Extracorporeal Techniques Based on Adsorption: Nomenclature, Hardware, and Circuit Design

Sepsis-associated acute kidney injury: is COVID-19 different?

High Cut-off Dialysis Membranes: Current Uses and Future Potential

Long-Term Outcomes of Acute Kidney Injury

Oxalate Nephropathy Caused by Excessive Vitamin C Administration in 2 Patients With COVID-19

Influence of renal replacement therapy on outcome of patients with acute renal failure

Towards Consensus in Timing of Kidney Replacement Therapy for Acute Kidney Injury?

Urinary IL-18 is an early predictive biomarker of acute kidney injury after cardiac surgery

Acute kidney injury requiring renal replacement therapy during the COVID-19 pandemic: what are our options for treating it in Latin America?

Improving Outcomes From Acute Kidney Injury: Report of an Initiative

Do Children With Acute Kidney Injury Require Long-term Evaluation for CKD?

Acute kidney injury (AKI) is a common complication in hospitalized patients, with an incidence of 3 to 10% (1–4). In-hospital mortality rates that are associated with AKI remain high, in the range of 30 to 70% (5–8), despite significant improvements in dialytic technology as well as important advances in critical care, which have resulted in improved survival for other critical illnesses, including acute lung injury and sepsis (9). These improvements include continuous renal replacement therapies, which allow for continuous removal of solutes and fluid and may be tolerated better from a hemodynamic standpoint, and biocompatible dialysis membranes, which are associated with reduced complement and granulocyte activation. In general, indications for dialysis in the acute care setting have been extrapolated from those that are applied in chronic kidney disease, including volume overload that is refractory to diuretic therapy; electrolyte abnormalities (in particular hyperkalemia); uremic complications (pericarditis or pleuritis); severe acidosis (pH < 7.20); and selected toxic ingestions, such as methanol, ethylene glycol, and other water-soluble agents (10,11). However, the evidence base supporting specific dialysis practices in the acute care setting is limited. For example, several studies that were completed in the 1960s and 1970s compared “early” and “late” initiation of dialysis, using blood urea nitrogen (BUN) to define early and late (Table 1). These studies primarily were cohort studies that used historical controls, not randomized, clinical trials. The results of these investigations, along with extrapolation from the ESRD population, promoted recent practice patterns. Currently, many nephrologists often delay dialysis in the acute care setting until the patient has an impending complication of AKI, such as hyperkalemia leading to cardiac arrhythmias, acidosis resulting in hypotension, or oliguria leading to volume overload or hypoxemia, or until the BUN exceeds 100 mg/dl (18). Given differences in protein catabolism, …

Critical Care Nephrology: Core Curriculum 2009

Do circulating cytokines really matter in sepsis?

Dialysis Dosing in Critically Ill Patients With Acute Kidney Injury

Acute kidney injury (AKI) is a common disease, with an increasing incidence, and critically ill patients with AKI are usually associated with a high mortality. Recently, novel therapeutic approaches have been developed to change this dismal prognosis in patients with AKI, among which cell therapy has developed into a new method to treat a vast array of clinical disorders. For safety reasons, extracorporeal cell therapy may be a better choice, which not only replaces the function of injured cells or modulates the pathophysiological processes, but also provides an immunoprotective barrier. This review focused on different extracorporeal cell therapies with renal epithelial cells, granulocytes, and vascular endothelial cells. Extracorporeal cell therapy with renal epithelial cells or granulocytes has a significant positive effect on the survival of patients with AKI, compared with the conventional continuous renal replacement treatment. The authors had developed an endothelial cell therapy system, which could significantly improve the cardiovascular performance, organ function, and survival in animals with sepsis. These advances will result in an improvement of the current dismal prognosis of patients suffering from AKI. Key words: Extracorporeal cell therapy; Acute kidney injury; Vascular endothelial cell; Renal tubular epithelial cell; Granulocyte