Hypercitratemia is a mortality predictor among patients on continuous venovenous hemodiafiltration and regional citrate anticoagulation.

The use of regional citrate anticoagulation (RCA) in liver failure (LF) patients can lead to citrate accumulation. We aimed to evaluate serum levels of citrate and correlate them with liver function markers and with the Cat/Cai in patients under intensive care and undergoing continuous venovenous hemodiafiltration with regional citrate anticoagulation (CVVHDF-RCA). A prospective cohort study in an intensive care unit was conducted.

Soluble Fas affects erythropoiesis in vitro and acts as a potential predictor of erythropoiesis-stimulating agent therapy in patients with chronic kidney disease.

Serum soluble Fas (sFas) levels are associated with erythropoietin (Epo) hyporesponsiveness in patients with chronic kidney disease (CKD). Whether sFas could predict the need for erythropoiesis-stimulating agent (ESA) usage and its influence in erythropoiesis remain unclear. We evaluated the relation between sFas and ESA therapy in patients with CKD with anemia and its effect on erythropoiesis in vitro.

Impact of machine perfusion after long static cold storage on delayed graft function incidence and duration and time to hospital discharge.

Delayed graft function (DGF) is very high in our center (70%-80%), and we usually receive a kidney for transplant after more than 22 hours of static cold ischemia time (CIT). Also, there is an inadequate care of the donors, contributing to a high rate of DGF. We decided to test whether machine perfusion (MP) after a CIT improved the outcome of our transplant patients.

The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function.

Background: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI.

Methods: We conducted a retrospective study investigating patients (≥16 years old) admitted to an intensive care unit with D-AKI from 1999 to 2012.

Presence of arteriolar hyalinosis in post-reperfusion biopsies represents an additional risk to ischaemic injury in renal transplant.

Aim: The role of post-reperfusion biopsy findings as a predictor of early and long-term graft function and survival is still a target of research.

Methods: We analyzed data from 136 post-reperfusion biopsies performed in deceased donor renal transplanted patients from November 2008 to May 2012. We analyzed the presence of acute tubular necrosis (ATN), arteriolar hyalinosis (AH), intimal thickness (IT), interstitial fibrosis (IF) and glomerulosclerosis (GS).

How to choose the ideal renal replacement therapy in sepsis?

Sepsis is the main cause of acute kidney injury (AKI) among individuals hospitalized in intensive care units. Acute kidney injury is an independent risk factor for mortality, and its occurrence increases the complexity and cost of treatment. However, the pathophysiological mechanisms of AKI remain unclear.

Impact of acute kidney injury exposure period among liver transplantation patients.

Background: Acute kidney injury is a common complication of liver transplantation. In this single-centre retrospective observational study, we investigated the impact of acute kidney disease on liver recipient survival.

Methods: The study population consisted of patients who underwent a liver engraftment between January 2002 and November 2006, at a single transplantation centre in São Paulo, Brazil.

Effects of simvastatin on cytokines secretion from mononuclear cells from critically ill patients with acute kidney injury.

Purpose: To assess the in vitro effects of simvastatin on IL-10 and TNF-α secretion from peripheral blood mononuclear cells (PBMC) of critically ill patients with and without acute kidney injury (AKI).

Methods: PBMC were collected from 63 patients admitted to the intensive care unit (ICU) and from 20 healthy controls. Patients were divided in 3 subgroups: with AKI, with sepsis and without AKI and with AKI and sepsis.

Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era.

Background: Central line-associated bloodstream infection (CLABSI) is one of the most important health care-associated infections in the critical care setting.

Methods: A quasiexperimental study involving multiple interventions to reduce the incidence of CLABSI was conducted in a medical-surgical intensive care unit (ICU) and in 2 step-down units (SDUs). From March 2005 to March 2007 (phase 1 [P1]), some Centers for Disease Control and Prevention evidence-based practices were implemented.

Successful prevention of ventilator-associated pneumonia in an intensive care setting.

Background: Ventilator-associated pneumonia (VAP) is one of the most common health care-associated infections (HAIs) in critical care settings.

Objective: Our objective was to examine the effect of a series of interventions, implemented in 3 different periods to reduce the incidence of VAP in an intensive care unit (ICU).

Methods: A quasiexperimental study was conducted in a medical-surgical ICU.

The role of growth factors on renal tubular cells submitted to hypoxia and deprived of glucose.

Background: In acute renal failure (ARF) renal tubular cell death and detachment can be induced by necrotic and apoptotic mechanisms. Several studies have demonstrated some benefits of the use of growth factors in experimental models of ARF.

Methods: MDCK cells were cultured in a glucose-free medium for 24h and were submitted to hypoxia (PO2 around 35 mmHg) for additional 24 h.