Agreement Between Resting Energy Expenditure Predictive Formulas and Indirect Calorimetry in Non-Dialysis Dependent Chronic Kidney Disease.

Background And Aims: The gold standard method for measuring resting energy expenditure (REE) is indirect calorimetry (IC) using an expensive device that requires specialized training. To overcome the limitations of IC, REE prediction formulas are used in patients with chronic kidney disease (CKD). However, it is still controversial which of these formulas has greater accuracy compared to IC.

The role of peritoneal dialysis in the treatment of acute kidney injury in neurocritical patients: a retrospective Brazilian study.

Background: Acute kidney injury (AKI) occurs frequently in the neurocritical intensive care unit and is associated with greater morbidity and mortality. AKI and its treatment, including acute kidney replacement therapy, can expose patients to a secondary greater brain injury. This study aimed to explore the role of peritoneal dialysis (PD) in neurocritical AKI patients in relation to metabolic and fluid control, complications related to PD and outcome.

Advances in Peritoneal Dialysis in Acute Kidney Injury.

In the 1970s, acute peritoneal dialysis (PD) was widely accepted for the treatment of acute kidney injury (AKI), but this practice has declined in favor of extracorporeal therapies, mainly in developed world. The lack of familiarity with the use of PD in critically ill patients has also led to a lack of use even among those receiving maintenance PD. Renewed interest in the use of PD for AKI therapy has emerged due to its increasing use in low- and middle-income countries due to its lower cost and minimal infrastructural requirements.

Successful Liberation from Acute Kidney Replacement Therapy in Critically Ill Patients: A Prospective Cohort Study.

Introduction: Recovery of kidney function to liberate patients from acute kidney replacement therapy (AKRT) is recognized as a vital patient-centered outcome. The lack of specific guidelines providing specific recommendations on therapy interruption is an important obstacle. We aimed to determine the prevalence of successful discontinuation of AKRT and its predictive factors after the elaboration of clinical protocol with these recommendations.

Comparison between FRAIL Scale and Clinical Frailty Scale in predicting hospitalization in hemodialysis patients.

Background: To assess the prevalence of frailty by the Clinical Frailty Scale (CFS) and the 5-item FRAIL scale and their association with hospitalization in hemodialysis (HD) patients.

Methods: This was a prospective observational study. We included patients of both genders ≥ 18 years old in HD treatment for at least 3 months.

Factors predicting successful discontinuation of acute kidney replacement therapy: A retrospective cohort study.

Background: Treatment for severe acute kidney injury (AKI) typically involves the use of acute kidney replacement therapy (AKRT) to prevent or reverse complications.

Methodology: We aimed to determine the prevalence of successful discontinuation of AKRT and its predictive factors. A retrospective cohort study was performed with 316 patients hospitalized at a public Brazilian university hospital between January 2011 and June 2020.

The Serum Concentration of Vancomycin as a Diagnostic Predictor of Nephrotoxic Acute Kidney Injury in Critically Ill Patients.

Unlabelled: The impact of serum concentrations of vancomycin is a controversial topic.

Results: 182 critically ill patients were evaluated using vancomycin and 63 patients were included in the study. AKI occurred in 44.

The Role of Peritoneal Dialysis in the Treatment of Acute Kidney Injury in Patients With Acute-on-Chronic Liver Failure: A Prospective Brazilian Study.

This study aimed to explore the role of peritoneal dialysis (PD) in acute-on-chronic liver disease (ACLD) in relation to metabolic and fluid control and outcome. Fifty-three patients were treated by PD (prescribed Kt/V = 0.40/session), with a flexible catheter, tidal modality, using a cycler and lactate as a buffer.

Meal timing and frequency implications in the development and prognosis of chronic kidney disease.

Patients with chronic kidney disease (CKD) have a higher risk of death than the general population, the main cause being cardiovascular disease (CVD). Nutrition plays a key role in the prevention and treatment of CVD and kidney diseases. Currently, new evidence reinforces the importance of specific foods and general dietary patterns rather than isolated nutrients for cardiovascular risk.

Pharmacokinetics of Intraperitoneal Vancomycin and Amikacin in Automated Peritoneal Dialysis Patients With Peritonitis.

The study aimed to evaluate the vancomycin and amikacin concentrations in serum and dialysate for automatic peritoneal dialysis (APD) patients A total of 558 serum and dialysate samples of 12 episodes of gram-positive and 18 episodes of gram-negative peritonitis were included to investigate the relationship between vancomycin and amikacin concentrations in serum and dialysate on the first and third days of treatment. Samples were analysed 30, 120 min, and 48 h after intraperitoneal administration of vancomycin in peritonitis caused by gram-positive agents and 30, 120 min, and 24 h after intraperitoneal administration of amikacin in peritonitis caused by gram-negative agents. Vancomycin was administered every 72 h and amikacin once a day.

Acute Kidney Injury in COVID-19: 90 Days of the Pandemic in a Brazilian Public Hospital.

Renal involvement is frequent in COVID-19 (4-37%). This study evaluated the incidence and risk factors of acute kidney injury (AKI) in hospitalized patients with COVID-19. This study represents a prospective cohort in a public and tertiary university hospital in São Paulo, Brazil, during the first 90 days of the COVID-19 pandemic, with patients followed up until the clinical outcome (discharge or death).

Evaluation of peptidylarginine deiminase 4 and PADI4 polymorphisms in sepsis-induced acute kidney injury.

Background: The aim of this study is to evaluate the peptidylarginine deiminase 4 (PAD 4) concentration and PADI4 polymorphisms as predictors of acute kidney injury (AKI) development, the need for renal replacement therapy (RRT), and mortality in patients with septic shock.

Methods: We included all individuals aged ≥ 18 years, with a diagnosis of septic shock at ICU admission. Blood samples were taken within the first 24 hours of the patient's admission to determine serum PAD4 concentration and its PADI4 polymorphism (rs11203367) and (rs874881).

Acute peritoneal dialysis in the treatment of COVID-19-related acute kidney injury.

The kidney is not typically the main target of severe acute respiratory syndrome coronavirus 2, but surprisingly, acute kidney injury (AKI) may occur in 4-23% of cases, whereas the dialysis management of AKI from coronavirus 2019 has not gained much attention. The severity of the pandemic has resulted in significant shortages in medical supplies, including respirators, ventilators and personal protective equipment. Peritoneal dialysis (PD) remains available and has been used in clinical practice for AKI for >70 years; however, it has been used on only a limited basis and therefore experience and knowledge of its use has gradually vanished, leaving a considerable gap.

Vancomycin dosing, monitoring and toxicity: Critical review of the clinical practice.

Vancomycin is an antibiotic used in the treatment of infections caused by multidrug-resistant Gram-positive bacteria, especially methicillin-resistant Staphylococcus aureus. In the last decades, vancomycin has been widely used in hospital environments due to the increasing incidence of sepsis and septic shock. Sepsis may lead to multiple organ failure; it is considered a risk factor for the development of acute kidney injury (AKI), with an overall mortality rate of around 45%, which can reach the surprising rate of 70% with the combination of AKI and sepsis.

Poor agreement between indirect calorimetry and predictive formula of rest energy expenditure in pre-dialytic and dialytic chronic kidney disease.

Background/aims: Protein-energy wasting (PEW) is common in the end-stage of chronic kidney disease (CKD) and can be caused by factors related to poor dietary intake and changes in energy expenditure. Indirect calorimetry (IC) is the gold standard method to measure resting energy expenditure (REE), however, it is not much available and it is common to use predictive formulas of REE in clinical practice. This study compared the values of REE measured by IC to those estimated by Harris & Benedict formula, the most one used in clinical practice in Brazil.

Effect of hemodialysis on respiratory mechanics in acute kidney injury patients.

Introduction: Hemodialysis (HD) is one treatment for acute kidney injury (AKI) patients. Studies have shown that this dialysis modality may lead to changes in pulmonary function with an impact on prognosis. The aim of our study was to evaluate changes in respiratory mechanics and oxygenation of AKI patients admitted to an intensive care unit who were undergoing intermittent mechanical ventilation (IMV) and daily HD.

Mortality and Recovery of Renal Function in Acute Kidney Injury Patients Treated with Prolonged Intermittent Hemodialysis Sessions Lasting 10 versus 6 Hours: Results of a Randomized Clinical Trial.

Purpose: This trial aimed to compare mortality and recovery of renal function in acute kidney injury (AKI) patients treated with different durations of prolonged hemodialysis (PHD) sessions (6 h versus 10 h).

Methodology: We included patients with sepsis-associated AKI, >18 years, who are in use of a norepinephrine (lower than 0.7 ucg/kg/min).

Acute kidney injury in elderly patients: narrative review on incidence, risk factors, and mortality.

Acute kidney injury (AKI) is characterized by a sudden renal dysfunction with consequent increase of nitrogenous products, hydroelectrolytic and acid-base disorders. Its prevalence is high in hospitalized populations (4.9%-7.

Urgent start peritoneal dialysis.

Purpose Of Review: Although historically peritoneal dialysis was widely used in nephrology, it has been underutilized in recent years. In this review, we present several key opportunities and strategies for revitalization of urgent start peritoneal dialysis use, and discuss the recent literature on clinical experience with peritoneal dialysis use in the acute and unplanned setting.

Recent Findings: Interest in using urgent start peritoneal dialysis to manage acute kidney injury (AKI) and unplanned chronic kidney disease (CKD) stage 5 patients has been increasing.

Effect of peritoneal dialysis vs. haemodialysis on respiratory mechanics in acute kidney injury patients.

Background: Peritoneal dialysis (PD) and hemodialysis (HD) are options for the treatment of acute kidney injury (AKI) patients. The aim of this study was to compare the effects of PD and daily HD on respiratory mechanics of AKI patients undergoing invasive mechanical ventilation (IMV).

Methods: A prospective cohort study evaluated 154 patients, 37 on continuous PD and 94 on HD.