Kinetic Comparison of Different Acute Dialysis Therapies

Liao, Zhenyu; Zhang, Weiming; Hardy, Peter; Poh, Churn K.; Huang, Zhongping; Kraus, Michael A.; Clark, William R.; Gao, Dayong

doi:10.1046/j.1525-1594.2003.07282.x

Cited by 67 publications

(27 citation statements)

References 22 publications

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“…At the same time it is less expensive than CRRT. 6,7 So, SLED combines the therapeutic advantages of CRRT with the logistic and cost advantages of iHD. Our study aimed to investigate the hemodynamic stability in critically ill patients with AKI treated with SLED.…”

Section: Resultsmentioning

confidence: 99%

Hemodynamic Tolerability of Sustained Low Efficiency Dialysis in Critically Ill Patients with Acute Kidney Injury

et al. 2017

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Background: Sustained low efficiency dialysis (SLED) has been evolved in recent years as technical hybrid of continuous renal replacement therapy and intermittent hemodialysis. It offers optimized hemodynamic stability of the critically ill patients with acute kidney injury (AKI). Our aim was to evaluate the hemodynamic tolerability of SLED in hemodynamically unstable patients with AKI.Methods: This prospective experimental study was conducted in Intensive Care Unit of BIRDEM General Hospital, Dhaka over a period of one year.Results: Forty three hemodynamically unstable patients with AKI were treated with one fifty three sessions of SLED. Mean arterial pressure of the patients before starting dialysis were 80.58±10.92 mmHg and 69.8% patients were on inotrope support. There were no significant differences (p>0.05) in mean arterial pressure during the procedure. No significant changes (p>0.05) occurred in pulse, respiratory rate and temperature during the sessions. Only thirty six out of 153 SLED sessions were associated with complications and hypotension was the commonest one (20.26%). Hypotensive episodes were effectively managed with addition or dose escalation of inotropes. No dialysis had to be discontinued because of hypotension/arrhythmia.Conclusion: SLED is an effective renal replacement therapy for the critically ill patients with AKI which maintains their hemodynamic stability.Birdem Med J 2016; 6(2): 84-90

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Section: Resultsmentioning

confidence: 99%

Hemodynamic Tolerability of Sustained Low Efficiency Dialysis in Critically Ill Patients with Acute Kidney Injury

et al. 2017

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“…At the same time it is less expensive than CRRT. 10,11 So, SLED combines the therapeutic advantages of CRRT with the logistic and cost advantages of intermittent HD.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamically Unstable Acute Kidney Injury Patients Treated with Sustained Low Efficiency Dialysis: Outcome in an ICU of Bangladesh

Fatema¹,

Faruq²

2017

Bangladesh Med Res Counc Bull

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Acute kidney injury (AKI) is a risk factor for increased mortality in critically ill patients. Sustained low efficiency dialysis (SLED) is a new approach in renal replacement therapy (RRT) and it combines the advantages of continuous renal replacement therapy (CRRT) and intermittent haemodialysis (HD). The study was aimed to evaluate the outcome of the haemodynamically unstable patients with AKI in Bangladesh who were treated with SLED. So far this is the first reported study on SLED in intensive care unit (ICU) in Bangladesh. This quasi-experimental study was conducted in a 10-bed adult ICU of a tertiary care hospital in Bangladesh from June 2012 to May 2013. A total of 153 sessions of SLED were performed on 43 AKI patients. Mean age of the patients was 60.12 ± 15.57 years with male preponderance (67.4% were male). Mean APACHE II score was 26.88 ± 6.25. Fourteen patients (32.55%) had de novo AKI. Twenty nine patients (67.4%) had chronic kidney disease (CKD) with baseline mean serum creatinine 2.56 mg/dl, but did not require any RRT before admission in ICU. After giving SLED, AKI of the study patients were completely resolved in 27.9%. Some forty two percent patients became dialysis dependant and 30.23% patients died. Patients who had AKI on CKD became dialysis dependant more often than the patients with de novo AKI (p <0.01). Mortality rate was significantly higher in patients who were on inotrope support (p= 0.017). Otherwise, there was no relation of 28 day mortality with age, prior renal function and mechanical ventilator requirement (p>0.05). Thus, SLED is an excellent renal replacement therapy for the haemodynamically unstable AKI patients of ICU. It is also cost-effective compared to CRRT.

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“…This is similar to our 70% reduction with 12 h of SLED. Liao et al [3] performed a kinetic comparison between continuous veno-venous haemofiltration (CVVH), SLED and haemodialysis. The solute clearance in CVVH was 8 and 60% higher than SLED and intermittent haemodialysis, respectively.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of sustained low-efficiency dialysis in the treatment of salicylate toxicity

Lund¹,

Seifert²,

Mayersohn³

2005

Nephrology Dialysis Transplantation

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Sustained low-efficiency dialysis (SLED) has been used for acute renal replacement therapy [1]. It has not been evaluated in the management of salicylate toxicity or the toxicity of any agent, however. We present a case of severe salicylate toxicity initially managed with haemodialysis and then with SLED. The efficacy of SLED is compared with that found in the literature for haemodialysis and continuous therapies. CaseThe patient was a 24-year-old male evaluated at a referring hospital 14 h after the ingestion of one hundred 325 mg salicylate pills (32 500 mg total dose). The serum salicylate concentration at that time was 110 mg/dl. He was transferred to our institution for dialysis.On arrival he had been treated with intravenous bicarbonate and oral charcoal. He was afebrile with a pulse of 145 b.p.m., blood pressure was 98/62 mmHg and respirations were 35/min. He was alert and oriented but anxious, tremulous and diaphoretic. ECG demonstrated sinus tachycardia and chest X-ray was normal. Blood gases were determined at presentation with pH 7.44, pCO 2 20 mmHg, and PO 2 86 mmHg. Pertinent laboratory data included: haemoglobin 17.3 g/dl, sodium 136 mmol/l, potassium 4.9 mmol/l, chloride 94 mmol/l, bicarbonate 13 mmol/l, anion gap 29 mmol/l, BUN 35 mg/dl, creatinine 2.9 mg/dl, glucose 161 mg/dl, calcium 11.1 mg/dl, phosphorus 9.9 mg/dl and INR 2.2.

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Kinetic Comparison of Different Acute Dialysis Therapies

Cited by 67 publications

References 22 publications

Hemodynamic Tolerability of Sustained Low Efficiency Dialysis in Critically Ill Patients with Acute Kidney Injury

Hemodynamic Tolerability of Sustained Low Efficiency Dialysis in Critically Ill Patients with Acute Kidney Injury

Haemodynamically Unstable Acute Kidney Injury Patients Treated with Sustained Low Efficiency Dialysis: Outcome in an ICU of Bangladesh

Efficacy of sustained low-efficiency dialysis in the treatment of salicylate toxicity

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