Extracorporeal renal replacement therapy and blood purification in critical care

Abstract

RRT is a valuable therapeutic tool for treatment of acute kidney injury and chronic kidney disease. The implementation of an RRT program needs to take into consideration multiple parameters beyond the choice of an RRT platform.

Treatment of acute kidney injury associated with cyclosporine overdose in a dog using hemodialysis and charcoal hemoperfusion

“…Hemodialysis typically is used for removal of uremic toxins, but also can be used for removal of drugs and exogenous poisons . In order to be effectively removed by hemodialysis, toxins should have a low molecular weight (<1,500 Daltons), a low volume of distribution, and minimal plasma protein binding .…”

“…Hemodialysis typically is used for removal of uremic toxins, but also can be used for removal of drugs and exogenous poisons . In order to be effectively removed by hemodialysis, toxins should have a low molecular weight (<1,500 Daltons), a low volume of distribution, and minimal plasma protein binding . The spectrum of toxins that can be removed effectively by extracorporeal techniques is extended when hemodialysis is combined with sorbent hemoperfusion .…”

“…Extracorporeal blood purification therapies are used to eliminate endogenous and exogenous toxins and to treat drug overdose . The veterinary applications of extracorporeal therapy have become more sophisticated and current modalities to remove toxins or drugs include conventional hemodialysis, hemoperfusion, and therapeutic plasma exchange . If the target toxin is a low molecular weight molecule, not protein bound, and its volume of distribution is low, conventional hemodialysis techniques can be used to remove it effectively.…”

“…If the target toxin is a low molecular weight molecule, not protein bound, and its volume of distribution is low, conventional hemodialysis techniques can be used to remove it effectively. However, if molecular size (>1,500 Daltons) or protein binding restricts effective elimination by diffusive hemodialysis, hemoperfusion may be utilized as an alternative technique . In contrast to hemodialysis, during hemoperfusion blood flows directly over a sorbent column commonly composed of activated charcoal .…”

Intermittent hemodialysis in dogs with chronic kidney disease stage III

“…The prognosis and therapy time differ for each patient depending on the underlying cause of disease, degree of renal injury, and presence of comorbidities (FISCHER et al, 2004). IHD has been used in veterinary medicine for 40 years, showing scientific evidence that it can be a safe and effective technique when performed correctly (COWGILL & GUILLAUMIN, 2013).…”