CRRT for sepsis-induced acute kidney injury

Purpose of review Sepsis-induced acute kidney injury (SI-AKI) represents the first cause of AKI in ICUs, and renal replacement therapy (RRT) is frequently applied in advanced AKI stages. The debate between ‘rescue’ indications for RRT start in patients with severe AKI (acidosis, hyperkalemia, uremia, oliguria/anuria, volume overload) and a proactive RRT initiation is still ongoing. In addition, current SI-AKI pathophysiologic theory has identified the toxic effects of soluble middle-molecules released during sepsis and inflammation (pathogen and damaged associated molecular patterns). The purpose of the present review is to summarize the recent literature on RRT for patients with SI-AKI. Supportive or replacement measures for severe stages of renal dysfunction and blood purification techniques for sepsis syndrome will be reviewed. Recent findings Anticipated RRT for SI-AKI does not seem to improve survival or renal recovery. There is no clinical advantage by delivering continuous RRT at high doses for blood purification purposes. Similarly, specific applications with dedicated devices and membranes have yielded no clinical benefit in these patients, so far. Summary In the present review, the recent insights and results from large randomized and nonrandomized trials in the area of RRT applied both as supportive measures for kidney failure and blood purification techniques are described.

• Publication year

  2018

• Venue

  Current Opinion in Critical Care

• Publication date

  2018-09-18

• Fields of study

  Medicine

• Identifiers
  DOI 10.1097/MCC.0000000000000544PMID 30239411
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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• Paradigms of acute kidney injury in the intensive care setting

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• Organ dysfunction during continuous veno-venous high cut-off hemodialysis in patients with septic acute kidney injury: A prospective observational study

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• High-volume haemofiltration for sepsis in adults.

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• Extracorporeal Treatments in Patients with Acute Kidney Injury and Sepsis.

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• High Cut-off Membranes in Acute Kidney Injury and Continuous Renal Replacement Therapy

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• Sepsis-Associated AKI.

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• Renal replacement therapy for AKI: When? How much? When to stop?

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  2016cited by this paper
• Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit.

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• When to start a renal replacement therapy in acute kidney injury (AKI) patients: many irons in the fire.

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• High-Dose Versus Conventional-Dose Continuous Venovenous Hemodiafiltration and Patient and Kidney Survival and Cytokine Removal in Sepsis-Associated Acute Kidney Injury: A Randomized Controlled Trial.

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• Why are patients still getting and dying from acute kidney injury?

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• Effectiveness of High Cut-Off Hemofilters in the Removal of Selected Cytokines in Patients During Septic Shock Accompanied by Acute Kidney Injury-Preliminary Study

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• Hemodialysis with High Cut-Off Hemodialyzers in Patients with Multi-Drug Resistant Gram-Negative Sepsis and Acute Kidney Injury: A Retrospective, Case-Control Study

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• Sepsis-induced acute kidney injury

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• Does early-start renal replacement therapy improve outcomes for patients with acute kidney injury?

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• Comparison of standard and accelerated initiation of renal replacement therapy in acute kidney injury.

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• Very high volume hemofiltration with the Cascade system in septic shock patients

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• Efficacy of coupled plasma filtration adsorption (CPFA) in patients with septic shock: A multicenter randomised controlled clinical trial

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• Assessment of the worldwide burden of critical illness: the intensive care over nations (ICON) audit.

  2014cited by this paper
• A Unified Theory of Sepsis-Induced Acute Kidney Injury: Inflammation, Microcirculatory Dysfunction, Bioenergetics, and the Tubular Cell Adaptation to Injury

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• Cytokines in Sepsis: Potent Immunoregulators and Potential Therapeutic Targets—An Updated View

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  2012cited by this paper
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• In Vitro Evaluation of High Mobility Group Box 1 Protein Removal with Various Membranes for Continuous Hemofiltration

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• Fluid balance, diuretic use, and mortality in acute kidney injury.

  2011cited by this paper
• Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients

  2010cited by this paper
• Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis.

  2009cited by this paper
• Intensity of continuous renal-replacement therapy in critically ill patients.

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• Intensity of renal support in critically ill patients with acute kidney injury.

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• Pilot study on the effects of high cutoff hemofiltration on the need for norepinephrine in septic patients with acute renal failure*

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• Acute renal failure in critically ill patients: a multinational, multicenter study.

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