Studies in a conscious, nonuremic dog model suggest that use of dialysate hyponatric to plasma tends to cause hypotension during dialytic ultrafiltration by accelerating the rate of contraction of plasma volume. No adverse effect of hyponatric dialysate on total peripheral resistance response could be demonstrated.
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Pan Afr Med J
December 2024
Department of Surgery, Faculty of Medicine, Hasanuddin University, Hasanuddin University Hospital, Makassar, Indonesia.
Acute heart failure is associated with high hospitalization and mortality rates. A strong, independent risk factor for mortality in patients with heart failure is acute kidney injury, and the condition caused by this connection between disturbances in heart function and proper kidney functioning is cardiorenal syndrome (CRS). This case report discusses the role of continuous renal replacement therapy (CRRT) in the management of a CRS case with septic shock due to pneumonia.
View Article and Find Full Text PDFHypertension
January 2025
Division of Nephrology, Department of Medicine (O.P.), Medical University of South Carolina, Charleston, SC.
Podocytes are specialized cells within the glomerular filtration barrier, which are crucial for maintaining glomerular structural integrity and convective ultrafiltration. Podocytes exhibit a unique arborized morphology with foot processes interfacing by slit diaphragms, ladder-like, multimolecular sieves, which provide size and charge selectivity for ultrafiltration and transmembrane signaling. Podocyte dysfunction, resulting from oxidative stress, dysregulated prosurvival signaling, or structural damage, can drive the development of proteinuria and glomerulosclerosis in hypertensive nephropathy.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
October 2024
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN. Electronic address:
Objective: To explore whether ultrafiltration (UF) volume adjusted for weight is associated with an increased risk of acute kidney injury (AKI) after cardiopulmonary bypass (CPB) in cardiac surgery patients.
Design: A retrospective cohort study.
Setting: Single-center study at a tertiary academic medical center.
J Crit Care
February 2025
Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea. Electronic address:
Intensive Care Med
December 2024
Service de Médecine Intensive-Réanimation, Hôpital de La Croix Rousse, Hospices Civils de Lyon, Lyon, France.
Purpose: Net ultrafiltration (UF) during continuous renal replacement therapy (CRRT) can control fluid balance (FB), but is usually 0 ml·h in patients with vasopressors due to the risk of hemodynamic instability associated with CRRT (HIRRT). We evaluated a UF strategy adjusted by functional hemodynamics to control the FB of patients with vasopressors, compared to the standard of care.
Methods: In this randomized, controlled, open-label, parallel-group, multicenter, proof-of-concept trial, adults receiving vasopressors, CRRT since ≤ 24 h and cardiac output monitoring were randomized (ratio 1:1) to receive during 72 h a UF ≥ 100 ml·h, adjusted using a functional hemodynamic protocol (intervention), or a UF ≤ 25 ml·h (control).
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