Background: Rhabdomyolysis is frequently associated with acute kidney injury (AKI). Due to the nephrotoxic properties of myoglobin, its rapid removal is relevant. If kidney replacement therapy (KRT) is necessary for AKI, a procedure with effective myoglobin elimination should be preferred. This pilot trial was designed to compare different KRT modes that enable myoglobin elimination.
Methods: In this prospective randomized single-center study, 15 patients with rhabdomyolysis and severe AKI requiring KRT were randomized 1:1:1 into three groups: continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) using a high cut-off dialyzer (CVVHD-HCO), or CVVHD using a high-flux dialyzer in combination with the adsorber CytoSorb (CVVHD-CS). Concentrations of serum myoglobin, urea, creatinine, β2-microglobulin, interleukin-6, and albumin were measured before and after the dialyzer 1, 6, 12, and 24 h after initiating KRT.
Results: There was no significant difference in the median myoglobin clearance between the KRT modes during the 24-h study period. Nevertheless, the CVVHD-CS group showed a significantly higher myoglobin elimination compared to the other modes in the first hours of treatment. However, as a greater decline in clearance performance was observed over time, no better performance was detected over the whole study period. Simulation of different device combinations showed the highest myoglobin clearance for CVVHD-HCO combined with CS with a 12-hourly adsorber exchange interval.
Conclusions: All tested modes showed an effective myoglobin elimination capacity. The time-dependent elimination performance could be further increased by combining KRT with more frequent adsorber exchange.
Trial Registration: German Clinical Trials Registry ( DRKS00023998 ); date of registration 03/03/2021.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1186/s12882-025-03945-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Kidney REPLACEment therapies in patients with acute kidney injury and RHABDOmyolysis (ReplaceRhabdo): a pilot trial.
BMC Nephrol
January 2025
Medical Department III, Division of Nephrology, University Hospital Leipzig, Leipzig, Germany.
Background: Rhabdomyolysis is frequently associated with acute kidney injury (AKI). Due to the nephrotoxic properties of myoglobin, its rapid removal is relevant. If kidney replacement therapy (KRT) is necessary for AKI, a procedure with effective myoglobin elimination should be preferred.
View Article and Find Full Text PDFThe mechanism of autoreduction in Dehaloperoxidase-A.
Biochem Biophys Res Commun
January 2025
Department of Chemistry, North Carolina State University, Raleigh, NC, 27695, USA. Electronic address:
Hemoglobin and myoglobin are known to undergo autoxidation, in which the oxyferrous form of the heme is oxidized to the ferric state by O. Dehaloperoxidase-A (DHP-A), a multifunctional catalytic hemoglobin from Amphitrite ornata is an exception and is observed to undergo the reverse process, during which the ferric heme is spontaneously reduced to the oxyferrous form under aerobic conditions. The high reduction potential of DHP (+202 mV at pH 7.
View Article and Find Full Text PDFThe highly hazardous veterinary drug "maduramicin" and its toxicokinetics in rats.
Heliyon
October 2024
State Key Laboratory of Trauma, Burn and Combined Injury, Third Military Medical University, Chongqing 400038, China.
Background: Maduramicin (MAD) is an anticoccidial veterinary drug, but it frequently causes fatal poisonings in poultry, livestock, or humans. However, there is no specific antidote or guidance on first aid for MAD poisoning.
Aim: The aim of the present study is to evaluate the acute toxicity and toxicokinetics of MAD after oral exposure, so as to make a foundation for developing diagnostic and therapeutic protocols for human intoxication.
Vacuum Packaging Can Protect Ground Beef Color and Oxidation during Cold Storage.
Foods
September 2024
Department of Animal Sciences, Auburn University, Auburn, AL 36849, USA.
Storing ground beef at frozen temperatures prior to refrigerated display when using thermoforming vacuum packaging is not a common manufacturing practice. However, limited data on thermoforming packaging film and its interaction with meat quality suggests that more information is needed. The current study aimed to identify the influences of thermoforming packaging on the surface color and lipid oxidation of ground beef.
View Article and Find Full Text PDFHemoadsorption therapy for myoglobin removal in rhabdomyolysis: consensus of the hemoadsorption in rhabdomyolysis task force.
BMC Nephrol
July 2024
Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, D-48149, Münster, Germany.
Background: Rhabdomyolysis describes a syndrome characterized by muscle necrosis and the subsequent release of creatine kinase and myoglobin into the circulation. Myoglobin elimination with extracorporeal hemoadsorption has been shown to effectively remove myoglobin from the circulation. Our aim was to provide best practice consensus statements developed by the Hemoadsorption in Rhabdomyolysis Task Force (HRTF) regarding the use of hemadsorption for myoglobin elimination.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!