Papel de la hemodiálisis extendida en COVID-19: a propósito de un caso

Valga, Francisco; Vega-Díaz, Nicanor; Monzón, Tania; Gonzalez-Cabrera, Fayna; Santana, A. S. T.; Baamonde, Eduardo; Gallego, Roberto; Quevedo-Reina, Juan Carlos; Rodríguez‐Pérez, José Carlos

doi:10.1016/j.nefro.2020.05.005

Cited by 1 publication

(2 citation statements)

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“…However, the NLR, PLR, MLR, and LCR are biomarkers of systemic inflammation, available in almost all laboratories, and are rarely used in this infection. The first of them has been the most thoroughly studied and has shown prognostic ability in multiple clinical settings, such as acute kidney injury [ 27 ], kidney disease [ 28 ], cardiovascular disease [ 29 ], ANCA-associated vasculitis [ 30 ], cancer patients [ 31 ], renal transplantation [ 32 ], and recently COVID-19 as a short-term predictor marker associated with severe forms of COVID-19 in HD patients [ 15 , 18 , 33 ]. In our study, the CRP levels at diagnosis were almost double in patients who died, as compared to survivors.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have described the incidence, clinical and radiologic features, laboratory characteristics, and hyperinflammatory parameters, therapeutic strategies, recovery, evolution, outcome, and screening of COVID-19 in MHD patients [10,11,[14][15][16][17][18]23]. However, there are few studies on the technique and the dialyzer used in patients with COVID-19 undergoing hemodialysis [10,19,20], as well as on the response of this infection on the removal of the inflammatory parameters.…”

Section: Discussionmentioning

confidence: 99%

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Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases

Merino

Valga

Marschall

et al. 2021

Case Reports in Nephrology

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Early reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been proposed. Some dialyzers, such as the new generation of asymmetric cellulose triacetate (ATA) membranes, could favor the effective elimination of medium-sized molecules and other inflammatory mediators. In this case series, we describe in depth the clinical, analytical, and radiological details, therapeutic aspects, and outcomes of the case series of 10 MHD patients of our dialysis unit, who tested positive for SARS-CoV-2 from 5 October to 30 November 2020. Furthermore, we evaluate the removal of hyperinflammatory parameters with the ATA membrane in postdilution online hemodiafiltration (OL-HDF) in these patients through a variety of biomarkers of systemic inflammation from the diagnosis until stripping. Biochemical blood analysis was carried out at baseline and at days 7 and 14 after diagnosis, respectively. 50% of the patients presented COVID-19 pneumonia and required hospital admission. Median hospitalization time was 21 days. A total of 4 patients developed severe pneumonia (3 of them died) and 1 patient developed moderate pneumonia. Patients who died (n = 3) were more likely to present bilateral pneumonia (100% vs 14.3%) at diagnosis and less reduction in interleukin 6 (IL-6) at day 14, as compared to those who survived. The use of the ATA membrane could be considered a therapeutic option, due to its immunomodulatory effect in MHD patients with SARS-CoV-2 infection, especially at the beginning of the disease, where the inflammatory component is predominant.

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