Current Status of Blood Purification in Critical Care in Japan

Kaizu, Kazo; Inada, Y; Kawamura, Akio; Oda, Seito; Hirasawa, Hiroyuki

doi:10.1159/000314844

Cited by 12 publications

(10 citation statements)

References 3 publications

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“…The optimal modality of blood purification for acute kidney injury (AKI) has been investigated. The primary continuous and intermittent modalities used in Japan are continuous hemodiafiltration (CHDF) and hemodialysis (HD), respectively [ 243 ]. The choice of therapy is generally based on a consideration of various factors, including the patient’s hemodynamics and anticoagulation, the facility’s equipment, and the staff’s experience and manpower.…”

Section: Commentarymentioning

confidence: 99%

The Japanese clinical practice guideline for acute kidney injury 2016

et al. 2018

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Acute kidney injury (AKI) is a syndrome which has a broad range of etiologic factors depending on different clinical settings. Because AKI has significant impacts on prognosis in any clinical settings, early detection and intervention is necessary to improve the outcomes of AKI patients. This clinical guideline for AKI was developed by a multidisciplinary approach with nephrology, intensive care medicine, blood purification, and pediatrics. Of note, clinical practice for AKI management which was widely performed in Japan was also evaluated with comprehensive literature search.

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Section: Commentarymentioning

confidence: 99%

The Japanese clinical practice guideline for acute kidney injury 2016

et al. 2018

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show abstract

“…The optimal modality of blood purification for acute kidney injury (AKI) has been investigated. The primary continuous and intermittent modalities used in Japan are continuous hemodiafiltration (CHDF) and hemodialysis (HD), respectively [ 241 ]. The choice of therapy is generally based on a consideration of various factors, including the patient’s hemodynamics and anticoagulation, the facility’s equipment, and the staff’s experience and manpower.…”

Section: Cq7-4: Should Blood Purification For Aki Be Performed Continmentioning

confidence: 99%

The Japanese Clinical Practice Guideline for acute kidney injury 2016

et al. 2018

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Acute kidney injury (AKI) is a syndrome which has a broad range of etiologic factors depending on different clinical settings. Because AKI has significant impacts on prognosis in any clinical settings, early detection and intervention are necessary to improve the outcomes of AKI patients. This clinical guideline for AKI was developed by a multidisciplinary approach with nephrology, intensive care medicine, blood purification, and pediatrics. Of note, clinical practice for AKI management which was widely performed in Japan was also evaluated with comprehensive literature search.

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“…The Beginning and Ending Supportive Therapy (BEST) kidney study, analyzing current methods of CRRT for AKI among 54 ICUs in 23 countries, showed that CVVHF was used most commonly (52.8 %), followed by CVVHDF (34 %) and CVVHD (13.1 %) [54]. In Japan, approximately 80 % of patients with AKI in the ICU who require CRRT are treated with CHDF [55]. At present, there is insufficient evidence or consensus to recommend the best RRT treatment modality for patients with AKI requiring RRT, although CRRT may be preferable to IRRT in hemodynamically unstable patients with AKI.…”

Section: Rrt Modality and Rrt Mode In Patients With Akimentioning

confidence: 99%

Renal replacement therapy for acute kidney injury

et al. 2016

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The annual incidence of acute kidney injury (AKI) has been increasing as the population ages. Despite advances in critical care and dialysis technology, the mortality remains unacceptably high in patients with AKI during the past few decades. Renal replacement therapy (RRT) is performed to treat patients with severe AKI and multiple organ failures, as well as to remove fluid in patients with fluid overload including those with acute heart failure and lung edema in the intensive care unit (ICU). The mortality in patients with AKI requiring RRT is higher than 50 %. RRT strategies in patients with AKI depend on various conditions. However, there is little consensus on when to start and stop RRT, its optimal dose, and the choice of different RRT modalities (intermittent versus (vs.) continuous) in patients with AKI. Patients with AKI in the ICU are preferentially treated with continuous rather than intermittent RRT (IRRT), usually because of hemodynamic stability and steady of solute clearance. At present, the type and dose of RRT are dependent on the experience of the attending clinicians, including intensivists and nephrologists.

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Current Status of Blood Purification in Critical Care in Japan

Cited by 12 publications

References 3 publications

The Japanese clinical practice guideline for acute kidney injury 2016

The Japanese clinical practice guideline for acute kidney injury 2016

The Japanese Clinical Practice Guideline for acute kidney injury 2016

Renal replacement therapy for acute kidney injury

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