A review: continuous renal replacement therapy for sepsis-associated acute kidney injury

Xu, Jundong

doi:10.1080/26895293.2022.2163305

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Acute Kidney Injury is a sudden fall in the kidney function and its foremost cause is sepsis 1 .AKI is independently associated with complications, poor prognosis and high mortality 2 . Septic AKI is considered to be a distinct clinical entity.…”

Section: Introductionmentioning

confidence: 99%

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Plasma NGAL (Neutrophil Gelatinase Associated Lipocalin) Levels in Septic Patients With & Without Acute Kidney Injury: A Plausible Biomarker

Amber Naureen,

Maryam Rao,

Farkhanda Naimat

et al. 2024

Proceedings S.Z.M.C

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Introduction: Acute kidney injury is extremely common among septic patients. Its early recognition among critically ill patients can help in better prognosis and decrease the risk of longer hospital stay and dialysis requirement. Creatinine is considered as a gold standard for diagnosis of Acute Kidney Injury but it has its own disadvantages. New biomarkers for Acute Kidney Injury that can help in its early recognition are the need of time. Many plasma and urinary markers including Neutrophil Gelatinase Associated Lipocalin are being studied. Its role in earlier detection of septic Acute Kidney Injury in septic patients in our set of population still needs extensive research where incidence of sepsis associated complications leading to death is extremely high. Aims and Objectives: To measure plasma Neutrophil Gelatinase Associated Lipocalin levels in septic patients with and without acute injury compare pNGAL levels in two groups, and to measure specificity and sensitivity of plasma Neutrophil Gelatinase Associated Lipocalin levels in both sets of patients. Place and Duration of study: A cross sectional analytical study was carried out in National Health Research Complex, Shaikh Zayed Hospital, Lahore over a period of 3 years from 2016-2019 Material and Methods: This is a cross-sectional analytical study carried out in ninety two patients that are divided in two groups on the basis of creatinine levels measured at 72hrs. First group consists of septic patients who developed Acute Kidney Injury (AKI) and second group consists of septic patients Without Acute Kidney Injury(WAKI). Plasma NGAL levels are compared in two groups. SPSS v 20 was used for analysis, p-value ? 0.05 was considered significant. Results: The plasma NGAL level at 24 hours for group without Acute Kidney Injury was 126.4±15.4 ng/ml and for the group which developed Acute kidney Injury was 191.1±15.9 ng/ml and the difference was clearly significant with p- value <0.001. Conclusion: pNGAL levels are significantly raised than the cut-off value of 150ng/ml at 0hrs in septic patients who developed AKI as compared to septic patients who didn’t develop AKI.

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Section: Introductionmentioning

confidence: 99%

“…Globally, acute generalized peritonitis ranks among the top surgical emergencies 1 . It is more common in Third World nations.…”

Section: Introductionmentioning

confidence: 99%

Plasma NGAL (Neutrophil Gelatinase Associated Lipocalin) Levels in Septic Patients With & Without Acute Kidney Injury: A Plausible Biomarker

Amber Naureen,

Maryam Rao,

Farkhanda Naimat

et al. 2024

Proceedings S.Z.M.C

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Bedside emergency surgical decompression and venoarterial extra‐corporeal membrane oxygenation for obstructive uropathy with uroseptic cardiomyopathy‐induced arrest: A case report

Xiong,

Xu,

Kwan

et al. 2024

UroPrecision

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BackgroundSeptic shock combined with septic cardiomyopathy greatly increases the risk of mortality in elderly patients. Patients with a rapid deteriorating state unresponsive to standard resuscitation may benefit from extra‐corporeal membrane oxygenation (ECMO). In cases where obstructive uropathies lead to urosepsis, emergent decompression with double‐J (D‐J) stenting may be necessitated.Case PresentationWe report the case of a 72‐year‐old woman who arrived at the emergency department and rapidly deteriorated into a state of shock. During the process of resuscitation, emergent biochemical and ultrasound results suggested septicemia and septic cardiomyopathy due to urinary tract infection caused by ureteric stone obstruction. She was transferred to the intensive care unit to be put on venoarterial ECMO after failed resuscitation. Given the suspected diagnosis, it was decided that an emergent bedside digital disposable flexible ureteroscopy (ddFURS) and D‐J catheterization to be performed as rescue decompression procedure. The patient was successfully stabilized with received antibiotic and continuous renal replacement therapy (CRRT) before being transferred to the cardiology department to correct her arrhythmia. She was weaned off CRRT and was able to walk without the need of aids upon discharge.ConclusionUroseptic cardiomyopathy can rapidly progress to renal and cardiac failure. Emergent decompression with ddFURS and D‐J stenting can be performed effectively even in a patient with venoarterial ECMO for rescuing uroseptic cardiomyopathy‐induced arrest secondary to obstructive uropathy. Short‐term outcomes were favorable. However, long‐term prognosis remains to be elucidated.

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Linezolid Adsorption on Filters during Continuous Renal Replacement Therapy: An In Vitro Study

Nosek,

Samiec,

Ziółkowski

et al. 2024

Pharmaceuticals

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Background: Renal replacement therapy (RRT), widely used in the treatment of renal injury during sepsis, aims to eliminate the toxins and proinflammatory cytokines involved in the pathomechanism underlying septic shock. Dialysis filters are characterized by a high adsorption potential for cytokines in RRT in the case of septic renal injury. For the treatment of sepsis with antibiotics, it is of key importance to achieve the desired values of PK/PD indices. Continuous renal replacement therapy (CRRT) may affect antimicrobial clearance, increasing their elimination in some cases. Methods: The aim of this study was to determine the degree of adsorption for linezolid on three different types of filters used in CRRT. In our in vitro study, a continuous veno-venous hemofiltration (CVVH) was conducted using three types of filters: polysulfone (PS), polyethyleneimine-treated polyacrylonitrile (PAN PEI), and non-PEI-treated polyacrylonitrile (PAN). Each type of filter was used in three CVVH cycles, involving the use of 600 mg of linezolid dissolved in 700 mL of bovine blood or in 700 mL of 0.9% NaCl. In each case, the total volume of the obtained solution was 1000 mL. Blood samples were collected at particular time points to measure their drug concentration. The differences in mean drug/NaCl adsorption and drug/blood adsorption were determined using a one-way ANOVA with multiple comparisons via Tukey’s post hoc test; a p-value of <0.05 was considered significant. Results: A significant adsorption of linezolid was found for PAN PEI filters, both in samples obtained from bovine blood and 0.9% NaCl solutions, at the endpoint. In PAN PEI samples, the concentration of linezolid in 0.9% NaCl solutions decreased from 594.74 μg/mL to 310.66 μg/mL after 120 min (the difference was established at 52%). In blood samples, the initial concentration was 495.18 μg/mL, which then decreased to 359.84 μg/mL (73% of the beginning value). No significant adsorption was demonstrated on PAN or PS filters. Conclusion: There is a need for in vivo research to confirm the effect of filter type on linezolid concentration in patients undergoing CRRT.

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A review: continuous renal replacement therapy for sepsis-associated acute kidney injury

Cited by 3 publications

References 27 publications

Plasma NGAL (Neutrophil Gelatinase Associated Lipocalin) Levels in Septic Patients With & Without Acute Kidney Injury: A Plausible Biomarker

Plasma NGAL (Neutrophil Gelatinase Associated Lipocalin) Levels in Septic Patients With & Without Acute Kidney Injury: A Plausible Biomarker

Bedside emergency surgical decompression and venoarterial extra‐corporeal membrane oxygenation for obstructive uropathy with uroseptic cardiomyopathy‐induced arrest: A case report

Linezolid Adsorption on Filters during Continuous Renal Replacement Therapy: An In Vitro Study

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