная артерия, пересадка пациентов с хроническими почечными заболеваниями: хроническая болезнь почек оказывает независимое отрицательное воздействие на долгосрочный результат пересадки коронарных артерий.

Мы изучили краткосрочные и долгосрочные результаты пересадки коронарной артерии (CABG) у пациентов с ишемической болезнью сердца и влияние почечной функции на эти результаты. Мы в том числе 2783 пациентов, прошедших первичную выборную КПЖ в одном учреждении 2002 и 2020 (возраст: 67.6 ± 10.2 годы; мужчина: 2281 мужского пола). Они были стратифицированы на основе их предварительной оценки скорости глумеркулярной фильтрации и прошли через насос CABG (коэффициент завершения, 98.1%); 57.6% в случаях использования двусторонних внутренних грудных артерий (БИТА). Коэффициент смертности в больницах 1.0

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… In our institution, patients on hemodialysis or those with reduced urine output during surgery are made to undergo continuous hemodiafiltration (CHDF) in the intensive care unit. Afterward, patients undergoing dialysis were transferred to the hemodialysis unit after achieving hemodynamic stability. …

Septic Hyperinflammation-Is There a Role for Extracorporeal Blood Purification Techniques?

This manuscript investigates the role of extracorporeal blood purification techniques in managing septic hyperinflammation, a critical aspect of sepsis characterized by an uncontrolled immune response leading to multiorgan dysfunction. We provide an overview of sepsis, focusing on the dynamics of immune response, the involvement of neutrophils, and the role of the endothelium in the disease's progression. It evaluates the effectiveness of various blood purification methods, including high-cut-off membranes, high-volume hemofiltration, adsorption techniques, and albumin dialysis, in removing cy

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… Following a small ( n = 16) retrospective observational study that suggested a positive effect on mortality (37.5% mortality with HCO filter vs. 87.5% with continuous veno-venous hemodiafiltration, p = 0.03), these results were to be verified by the randomized High Cut-Off Sepsis Study (HICOSS) [ 48 … High-Volume Hemofiltration Continuous hemodialysis or hemodiafiltration with high filtration volume is likely the oldest method for extracorporeal removal of small molecules. …

Risk factors for ICU mortality in patients with hematological malignancies: a singlecenter, retrospective cohort study from Turkey.

BACKGROUND: Patients with hematological malignancies (HM) often require admission to the intensive care unit (ICU) due to organ failure, disease progression or treatment-related complications, and they generally have a poor prognosis. Therefore, understanding the factors affecting ICU mortality in HM patients is important. In this study, we aimed to identify the risk factors for ICU mortality in our critically ill HM patients. METHODS: We retrospectively reviewed the medical records of HM patients who were hospitalized in our medical ICU between January 1, 2010 and December 31, 2018. We recor

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… During ICU stay, 227 patients (61.7%) required invasive mechanical ventilation support, 116 (31.5%) developed AKI, 145 underwent renal replacement therapy (intermittent hemodialysis or continuous hemodiafiltration), and 123 (33.4%) developed septic shock ( Table 2 ). …

Изучение воздействия программы ухода за больными на основе эффективности, интегрированной со стратегиями вмешательства в области питания, на результаты лечения нескольких больных миеломой с почечной неполноценностью.

ЦЕЛЬ: Изучение воздействия схемы ухода за больными на основе теории эффективности в сочетании с пищевым вмешательством на пациентов с множественной миеломой (ММ), связанной с почечной недостаточностью. МЕТОДЫ: Ninety-two Пациенты с MM были осложнены почечной недостаточностью в нашей больнице с апреля 2022 по апрель 2024 были произвольно разделены на контрольную группу (46 :: случаи с использованием традиционных медицинских сестер) и наблюдательной группы46 - случаи с использованием схемы ухода за больными, основанной на теории эффективности, в сочетании с мерами в области питания). Показатели

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… Effect of Hemodiafiltration or Hemodialysis on mortality in kidney failure. N Engl J Med. (2023) 389:700–9. doi: 10.1056/NEJMoa2304820, PMID: 21. Jones TL, Edbrooke L, Rawstorn JC, Hayes SC, Maddison R, Denehy L, et al. …

Conservative therapy is associated with worse clinical features and biochemical derangements than renal replacement therapy: a retrospective study in Kumasi, Ghana.

BACKGROUND: The incidence of end stage kidney disease (ESKD) is increasing in Ghana as with the rest of the world. This study compared the sociodemographic, diagnostic characteristics (clinical, biochemical and imaging) and clinical outcomes of ESKD patients who chose either renal replacement therapy (RRT) or conservative therapy as well as the factors that influenced their choice. METHODS: We retrospectively reviewed the records of 382 ESKD patient from 2006 to 2018. The data was collected from the Nephrology Clinic at the Komfo Anokye Teaching Hospital (KATH). Sociodemographic, diagnostic (

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… RRT includes hemodiafiltration, hemodialysis, kidney transplantation and peritoneal dialysis. …

The Molecular Aspect of Antitumor Effects of Protease Inhibitor Nafamostat Mesylate and Its Role in Potential Clinical Applications.

Nafamostat mesylate (NM), a synthetic serine protease inhibitor first placed on the market by Japan Tobacco in 1986, has been approved to treat inflammatory-related diseases, such as pancreatitis. Recently, an increasing number of studies have highlighted the promising effects of NM in inhibiting cancer progression. Alone or in combination treatments, studies have shown that NM attenuates various malignant tumors, including pancreatic, colorectal, gastric, gallbladder, and hepatocellular cancers. In this review, based on several activating pathways, including the canonical Nuclear factor-κB (N

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… Nafamostat mesylate as anticoagulant in continuous hemofiltration and continuous hemodiafiltration. Contrib Nephrol. (1991) 93:215–7. 10.1159/000420222 9. Yamashita Y, Ishiguro Y, Sano D, Kimura M, Fujita K, Yoshida T, et al. …

Subject index

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… risk of ARF in nonsteroidal anti-inflammatory drug users, 531–539 Heart surgery, postoperative renal injury, genetic polymorphisms and, 519–530 Hematopoietic cell transplantation, myeloablative vs. nonmyeloablative, acute renal failure after, 502–509 Hematuria, microscopic, in pregnancy, 667–673 Hemodiafiltration …

Последние новости о диагностике и лечении почечных заболеваний в Множественной миеломе.

Множественная миелома (ММ) представляет собой сложно обработанную плазменную порчу клеток и вторую наиболее часто распространенную гематологическую гелингологию у взрослых, что оказывает значительное воздействие на функцию почек. Широкий спектр участия почек в MM включает в себя дисбаланс электролитов, повреждение трубки и даже редкие глумерлуарные заболевания. Эволюция методов лечения MM привела к заметным улучшениям в долгосрочном выживании пациентов, страдающих осложнениями, связанными с почками. За последнее десятилетие появились новейшие терапевтические агенты, включая протеазные ингибито

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… removal of serum FLC, PLEX is being used in the initial management of severe AKI due to MCN, especially in the presence of serum FLC >150 mg/dL, to target; <50% reduction in serum FLC rapidly, at many centers. 54 While some use high cut-off membranes, others have experimented with online high-efficiency hemodiafiltration …

Risk of malignancy in adult patients with congenital heart disease: a clinical practice review.

This paper presents case studies of adult patients with congenital heart disease (CHD) who developed cancer and also discusses relevant epidemiological studies, risk factors, and reports on early detection. Herein, we describe three cases: a 63-year-old man with an atrial septal defect and multiple myeloma; a 48-year-old man with tetralogy of Fallot and colorectal cancer; and a 25-year-old man with Fontan circulation and hepatocellular carcinoma (HCC). Previous studies have found that the incidence of cancer in adult patients with CHD is higher than that in the general population. The manageme

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… Despite intensive care, including continuous hemodiafiltration, he died after starting palliative care. …

Mechanistic Insights in Hemophagocytic Lymphohistiocytosis: Subsequent Acute Hepatic Failure in a Multiple Myeloma Patient Following Therapy with Ixazomib-Lenalidomide-Dexamethasone.

Hemophagocytic lymphohistiocytosis (HLH) is a rare, elusive, and life-threatening condition that is characterized by the pathologic and uncontrolled secondary activation of the cytotoxic T-cells, natural killer cells (NK-cells), and macrophages of the innate immune system. This condition can develop in sporadic or familial contexts associated with hematological malignancies, as a paraneoplastic syndrome, or linked to an infection related to immune system deficiency. This leads to the systemic inflammation responsible for the overall clinical manifestations. Diagnosis should be thorough, and tr

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… The patient was transferred to the ICU and started treatment with etoposide, high-dose dexamethasone, and hemodiafiltration, according to a previously published protocol [ 56 ]. Unfortunately, the patient died three days later. 8. …

POSTER PRESENTATIONS

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Persistent lactic acidosis in ALK-positive anaplastic large cell lymphoma: a case report and literature review.

Lactic acidosis is common in the ICU, but malignancy-associated type B lactic acidosis mediated by the clinical Warburg effect (CWE) is uncommon and easily missed when infection or organ dysfunction dominates the presentation. We report a 35-year-old man with a month of fever and progressive dyspnea who presented with persistent hyperlactatemia (peak 15.46 mmol/L) and markedly elevated LDH despite stable hemodynamics. Imaging revealed generalized lymphadenopathy, multifocal osteolytic lesions, and bilateral pleural effusions; infectious studies were unrevealing apart from chronic hepatitis B.

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… Additionally, on June 10, in response to acute kidney injury (manifested by oliguria) and refractory metabolic acidosis (pH 7.313, bicarbonate 14.5 mmol/L), continuous renal replacement therapy (CRRT) was commenced (continuous venovenous hemodiafiltration [CVVHDF] mode with bicarbonate replacement fluid …

Hypophosphatemia in cancer patients.

Dysregulation of phosphorus homeostasis resulting in hypophosphatemia is common in cancer patients and can result in serious complications and impact outcomes. Several factors, including critical illness, nutritional status, cancer type and therapy, influence the development of hypophosphatemia. Hypophosphatemia can develop as a result of phosphaturic mesenchymal tumors or as a paraneoplastic phenomenon. The clinical presentation for hypophosphatemia varies depending on the duration and severity of the hypophosphatemia and affects several organ systems. Among other serious effects, hypophospha

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… Electrolytes-enriched hemodiafiltration solutions for continuous renal replacement therapy in acute kidney injury: a crossover study . Blood Purif 2016 ; 42 : 18 – 26 26949936 10.1159/000444248 130 Oronsky B , Caroen S , Oronsky A et al . …

Clinical approaches to osteoporosis in patients with chronic kidney disease: A comprehensive review.

Chronic kidney disease (CKD) induces secondary osteoporosis, characterized by an imbalance between bone formation and resorption due to kidney dysfunction; the result is a reduction in both bone mineral density and quality. This condition is compounded by disruption of bone metabolic turnover, abnormalities in bone microstructure and collagen cross-linking, and compromised bone quality, all of which contribute to increased bone fragility. Reduced kidney function is complicated by secondary hyperparathyroidism, which exacerbates bone fragility. Managing osteoporosis in patients with CKD is chal

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… Rodríguez N, Gómez M, Rico N, María Campistol J, Maduell F (2019) Vancomycin hemodialysis: Clearance differences between high-flux hemodialysis and on-line hemodiafiltration. Artif Organs 43: 261–269. …

Rhabdomyolysis secondary to COVID-19 infection and vaccination: a review of literature.

Rhabdomyolysis (RML), characterized by the breakdown of skeletal muscle fibers and the release of muscle contents into the bloodstream, has emerged as a notable complication associated with Coronavirus disease 2019 (COVID-19) infection and vaccination. Studies have reported an increased incidence of RML in individuals with severe COVID-19 infection. However, the exact mechanisms remain unclear and are believed to involve the host's immune response to the virus. Furthermore, RML has been documented as a rare adverse event following COVID-19 vaccination, particularly with mRNA vaccines. Proposed

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… Hemodiafiltration and continuous renal replacement approach help manage cardiovascular instabilities in patients ( 29 ). …

Углубленный анализ безопасности клеточной терапии CAR-T для твердых опухолей.

В последние годы стремительный прогресс в онкологии, иммунологии и молекулярной биологии привел к резкому усовершенствованию иммунотерапии рака, особенно клеточной терапии CAR-T. Этот новаторский подход включает в себя проектирование Т клеток пациента, чтобы выразить рецепторы, которые специально нацелены на антигены опухоли, расширяя их способность выявлять и устранять раковые клетки. Однако эффективность терапии CAR-T для твердых опухолей зачастую затрудняется из-за сложной микроопухолей (TME). Комплекс TME включает плотную строму, препятствующую инфильтрации Т клеток, аномальные структуры к

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… In terms of supportive care, continuous venovenous hemodiafiltration (CVVH) plays a crucial role in correcting electrolyte imbalances, acid-base disturbances, and fluid management, aiding in renal function recovery and preventing severe complications ( 54 ). …

Diagnostics, Risk Factors, Treatment and Outcomes of Acute Kidney Injury in a New Paradigm.

Acute kidney injury (AKI) is a common clinical condition among patients admitted in the hospitals. The condition is associated with both increased short-term and long-term mortality. With the development of a standardized definition for AKI and the acknowledgment of the impact of AKI on patient outcomes, there has been increased recognition of AKI. Two advances from past decades, the usage of computer decision support and the discovery of AKI biomarkers, have the ability to advance the diagnostic method to and further management of AKI. The increasingly widespread use of electronic health reco

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… The other three modalities are continuous veno-venous hemofiltration (CVVH) (convection), continuous veno-venous hemodialysis (CVVHD) (diffusion) and continuous veno-venous hemodiafiltration (CVVHDF) (diffusion and convection) [ 163 , 164 , 165 , 166 ]. …

Intestinal/Multivisceral Transplantation

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… Continuous venovenous hemodiafiltration is preferred to intermittent hemodialysis in many centers because of the latter’s potential for large fluid shifts leading to hypotension and reduced organ perfusion [ 94 ]. …