Blood Purification最新文献

{"title":"A Randomised Prospective Crossover Study on the Effects of Medium Cut-Off Membranes on FGF-23 and Inflammatory Mediators in Patients Receiving Regular Haemodialysis.","authors":"Saif Al-Chalabi, Smeeta Sinha, Philip A Kalra, Dawn Evans, Darren Green, Leon Schurgers, Dimitrios Poulikakos","doi":"10.1159/000545745","DOIUrl":"10.1159/000545745","url":null,"abstract":"<p><strong>Introduction: </strong>In contrast to high-flux dialysis (HFD) membranes, medium cut-off membranes (MCO) can potentially remove a wide range of middle molecules. Our study aimed to compare the clearance rate (CR) of fibroblast growth factor 23 (FGF-23) and other selected inflammatory cytokines between medium MCO and HFD membranes and investigate the intrasubject stability of these biomarkers.</p><p><strong>Methods: </strong>This prospective randomised case-crossover study recruited 20 adult patients who were randomised into two groups: group A: to start with 1 week of thrice-weekly dialysis using HFD membrane followed by a 3-week washout period and then 1 week of dialysis with an MCO membrane. Group B followed the reverse sequence. Blood samples were taken before and after each dialysis session for the analysis of the assessed biomarkers (FGF-23, interleukin-6 [IL-6], interleukin-18 [IL-18], high-sensitivity C-reactive protein [hsCRP], and dephosphorylated uncarboxylated matrix Gla protein [dp-ucMGP]). Wilcoxon signed rank and paired t tests were used for comparison between the membranes. One-way repeated measures ANOVA or Friedman tests were used for the intrasubject stability of the biomarkers.</p><p><strong>Results: </strong>The use of both MCO and HFD membranes resulted in a significant reduction of FGF-23 levels and other selected inflammatory cytokines. However, there was no significant difference in the CR: FGF-23 (0.31 vs. 0.23], p = 0.242), IL-6 (0.19 vs. 0.12, p = 0.215), IL-18 (-0.05 vs. -0.03, p = 0.704), dp-ucMGP (0.33 vs. 0.33, p = 0.903), and hsCRP (-0.05 vs. -0.08, p = 0.107). There was no significant intrasubject variability for all assessed biomarkers except in pre-dialysis high hsCRP levels when using HFD membrane.</p><p><strong>Conclusion: </strong>The use of both MCO and HFD membranes resulted in a significant reduction of FGF-23 levels and other selected inflammatory cytokines. However, the MCO membrane did not demonstrate a significant advantage over the HFD in the short term. There was no significant intrasubject variability for all assessed biomarkers apart from hsCRP.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-Range Dialysate Flow and Adequacy of Dialysis.","authors":"Ami M Patel, Nazli Atefi, Jagman Chahal, Abutaleb Ahsan Ejaz","doi":"10.1159/000545703","DOIUrl":"10.1159/000545703","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective was to investigate the efficiency of a fully integrated, hemodialysis machine that utilizes mid-range dialysate flow rate of 300 mL/min in the acute hospital setting.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center pilot study. All veterans with end-stage kidney disease or dialysis-dependent acute kidney injury, who completed ≥3 h of hemodialysis and had pre-dialysis blood urea nitrogen (BUN) >20 mg/dL with available post-dialysis BUN from February 2023 to June 2023 were included. Urea reduction ratio (URR) and single-pool Kt/V were compared between groups with varying dialyzer sizes and duration of treatment.</p><p><strong>Results: </strong>Fifty-nine dialysis sessions were included for analysis. Mean Kt/V and URR for the full cohort were 1.26 ± 0.04 and 60.8 ± 7.3%, respectively. The percentage of sessions achieving minimum adequate clearance per Kt/V and URR criteria were 50.6% and 32.5%, respectively. In the subgroup analysis of dialysis sessions of different filter size (Optiflux™ F160NR or F180NR dialyzers) and varying duration (3, 3.5, 4 h), the percentage of sessions achieving minimum adequate Kt/V in the F160/3.5 h, F180/3.5 h and F180/4 h groups were 44%, 50%, and 58.8%, respectively.</p><p><strong>Conclusion: </strong>The restriction of QD to 300 mL/min may compromise adequacy of dialysis in acute care setting. This may be mitigated by prolonging session times, albeit at the expense of higher resource utilization, and improving the QD:QB ratio. Further studies in a larger hospital cohort are necessary to elucidate these issues.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Effects of Moxibustion on Gastrointestinal Function and Gut Microbiota in Chronic Renal Failure: A CARE Non-Placebo Randomized Controlled Study in Peritoneal Dialysis Patients.","authors":"Weiguo Yao, Chunli Yu, Aiying Xiong, Li Li, Junli Gao, Kun Liu","doi":"10.1159/000545242","DOIUrl":"10.1159/000545242","url":null,"abstract":"<p><strong>Introduction: </strong>Moxibustion is regarded as a complementary and alternative treatment for chronic renal failure (CRF) patients.</p><p><strong>Methods: </strong>This study was a randomized controlled trial, and we collected case data from 52 CRF patients who received moxibustion combined with PD treatment (moxibustion group) and 50 CRF patients who only received PD treatment (control group) in our hospital from March 2020 to February 2022. After a 12-week treatment cycle, the changes in blood routine test indicators, blood electrolytes, routine biochemical indicators, 24 h urinary protein quantification, and gastrointestinal function indicators before and after treatment were compared between the two groups. The primary outcome was blood urea nitrogen (BUN) levels, indicative of kidney function.</p><p><strong>Results: </strong>Fifty two patients remained in the moxibustion group and 50 in the control group. After 12 weeks of treatment, the moxibustion group demonstrated significantly lower serum potassium and phosphorus levels than before treatment. Regarding biochemical blood analysis, the moxibustion group had significantly lower BUN levels, 24 h urinary protein quantification, and parathyroid hormone after treatment compared with the control group. However, although the serum creatinine, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase were numerically lower in the moxibustion group, the difference between the two groups was not statistically significant. The moxibustion group had improved gastrointestinal function, in terms of increased motilin and cholecystokinin levels, compared to the control group.</p><p><strong>Conclusion: </strong>Moxibustion combined with PD can improve renal and gastrointestinal functions and regulate the structure of the gut microbiota to in CRF patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Removal by Hemoadsorption.","authors":"Ilona Lemagnen, Céline Monard, Maxime Palluau, Layla Bergamaschi, Taku Furukawa, Rinaldo Bellomo, Antoine Schneider","doi":"10.1159/000545804","DOIUrl":"10.1159/000545804","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest in hemoadsorption (HA) therapies in critically ill patients although their precise indications remain to be established. Several devices are available on the market with heterogeneous properties and capabilities.</p><p><strong>Summary: </strong>Due to the nonspecific removal associated with most HA techniques, concerns have been raised on their unintended removal of drugs such as anti-infectives in sepsis. On the other hand, drug removal might be beneficial in certain situations for instance antithrombotic medications in patients requiring emergency surgery or in case of accidental or self-induced intoxication. In this review, we summarize available in vitro, in vivo, and clinical studies reporting on the influence of various HA techniques on drugs pharmacokinetics.</p><p><strong>Key message: </strong>We conclude that further studies should aim at providing drug dosing recommendations during HA and confirm its safety, efficacy, and practicalities when used for intoxications.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Influencing Factors of Mortality in Chinese Patients with Liver Failure Undergoing Plasma Exchange.","authors":"Xin Zhang, Huafen Zhang, Haiyin Jiang, Hui Chen, Qinxian Chen","doi":"10.1159/000545270","DOIUrl":"10.1159/000545270","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis aimed to evaluate the determinants that influence mortality of individuals with liver failure who are undergoing the treatment of plasma exchange (PE).</p><p><strong>Methods: </strong>The search for relevant literature was conducted from the beginning of the database records up to January 5, 2024, encompassing a range of databases such as PubMed, Embase, the Cochrane Library, Web of Science, as well as Chinese databases including China National Knowledge Infrastructure (CNKI), WanFang, and VIP. For the analysis of continuous variables, the weighted mean difference was utilized, while for categorical variables, the odds ratio was employed. Both statistical measures were presented alongside their respective 95% confidence intervals. Subgroup analyses were conducted based on liver failure type, volume of plasma exchanged, and HBV etiology.</p><p><strong>Results: </strong>In total, 33 studies involving 5,842 patients were included. Older age, a higher Model for End-Stage Liver Disease score, the presence of hepatic encephalopathy, cirrhosis, hepatorenal syndrome, and peritonitis, elevated aspartate transaminase levels, low albumin level, low prothrombin activity, prolonged prothrombin time, low platelet, and white blood cell counts were associated with mortality in Chinese patients with liver failure who underwent PE (all p < 0.05). However, these influencing factors could vary depending on the type of liver failure and the exchange volume during PE.</p><p><strong>Conclusion: </strong>Several demographic indicators, liver function indicators, coagulation indicators, and routine blood are associated with mortality in patients with liver failure undergoing PE. This study may provide important clinical guidance for the care of patients with liver failure, helping to improve patient survival.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term safety of '4-hour' hemoadsorption combined with hemodialysis (HAHD) in maintenance hemodialysis patients: A multicenter prospective cohort study.","authors":"Dongliang Zhang, Cuiping Liu, Tao Yang, Jingxin Zhao, Xiaofei Wang, Liping Zhang, Yuanyuan Li, Yangyang Shen, Yanjun Gao, Hongjuan Zhang","doi":"10.1159/000545988","DOIUrl":"https://doi.org/10.1159/000545988","url":null,"abstract":"<p><strong>Introduction: </strong>Current guidelines recommend limiting hemoadsorption (HA) duration to 2 hours during hemodialysis (HD) sessions due to theoretical concerns about adsorbent saturation and clotting risks. This multicenter prospective cohort study evaluated the long-term safety and efficacy of a novel \"4Hs\" protocol (4-hour HA-HD with blood flow >250 mL/min).</p><p><strong>Methods: </strong>Seventy-eight maintenance HD patients from four centers underwent 26 weeks of 4Hs therapy. Key outcomes included dialysis adequacy (spKt/V, urea reduction ratio [URR]), uremic toxin (UT) clearance (indoxyl sulfate [IS], p-cresyl sulfate [pCS], β2-microglobulin [B2MG]), clotting rates, and adverse events (AEs). Statistical comparisons were made against pre-study conventional HA+HD (2-hour HA) data using paired t-tests and repeated-measures ANOVA.</p><p><strong>Results: </strong>The 4Hs protocol demonstrated non-inferior safety to conventional HA+HD, with comparable clotting rates (1.79% vs. 1.62%, p=0.665) and no significant differences in anemia markers or hypoalbuminemia. Dialysis efficacy improved significantly: spKt/V increased by 0.28 (p=0.012), URR by 1.18% (p=0.003), and UT reduction rates (IS: 56.17% vs. 40.14%, p<0.001; p-CS: 47.39% vs. 35.91%, p<0.001; B2MG: 55.82% vs. 48.41%, p<0.001). Albumin loss remained comparable between protocols (Δ0.5 g/L, p>0.05).</p><p><strong>Conclusion: </strong>Extending HA duration to 4 hours with high-flow hemodynamics (Qb >250 mL/min) is safe and enhances toxin clearance without increasing clotting risks. These findings challenge current SOP limitations on HA duration and support protocol optimization in maintenance HD patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Lowering Dialysate Flow Rate on Dialysis Dose and Laboratory Values.","authors":"Maryn Gardner, Nicole E Wyatt, Neil Sanghani, Ahmed Attia, Andrew Guide, Robert A Greevy, Megha Salani, Osama El Shamy","doi":"10.1159/000545898","DOIUrl":"https://doi.org/10.1159/000545898","url":null,"abstract":"<p><strong>Background: </strong>The rationale behind using higher dialysate flow rates stems from the idea of maximizing a dialysis membrane's extraction ratio. Subsequent developments in dialysis membrane design, including the hollow fiber undulations, spacer yarns, and altering the fiber packing density helped reduce blood and dialysate flow mismatch in dialysis membranes.</p><p><strong>Methods: </strong>Single-center retrospective analysis of in-center dialysis patients. Adult (age ≥18 years) in-center hemodialysis patients who were receiving dialysis at the centers 3 months prior to and 3 months following the change in dialysate flow rates were included in the study (December 2022 to May 2023). Dialysate flow rates were reduced from 800 to 600ml/min - using the same access and dialysis membrane.</p><p><strong>Results: </strong>68 patients were enrolled in the study. The change of dialysate flow rate did not result in a statistically significant change in dialysis adequacy (Kt/Vurea). All regression coefficients were below 0.05 (i.e. a 0.05 change in dialysis adequacy for flow rate 600 vs 800ml/min). Significant associations were found between dialysis adequacy and both the blood flow rate and dialysate sodium, but these were also clinically negligible differences. Analysis of patients' laboratory testing showed no statistically significant difference in serum electrolyte values (sodium, potassium, bicarbonate, blood urea nitrogen and creatinine) Conclusion: In patients treated using the same dialysate filter and dialysis access, changing the dialysate flow rate from 800 to 600ml/min does not result in clinically significant changes in either patients' measured serum electrolytes or dialysis adequacy.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoadsorption: One Name, Varied Techniques.","authors":"Stefano Romagnoli, Gianluca Villa, Francesco Barbani, Zaccaria Ricci","doi":"10.1159/000545741","DOIUrl":"10.1159/000545741","url":null,"abstract":"<p><strong>Background: </strong>Despite significant efforts to improve outcomes for patients with sepsis and septic shock, mortality rates remain alarmingly high.</p><p><strong>Summary: </strong>Beyond standard management, novel adjuvant treatments seek to improve outcomes through a personalized approach. Among these, immunomodulation strategies aim to reestablish a balance in the dysregulated immune system, managing both pro-inflammatory and anti-inflammatory mediators. In recent years, various techniques utilizing extracorporeal circuits equipped with filters or cartridges, collectively referred to as blood purification therapies, have been developed and introduced to the market. Hemoadsorption, whether used alone or in conjunction with hemofiltration, may clear a broad range of substances from the blood, including inflammatory mediators, drugs, trace elements, bacteria, and viruses.</p><p><strong>Key messages: </strong>Understanding the fundamental principles of blood purification techniques is essential for enhancing survival probabilities, keeping in mind the principle of primum non nocere as a guiding tenet of our daily practice. This review aimed to give an overview of hemoadsorption techniques by presenting current evidence and highlighting key areas that require further investigation.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous Chamber Design: A Comparative Analysis of Retention Characteristics.","authors":"Osamu Yamaga, Masafumi Fukuda, Kei Fukami, Nobuhisa Hirayu, Masakazu Nabeta, Tetsurou Imai, Gaku Sugihara, Osamu Takasu, Norio Yamashita","doi":"10.1159/000545779","DOIUrl":"10.1159/000545779","url":null,"abstract":"<p><strong>Introduction: </strong>The air trap chamber used in continuous renal replacement therapy (CRRT) often causes clot formation due to gas interface, blood stasis and turbulent flow. The designs of this chamber vary widely. Few studies have quantitatively evaluated ex vivo quasi-blood stasis for different chamber types.</p><p><strong>Methods: </strong>Flow retention characteristics at 20, 30, 40, 50, and 60 s in a top-feed chamber (where blood flow enters vertically from the top and passes through a mesh within the air trap chamber with a chamber 12 mL in volume) and a side-feed chamber (where blood flow enters from the side and bottom, without a mesh filter, with a flow deviator and 6 mL chamber volume) were evaluated using a 30% glycerin and iodine povidone-solution. Still images of the chambers at each time point were converted to 8-bit grayscale using Image J software (ver.1.54, Maryland, USA), with a brightness threshold in the range of 1-80 to compare the two chamber designs.</p><p><strong>Results: </strong>Both chambers showed a decrease in the values of the highlighted areas over time; however, from 20 s, the side-feed chamber showed significantly lower values of the highlighted areas compared with the top-feed chamber. Similar to the findings at 20 s, significant differences in the values of the highlighted areas favored the side-feed chamber and persisted at 30, 40, 50, and 60 s. Furthermore, pseudo blood remained superficially in the top-feed chamber, while the side-feed chamber exhibited vortex flow, less stasis, turbulence, and stagnation.</p><p><strong>Conclusion: </strong>The two chambers tested emptied of pseudo blood at different rates, with varying retention characteristics, with the side-feed chamber showing less pseudo-blood retention at all-time points assessed.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombocytopenia in Children and Young Adults Undergoing Continuous Renal Replacement Therapy: A WE-ROCK Study.","authors":"Abby Basalely, Katja M Gist, Natalja L Stanski, Dana Y Fuhrman, JangDong Seo, Nicholas J Ollberding, Amy Strong, Mihaela Damian, Catherine Morgan, Stephanie Reynaud, Melissa Muff-Luett, Akash Deep, Carmela Serpe, Kelli A Krallman, Shina Menon","doi":"10.1159/000545777","DOIUrl":"10.1159/000545777","url":null,"abstract":"<p><strong>Introduction: </strong>Thrombocytopenia in patients treated with continuous renal replacement therapy (CRRT) in adults is associated with mortality. Pediatric data are limited. The association between pre-CRRT thrombocytopenia and platelet decline at 24 h of CRRT with outcomes was evaluated.</p><p><strong>Methods: </strong>Secondary analysis of the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) includes patients' birth-25 years who underwent CRRT. Exclusions were end-stage kidney disease, non-acute kidney injury/fluid overload CRRT indication, concurrent extracorporeal membrane oxygenation, missing baseline platelets, platelet disorders, and hematologic malignancy. Primary exposures were (i) pre-CRRT thrombocytopenia (≤100 × 103/μL) and (ii) ≥30% decline at 24 h of CRRT in those with pre-CRRT >100 × 103/μL. Primary outcome was survival to intensive care unit (ICU) discharge. Secondary outcomes included major adverse kidney events at 90 days (MAKE-90) (death, dialysis dependence, creatinine >125% baseline) from CRRT initiation.</p><p><strong>Results: </strong>A total of 805 patients were included. Overall, 63.9% had baseline thrombocytopenia, median (IQR) platelets of 38 (20, 63) ×103/μL. Baseline thrombocytopenia occurred in younger septic patients with higher illness severity. A ≥30% decline occurred in 33% of patients. Those with a ≥30% platelet decline were more commonly younger patients and had smaller catheters. Pre-CRRT thrombocytopenia and platelet decline were associated with ICU mortality in univariate but not multivariate models. There was no association with MAKE-90.</p><p><strong>Conclusions: </strong>Thrombocytopenia is common prior to CRRT initiation and is associated with greater illness severity. These findings stress the importance of vigilant monitoring of platelet levels before CRRT initiation and during therapy as thrombocytopenia at both time points may be a prognostic indicator. Additionally, this study highlights the need for future research to clarify the interplay of patient and mechanical factors in this phenomenon and guide potential interventions.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}