PMID- 32907438
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20220422
IS  - 1724-6040 (Electronic)
IS  - 0391-3988 (Linking)
VI  - 44
IP  - 4
DP  - 2021 Apr
TI  - Intermittent hemodiafiltration as a down-step transition therapy in patients with 
      acute kidney injury admitted to intensive care unit who initially underwent 
      continuous venovenous hemodiafiltration.
PG  - 223-228
LID - 10.1177/0391398820952801 [doi]
AB  - BACKGROUND/AIMS: Continuous renal replacement therapies (CRRT) are initially 
      employed in patients with acute kidney injury (AKI) in ICU setting. After the 
      period of serious illness, hemodialysis is usually used as a mode of transition 
      from CRRT. Intermittent hemodiafiltration (HDF) is not commonly applied in this 
      scenario. OBJECTIVES: To evaluate the feasibility of using HDF as transition 
      therapy after CVVHDF in critically patients with AKI. METHODS: An observational 
      and prospective pilot study was conducted in ICU patients with dialysis-requiring 
      AKI. Patients were initially treated with CVVHDF and, after medical improvement, 
      those who still needed renal replacement therapy were switched to HDF treatment. 
      RESULTS: Ten Patients underwent 53 HDF sessions (mean of 5.3 sessions/patient). 
      The main cause of renal dysfunction was sepsis (N = 7; 70%). The APACHE II mean 
      score was 27.6 +/- 6.9. During HDF treatment, the urea reduction ratio was 64.5 +/- 
      7.5%, for beta-2 microglobulin serum levels the percentage of decrease was 42.0 +/- 
      7.8%, and for Cystatin C was 36.2 +/- 6.9%. Five episodes of arterial hypotension 
      occurred (9.4% of sessions). There were 20 episodes of electrolytic disturbance 
      (37.7% of sessions), mainly hypophosphatemia. No pyrogenic or suggestive episode 
      of bacteremia was observed. CONCLUSION: Hemodiafiltration was safe and efficient 
      to treat critically ill patients with acute kidney injury during the transition 
      phase from continuous to intermittent dialysis modality. Special attention should 
      be paid regarding the occurrence of electrolytic disturbance, mainly 
      hypophosphatemia.
FAU - Scherer, Patricia Faria
AU  - Scherer PF
AUID- ORCID: 0000-0002-6927-1672
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Intensive Care Unit, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Iizuka, Ilson Jorge
AU  - Iizuka IJ
AD  - Dialysis Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Ammirati, Adriano Luiz
AU  - Ammirati AL
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Dialysis Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Doher, Marisa Petrucelli
AU  - Doher MP
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Dialysis Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Matsui, Thais Nemoto
AU  - Matsui TN
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Dialysis Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Dos Santos, Bento Fortunato Cardoso
AU  - Dos Santos BFC
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Dialysis Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Monte, Julio Cesar Martins
AU  - Monte JCM
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Batista, Marcelo Costa
AU  - Batista MC
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Nephrology Division, Escola Paulista de Medicina, Universidade Federal de Sao 
      Paulo, Brazil.
FAU - Pereira, Virgilio Goncalves
AU  - Pereira VG
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Dos Santos, Oscar Fernando Pavao
AU  - Dos Santos OFP
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Nephrology Division, Escola Paulista de Medicina, Universidade Federal de Sao 
      Paulo, Brazil.
FAU - Durao, Marcelino de Souza
AU  - Durao MS
AUID- ORCID: 0000-0003-1341-5697
AD  - Nephrology Division, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
AD  - Nephrology Division, Escola Paulista de Medicina, Universidade Federal de Sao 
      Paulo, Brazil.
AD  - Kidney Transplant Unit, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200910
PL  - United States
TA  - Int J Artif Organs
JT  - The International journal of artificial organs
JID - 7802649
SB  - IM
MH  - *Acute Kidney Injury/etiology/therapy
MH  - Continuous Renal Replacement Therapy/methods
MH  - Critical Illness/*therapy
MH  - Female
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Intensive Care Units/statistics & numerical data
MH  - Intermittent Renal Replacement Therapy/*methods
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Sepsis/complications
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Acute renal failure
OT  - apheresis & detoxification techniques
OT  - artificial kidney
OT  - dialysis adequacy
OT  - hemodiafiltration
OT  - sepsis
OT  - solute kinetics in dialysis
EDAT- 2020/09/11 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/09/10 05:25
PHST- 2020/09/11 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/09/10 05:25 [entrez]
AID - 10.1177/0391398820952801 [doi]
PST - ppublish
SO  - Int J Artif Organs. 2021 Apr;44(4):223-228. doi: 10.1177/0391398820952801. Epub 
      2020 Sep 10.