Extracorporeal therapies in sepsis.

The treatment of sepsis is an ongoing challenge for clinicians; despite the wide choice of effective antibiotics to treat infection, sepsis remains the leading cause of morbidity and mortality for patients admitted to an intensive care unit. Dysregulation of the immune response is now recognized to be a key factor in multiple organ dysfunction, yet our therapy for inflammation remains ineffective. It has been advocated for more than a decade that cytokine reduction in blood compartment could lead to a reduction in mortality in sepsis.

Continuous real-time urine output monitoring for early detection of acute kidney injury.

In critically ill patients, acute kidney injury (AKI) is a common complication. In some cases, oliguria may be the only sign verifying this condition. The consensus definitions of RIFLE and AKIN are based on changes in creatinine and urine output and define classes of severity within AKI.

Antioxidant dialytic approach with vitamin E-coated membranes.

Oxidative stress is prevalent in dialysis patients and has been implicated in the pathogenesis of anemia and cardiovascular disease. Vitamin E-coated membranes are low-flux dialyzers consisting of a multilayer membrane with liposoluble vitamin E on the blood surface allowing direct contact with free oxygen radicals to be scavenged on the membrane site. The antioxidant properties of these membranes have an important clinical benefit because of reducing oxygen stress and inflammation may contribute to an improvement of hemoglobin levels, lower recombinant human erythropoietin dose and better anemia management, and at the same time may have a favorable impact on cardiovascular complications.

ADPKD: Prototype of Cardiorenal Syndrome Type 4.

The cardiorenal syndrome type 4 (Chronic Renocardiac Syndrome) is characterized by a condition of primary chronic kidney disease (CKD) that leads to an impairment of the cardiac function, ventricular hypertrophy, diastolic dysfunction, and/or increased risk of adverse cardiovascular events. Clinically, it is very difficult to distinguish between CRS type 2 (Chronic Cardiorenal Syndrome) and CRS type 4 (Chronic Renocardiac Syndrome) because often it is not clear whether the primary cause of the syndrome depends on the heart or the kidney. Autosomal dominant polycystic kidney disease (ADPKD), a genetic disease that causes CKD, could be viewed as an ideal prototype of CRS type 4 because it is certain that the primary cause of cardiorenal syndrome is the kidney disease.