Sustained low-efficiency daily dialysis with hemofiltration for acute kidney injury in the presence of sepsis

Bg, Holt; Jj, White; Kuthiala, A; Fall, Pamela J.; Szerlip, Harold M.

doi:10.5414/cnp69040

Cited by 20 publications

(20 citation statements)

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“…In the other 27 studies (2536 survivors), a single initial RRT modality was applied to all patients. This modality was IRRT in 11 of these studies (644 survivors) [42][43][44][45][46][47][48][49][50][51][52] and CRRT in 16 (1892 survivors) [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68].…”

Section: Resultsmentioning

confidence: 99%

Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis

et al. 2013

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Section: Resultsmentioning

confidence: 99%

Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis

et al. 2013

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“…Recent studies have shown that patients treated with high-volume hemofiltration, daily IHD or SLEDD-f demonstrate lower mortality and an improved solute clearance [ 13 , 14 , 15 ]. However, studies on the application of SLEDD-f in patients with AKI/DN are still limited [ 13 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Sustained Low-Efficiency Daily Diafiltration for Diabetic Nephropathy Patients with Acute Kidney Injury

Chen

2014

Med Princ Pract

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Objective: To investigate the efficacy, safety and cost of treating patients with acute kidney injury (AKI) and diabetic nephropathy (DN) with continuous renal replacement therapy (CRRT) or sustained low-efficiency daily diafiltration with hemofiltration (SLEDD-f). Subjects and Methods: Medical records of patients with AKI/DN from January 2006 to December 2012 were reviewed. Fifty-five patients who received CRRT and 52 who received SLEDD-f were included in the study. CRRT and SLEDD-f were performed for 20-72 h per session and 8-10 h per session, respectively. Mortality and renal function recovery rates were evaluated 30 days after the initiation of renal replacement therapy (RRT) and APACHE-II and SOFA scores, anticoagulant dose, inflammatory indices and cost were calculated at baseline and at the end of RRT. Results: Of the 55 patients treated with CRRT, 49 (89.1%) had a 30-day survival rate and 30 (54.5%) had a 30-day renal recovery rate. Of the 52 patients with SLEDD-f, these rates were 92.3% (n = 48) and 61.5% (n = 32), respectively. The dosage of low-molecular-weight heparin in the CRRT and SLEDD-f groups was 15,230 ± 1,460 and 6,320 ± 490 U/day, respectively. The cost of hemopurification and the total cost for patients treated with CRRT was CNY 28,628 ± 5,576 (USD 4,210 ± 820) and CNY 38,828 ± 6,324 (USD 5,710 ± 930), respectively. These were higher than those for patients treated with SLEDD-f at CNY 13,260 ± 1,564 (USD 1,950 ± 230) and CNY 19,720 ± 2,652 (USD 2,900 ± 390), respectively. Conclusions: SLEDD-f offered a similar chance of renal recovery and also had further advantages such as a lower heparin dosage, a shorter therapy time and lower hospitalization costs for patients than CRRT. Studies with larger, randomized sample sizes are needed to confirm these findings.

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“…Although RRT is important in saving critically injured AKI patients, there is no consensus regarding the optimal dose or form. There is insufficient evidence to show that continuous renal replacement therapy (CRRT) is better than intermittent renal replacement therapy (IRRT) [4,5], and the efficacy of hybrid patterns, such as sustained low-efficiency dialysis (SLED), has not yet been evaluated [6]. It is also unclear what the optimal dose is, although it is argued that, for critically injured AKI patients, the dose should be at least 35 ml/kg/h of hemofiltration (HF) and an spKt/V value of 1.4 for hemodialysis (HD) [7].…”

Section: Introductionmentioning

confidence: 99%

New, goal-directed approach to renal replacement therapy improves acute kidney injury treatment after cardiac surgery

Ding

Fang

et al. 2014

J Cardiothorac Surg

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Aim: The aim of this study was to compare the efficacies of goal-directed renal replacement therapy (GDRRT) and daily hemofiltration (DHF) for treating acute kidney injury (AKI) patients after cardiac surgery. Methods: In our retrospective study, we included 140 cardiac surgery AKI patients who were treated with renal replacement therapy (RRT) from 2002 to 2010. Two patient groups, which comprised 70 patients who received DHF from January 2002 to September 2008 and 70 patients treated with GDRRT from October 2009 to September 2010 were pair-wise compared regarding clinical outcomes, as well as the incidence of adverse events.Results: In-hospital and 30-day mortality rates were 45.7% and 41.4% in the GDRRT and 48.6% and 54.3% in the DHF group, respectively, but without statistically significant differences. GDRRT patients needed statistically significantly shorter hospital and intensive care unit (ICU) stays, less frequent RRT, and shorter RRT sessions, whereas, of 11 analyzed renal outcome parameters, 6 values, including percentage of complete renal recovery and time for complete renal recovery, were significantly superior in the GDRRT group at the time of discharge. There was no significant difference in the incidence of adverse events within the initial 72 treatment hours between the 2 groups. Hospitalization expenses were less in GDRRT group than in DHF group. Conclusion:The GDRRT approach is superior to DHF for improving renal outcome, as well as reducing the time and cost of RRT therapy, for cardiac surgery AKI patients.

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Sustained low-efficiency daily dialysis with hemofiltration for acute kidney injury in the presence of sepsis

Cited by 20 publications

References 0 publications

Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis

Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis

Sustained Low-Efficiency Daily Diafiltration for Diabetic Nephropathy Patients with Acute Kidney Injury

New, goal-directed approach to renal replacement therapy improves acute kidney injury treatment after cardiac surgery

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