Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Feb 2009
Changes in blood pressure before the development of nosocomial acute kidney injury.
Blood pressure is an important determinant of renal perfusion and acute kidney injury (AKI) is common in hospital patients. However, there is limited knowledge concerning the incidence of relative hypotension prior to its development in general wards. ⋯ Relative hypotension is more common in ward patients who develop nosocomial AKI than in controls. In these patients, a decrease in SBP relative to pre-morbid value is a significant independent predictor of the development of severe AKI.
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Nephrol. Dial. Transplant. · Feb 2009
Comparative StudyHigh-volume haemofiltration with a new haemofiltration membrane having enhanced adsorption properties in septic pigs.
High-volume haemofiltration (HVHF) has been suggested as an adjuvant treatment of septic shock due to its capacities to remove from blood both pro- and anti-inflammatory mediators involved in the sepsis syndrome. Adsorption properties of some haemofiltration membranes are also interesting with this indication because inflammatory mediators are caught in the membrane itself. The aim of this study was to determine the haemodynamic and immunological effects of a new haemofiltration membrane, which has enhanced adsorption properties due to a special surface treatment, allowing the adsorption of endotoxins. ⋯ The use of a membrane with enhanced adsorption properties during a 6-h HVHF session in septic pigs improves haemodynamics compared to a standard haemofiltration membrane. These results are probably due to an efficient endotoxins and cytokines adsorption. A human study using this membrane is now necessary to confirm these results.
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Nephrol. Dial. Transplant. · Jan 2009
Pharmacokinetics of ertapenem in critically ill patients with acute renal failure undergoing extended daily dialysis.
Extended (daily) dialysis (EDD) is an increasingly popular mode of renal replacement therapy in the ICU (intensive care unit) as it combines the advantages of intermittent haemodialysis (IHD) and continuous renal replacement therapy (CRRT), i.e. excellent detoxification accompanied by cardiovascular tolerability. The aim of this study was to evaluate pharmacokinetics (PK) of ertapenem, the newest carbapenem with once-daily dosing, in critically ill patients with anuric acute renal failure (ARF) undergoing EDD. ⋯ In contrast to patients undergoing regular IHD, in which a dose reduction is required, our data suggest that in patients treated with EDD a standard dose of ertapenem (1 g/day), i.e. dose for patients without renal failure, is required to maintain adequate plasma drug levels.
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Nephrol. Dial. Transplant. · Jan 2009
Randomized Controlled Trial Multicenter StudyLongitudinal analysis of performance of estimated glomerular filtration rate as renal function declines in chronic kidney disease.
Numerous studies have assessed the accuracy of equations estimating glomerular filtration rate (eGFR) from serum creatinine in individuals with chronic kidney disease (CKD) in cross-sectional studies. Limited literature exists, however, on the consistency of performance of these equations in longitudinal studies as renal function declines. ⋯ GFR estimates are inexpensive and show an acceptable longitudinal performance for monitoring CKD patients with GFR <50 mL/min/1.73 m(2). Inaccuracies appear more substantial above this level of GFR, and care with interpretation is required.