Blood Purification最新文献_第5页

Effects of Blood Hemoadsorption Therapy with HA-380 in Total Arch Replacement for Acute Type A Aortic Dissection: A Retrospective Observational Study. HA-380血液吸附治疗急性A型主动脉夹层全足弓置换术的疗效：回顾性观察研究。

IF 3 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2023-10-30 DOI: 10.1159/000534852

Juxiang Wang, Bin Chen, Junhao Xie, Huilong Chen, Lihua Li, Weiqun Zhang, Lin Lu

{"title":"Effects of Blood Hemoadsorption Therapy with HA-380 in Total Arch Replacement for Acute Type A Aortic Dissection: A Retrospective Observational Study.","authors":"Juxiang Wang, Bin Chen, Junhao Xie, Huilong Chen, Lihua Li, Weiqun Zhang, Lin Lu","doi":"10.1159/000534852","DOIUrl":"10.1159/000534852","url":null,"abstract":"Introduction: This study aimed to evaluate whether the addition of a hemoadsorption (HA) cartridge, HA-380, in the cardiopulmonary bypass (CPB) circuit in acute type A aortic dissection (ATAAD) surgery reduced inflammatory cytokine levels and decreased postoperative complications.Methods: A retrospective observational cohort study was conducted between March 1, 2021, and February 28, 2022. Patients with ATAAD undergoing emergent total arch replacement surgery were divided into the control (CON) and HA groups on the basis of the addition of the HA-380 cartridge in the CPB circuit.Results: Overall, 121 patients met the eligibility criteria; 2 patients in each group who died within the first postoperative week were excluded. Further, 57 and 60 patients in the CON and HA groups, respectively, were included in the pooled analysis. The major perioperative data, baseline values of interleukin-6 (IL-6) and C-reactive protein, and therapeutic interventions were similar in the two groups (all, p > 0.05). The serum IL-6 levels increased more rapidly in the CON group than those in the HA group postoperatively (205.73 ± 174.72 vs. 146.13 ± 64.15 pg/mL, p = 0.020). The HA group had a lower incidence of postoperative acute kidney injury (AKI) and severe acute respiratory distress syndrome than the CON group (25.4 vs. 44.6%, p = 0.032 and 18.3 vs. 35.1%, p = 0.040, respectively). Logistic regression analyses showed that HA may be a protective factor against postoperative AKI. The incidence of bleeding, delirium, and stroke as well as the lengths of intensive care unit and hospital stay in both groups were similar (all, p > 0.05).Conclusions: The use of HA-380 in the CPB circuit may attenuate inflammatory response and reduce major complications following ATAAD surgery. HA may be associated with lower rate of postoperative AKI.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"138-150"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71410378","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}

引用次数: 0

Rapid and Effective Elimination of Myoglobin with CytoSorb® Hemoadsorber in Patients with Severe Rhabdomyolysis. CytoSorb®血液吸附器快速有效消除严重横纹肌溶解症患者的肌红蛋白。

IF 3 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2023-11-02 DOI: 10.1159/000534479

Frederic Albrecht, Stefan Schunk, Maren Fuchs, Thomas Volk, Juergen Geisel, Danilo Fliser, Andreas Meiser

{"title":"Rapid and Effective Elimination of Myoglobin with CytoSorb® Hemoadsorber in Patients with Severe Rhabdomyolysis.","authors":"Frederic Albrecht, Stefan Schunk, Maren Fuchs, Thomas Volk, Juergen Geisel, Danilo Fliser, Andreas Meiser","doi":"10.1159/000534479","DOIUrl":"10.1159/000534479","url":null,"abstract":"Introduction: Rhabdomyolysis is characterized by destruction of muscle fibers by various causes and is diagnosed by increased creatine kinase concentrations in the blood. Myoglobin released into the blood may cause acute kidney injury. In this randomized controlled study, we hypothesized that myoglobin elimination would be faster when a hemoadsorber was added to a continuous veno-venous hemodialysis (CVVHD).Methods: Four patients in the control group received CVVHD with a high cut-off hemofilter using high blood and dialysate flows for 48 h. Four patients in the CytoSorb group received the same treatment, but in addition, the hemoadsorber CytoSorb® was inserted in front of the hemofilter and replaced once after 24 h. Blood samples were drawn simultaneously before (pre) and after (post) the hemofilter or else the hemoadsorber, after 5 and 30 min, as well as after 2, 4, 8, and 24 h. All measurements were repeated the next day after the hemoadsorber had been renewed in the CytoSorb group. Primary outcome was the area under the curve (AUC) of the relative myoglobin concentrations as percent of baseline. To evaluate the efficacy of myoglobin removal, relative reductions in myoglobin concentrations during one passage through each device at each time point were calculated.Results: Patients in the CytoSorb group had a significantly lower AUC during the first 24 h (42 ± 10% vs. 63 ± 6%, p = 0.029) as well as during the observation period of 48 h (26 ± 7% vs. 51 ± 12%, p = 0.029). The relative reductions for myoglobin were considerably higher in the CytoSorb group compared to the control group during the first 8 h.Conclusion: Myoglobin concentrations declined considerably faster when CytoSorb was added to a CVVHD. When compared to a high-cut-off hemofilter, efficacy of CytoSorb in myoglobin elimination was much better. Because of saturation after 8-12 h an exchange may be necessary.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"88-95"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71420374","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}

引用次数: 0

Haptoglobin Administration for Intravascular Hemolysis: A Systematic Review. 应用巯基乙醇治疗血管内溶血：系统回顾

IF 2.2 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2024-08-05 DOI: 10.1159/000539363

Luca Baldetti, Rosa Labanca, Alessandro Belletti, André Dias-Frias, Beatrice Peveri, Yuki Kotani, Stefano Fresilli, Francesco Calvo, Evgeny Fominskiy, Marina Pieri, Silvia Ajello, Anna Mara Scandroglio

{"title":"Haptoglobin Administration for Intravascular Hemolysis: A Systematic Review.","authors":"Luca Baldetti, Rosa Labanca, Alessandro Belletti, André Dias-Frias, Beatrice Peveri, Yuki Kotani, Stefano Fresilli, Francesco Calvo, Evgeny Fominskiy, Marina Pieri, Silvia Ajello, Anna Mara Scandroglio","doi":"10.1159/000539363","DOIUrl":"10.1159/000539363","url":null,"abstract":"Introduction: Exogenous haptoglobin administration may enhance plasma-free hemoglobin (pfHb) clearance during hemolysis and reduce its end-organ damage: we systematically reviewed and summarized available evidence on the use of haptoglobin as a treatment for hemolysis of any cause.Methods: We included studies describing haptoglobin administration as treatment or prevention of hemolysis-related complications. Only studies with a control group reporting at least one of the outcomes of interest were included in the quantitative synthesis. Primary outcome was the change in pfHb concentration 1 h after haptoglobin infusion.Results: Among 573 articles, 13 studies were included in the review (677 patients, 52.8% received haptoglobin). Median initial haptoglobin intravenous bolus was 4,000 (2,000, 4,000) IU. Haptoglobin was associated with lower pfHb 1 h (SMD -11.28; 95% CI: -15.80 to -6.75; p < 0.001) and 24 h (SMD -2.65; 95% CI: -4.73 to -0.57; p = 0.001) after infusion. There was no difference in all-cause mortality between haptoglobin-treated patients and control group (OR 1.41; 95% CI: 0.49-4.95; p = 0.520). Haptoglobin was associated with a lower incidence of acute kidney injury (OR 0.64; 95% CI: 0.44-0.93; p = 0.020). No adverse events or side effects associated with haptoglobin use were reported.Conclusions: Haptoglobin administration has been used in patients with hemolysis from any cause to treat or prevent hemolysis-associated adverse events. Haptoglobin may reduce levels of pfHb and preserve kidney function without increase in adverse events.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"851-859"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892807","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}

引用次数: 0

Sampling from Extracorporeal Circuit: A Step Forward for Dose Monitoring in Continuous Renal Replacement Therapy. 体外电路采样:CRRT中剂量监测的新进展。

IF 3 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2023-11-22 DOI: 10.1159/000535308

Maria Cristina Ruffa, Vittorio Bocciero, Sergio Fabbri, Francesca Nencini, Alessandra Fanelli, Stefano Romagnoli, Zaccaria Ricci, Valentina Cauda, Gianluca Villa

{"title":"Sampling from Extracorporeal Circuit: A Step Forward for Dose Monitoring in Continuous Renal Replacement Therapy.","authors":"Maria Cristina Ruffa, Vittorio Bocciero, Sergio Fabbri, Francesca Nencini, Alessandra Fanelli, Stefano Romagnoli, Zaccaria Ricci, Valentina Cauda, Gianluca Villa","doi":"10.1159/000535308","DOIUrl":"10.1159/000535308","url":null,"abstract":"Introduction: Continuous renal replacement therapies (CRRTs) require constant monitoring and periodic treatment readjustments, being applied to highly complex patients, with rapidly changing clinical needs. To promote precision medicine in the field of renal replacement therapy and encourage dynamic prescription, the Acute Dialysis Quality Initiative (ADQI) recommends periodically measuring the solutes extracorporeal clearance with the aim of assessing the current treatment delivery and the gap from the therapeutic prescription (often intended as effluent dose). To perform this procedure, it is therefore necessary to obtain blood and effluent samples from the extracorporeal circuit to measure the concentrations of a target solute (usually represented by urea) in prefilter, postfilter, and effluent lines. However, samples must be collected simultaneously from the extracorporeal circuit ports, with the same suction flow at an unknown rate.Methods: The proposed study takes the first step toward identifying the technical factors that should be considered in determining the optimal suction rate to collect samples from the extracorporeal circuit to measure the extracorporeal clearance for a specific solute.Results: The results obtained identify the low suction rate (i.e., 1 mL/min) as an ideal parameter for an adequate sampling method. Low velocities do not perturb the external circulation system and ensure stability prevailing pressures in the circuit. Higher velocities can be performed only with blood flows above 120 mL/min preferably in conditions of appropriate filtration fraction.Discussion/conclusions: The specific value of aspiration flow rate must be proportioned to the prescription of CRRT treatments set by the clinician.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"181-188"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138294497","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}

引用次数: 0

In vivo Assessment of a Manual Single Lumen Alternating Micro-Batch Hemodiafiltration System. 手动单腔交替微批次血液渗滤 (mSLAMB) 系统的体内评估。

IF 2.2 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2024-03-27 DOI: 10.1159/000538358

Sabrina L Lanker, Christopher J Pino, H David Humes, Lakhmir Chawla, Kimberly A Johnston

{"title":"In vivo Assessment of a Manual Single Lumen Alternating Micro-Batch Hemodiafiltration System.","authors":"Sabrina L Lanker, Christopher J Pino, H David Humes, Lakhmir Chawla, Kimberly A Johnston","doi":"10.1159/000538358","DOIUrl":"10.1159/000538358","url":null,"abstract":"Introduction: The manual single lumen alternating micro-batch hemodiafiltration (mSLAMB) system is a closed-loop dialysis system designed to provide kidney support in emergency situations (e.g., fluid overload, hyperkalemia, acidemia). If done repeatedly in small batches and at high flow rates, this system was found to achieve clearance levels comparable to traditional renal replacement therapy.Methods: Using a porcine model, uremic toxins and exogenous fluorescent tracer concentrations were successfully lowered within just 1 h of treatment.Results: With a maximal dialysate flow, mSLAMB can achieve decreases in serum potassium concentration of >0.5 mmol/L/h. With the mSLAMB hemodiafiltration system, micro-batch processing was also successful in removing up to 250 mL of ultrafiltrate in 8 cycles.Conclusion: This process could create a better fluid balance allowing for administering therapeutic fluids such as sodium bicarbonate in the clinic. Electrolyte imbalance and volume overload remain severe life-threatening emergencies in low resource settings; therefore, mSLAMB should be explored further due to its modest vascular access requirements, low cost, and ability to be performed without electricity or batteries.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"650-656"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140304767","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}

引用次数: 0

Japanese Study of the Effects of AMG (α1-Microglobulin) Reduction Rates on Survival (JAMREDS): A Protocol of a Multicenter Prospective Observational Cohort Study. 日本 AMG（α1-微球蛋白）降低率对生存的影响研究（JAMREDS）：多中心前瞻性观察队列研究方案。

IF 2.2 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2024-02-04 DOI: 10.1159/000536537

Toshihide Naganuma, Yoshiaki Takemoto, Naohiro Kamada, Daijiro Kabata, Ayumi Shintani, Keiko Ota, Jun Minakuchi, Ken Tsuchiya, Hideki Kawanishi

{"title":"Japanese Study of the Effects of AMG (α1-Microglobulin) Reduction Rates on Survival (JAMREDS): A Protocol of a Multicenter Prospective Observational Cohort Study.","authors":"Toshihide Naganuma, Yoshiaki Takemoto, Naohiro Kamada, Daijiro Kabata, Ayumi Shintani, Keiko Ota, Jun Minakuchi, Ken Tsuchiya, Hideki Kawanishi","doi":"10.1159/000536537","DOIUrl":"10.1159/000536537","url":null,"abstract":"Introduction: Recent advances in dialysis therapy have made it possible to remove middle molecules. Removal of small-middle molecules, such as β2-microglobulin, can now be achieved with conventional hemodialysis (HD), and removal of large-middle molecules has become a target, particularly for α1-microglobulin (AMG, 33 kD). The AMG reduction rate has emerged as a target for improvement of various clinical symptoms, but the effects on prognosis have yet to be determined. The \"Japanese study of the effects of AMG (α1-microglobulin) reduction rates on survival\" (JAMREDS) was started in April 2020, with the goal of determining if the AMG reduction rate associates with the risk of mortality and cardiovascular disease (CVD) events.Methods: JAMREDS is a prospective observational study in patients on HD to examine the effects of: (1) AMG reduction rate on survival outcome and CVD events; (2) dialysis treatment modalities (HD, intermittent infusion hemodiafiltration(iHDF), pre/post-dilution online HDF) on survival and CVD events (based on AMG reduction rates with treatment mode); and (3) AMG reduction rates on survival and CVD events in patients undergoing each therapy (iHDF, pre/post-dilution online HDF). The number of planned subjects was 4,000 in preplanning. Data are collected using RED-Cap, which is an EDC system. A total of 9,930 patients were enrolled at the beginning of the study at 59 registered facilities. The JAMREDS observation period will continue until the end of 2023, after which the data will be cleaned and confirmed before analysis.Conclusion: This study may provide new evidence for the relationship between the amount of removed large-middle molecules (such as AMG) and the mortality and CVD risk. Comparisons with convection volumes will also be of interest.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"527-532"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680642","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}

引用次数: 0

Low-Frequency/High-Frequency Ratio Is a Predictor of Death and Hospitalization in Patients on Maintenance Hemodialysis: A Prospective Study. 低频率/高频率比率是维持性血液透析患者住院和死亡的预测因素：一项前瞻性研究。

IF 2.2 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2024-02-07 DOI: 10.1159/000536538

Yafei Chen, Xu Li, Li Zhu, Yan Wang, Liangying Gan, Li Zuo

{"title":"Low-Frequency/High-Frequency Ratio Is a Predictor of Death and Hospitalization in Patients on Maintenance Hemodialysis: A Prospective Study.","authors":"Yafei Chen, Xu Li, Li Zhu, Yan Wang, Liangying Gan, Li Zuo","doi":"10.1159/000536538","DOIUrl":"10.1159/000536538","url":null,"abstract":"Introduction: This study aimed to evaluate the predictive value of the low-frequency/high-frequency (LF/HF) ratio in all causes of death and hospitalizations in maintenance hemodialysis (MHD) patients.Methods: This is a single-center prospective study with a 48-h electrocardiograph (ECG) recording. A total of 110 patients were enrolled in the study from October 1, 2021, to September 30, 2022. ECG recordings started before initiation of the hemodialysis (HD) session and lasted for 48 h, covering the intra- as well as inter-HD period. We divided our participants into two groups based on the median value of LF/HF, one of the frequency domain parameters of heart rate variability (HRV). Patients with LF/HF <1.33 were categorized as group A and those with LF/HF ≥1.33 were group B. The endpoint of the study was a composite event of death or hospitalization. We followed all patients until the composite endpoint or the end of the study on February 28, 2023. Multivariate Cox regression was used to assess the adjusted effect of LF/HF on the composite endpoint.Results: Patients in group A were older and the number of patients with diabetes was more than that of group B. With regards to the laboratory data, group A had lower serum creatinine and uric acid and higher ferritin and NT-ProBNP. In the index HD session, systolic blood pressure was higher but diastolic blood pressure was significantly lower in group A. During the median follow-up period of 8.8 (7.6-9.8) months, 27 hospitalizations and 10 deaths were documented. Increased LF/HF ratio was an independent protective factor of composite endpoint events (HR = 0.357, 95% CI: 0.162-0.790, p = 0.011).Conclusion: Risks of mortality and hospitalizations are higher among HD patients having decreased LF/HF ratios. LF/HF in the 48-h recording can be considered as a prognostic factor for risk stratification in HD patients.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"557-564"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139701733","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}

引用次数: 0

Pediatric Emergent Peritoneal Dialysis in Intensive Care Units: Indications, Techniques, and Outcomes. 重症监护病房的儿科紧急腹膜透析：适应症、技术和结果。

IF 2.2 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2024-05-26 DOI: 10.1159/000539512

Yi-Hsuan Huang, Chia-Man Chou, Sheng-Yang Huang, Hou-Chuan Chen

{"title":"Pediatric Emergent Peritoneal Dialysis in Intensive Care Units: Indications, Techniques, and Outcomes.","authors":"Yi-Hsuan Huang, Chia-Man Chou, Sheng-Yang Huang, Hou-Chuan Chen","doi":"10.1159/000539512","DOIUrl":"10.1159/000539512","url":null,"abstract":"Introduction: This study aimed to identify risk factors affecting outcomes in pediatric patients requiring emergent peritoneal dialysis (PD) for all causes, focusing on survival rates, kidney function recovery, PD duration, complications, and quality of life.Methods: A retrospective review was conducted on medical records of pediatric patients who received emergent bedside PD in the intensive care unit from January 2010 to February 2023. Thirty-four catheters were placed, with demographic, preoperative, and procedural data collected. MedCalc® Statistical Software was used for analysis with a significance level set at p < 0.05. Prophylactic antibiotics were administered prior to surgery, and catheters were placed using a consistent technique by a single team of pediatric surgeons.Results: The median age at catheter placement was 39 days (range 2-2,286), and the median body weight was 3.53 kg (range 1.2-48.8). The majority were male (64.7%), with 17.6% preterm. The most common indication for PD was acute kidney injury (AKI) (88.2%), followed by hyperammonemia, metabolic acidosis, and abdominal compartment syndrome. The median waiting period for PD placement was 1 day, and the median duration of PD was 7 days. Complications included dialysate leakage (22.8%) and catheter obstruction leading to PD discontinuation (31.4%). The mortality rate was high at 71.4%.Conclusion: It is advisable to advocate for the early initiation of PD in pediatric patients following cardiac surgery. AKI is a significant risk factor for mortality, while prematurity increases the risk of dialysate leakage. Omentectomy and the method of catheter exit did not significantly affect outcomes. The study's limitations highlight the need for larger prospective studies to better understand and improve emergent PD management in this vulnerable population.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"676-685"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155093","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}

引用次数: 0

Characteristics and Prognostic Factors of SARS-CoV-2 Omicron Variant Infection in Hemodialysis Patients: A Single-Center Study in China. 血液透析患者SARS-CoV-2组粒变异感染的特点及预后因素:中国单中心研究

IF 2.2 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2023-11-16 DOI: 10.1159/000535244

Fan Zhang, Guoli Li, Jie Yu, Yiyu Shen, Yiya Yang, Shuangshuang Fu, Kanghan Liu, Yumei Liang, Xun Luo, Yinyin Chen

{"title":"Characteristics and Prognostic Factors of SARS-CoV-2 Omicron Variant Infection in Hemodialysis Patients: A Single-Center Study in China.","authors":"Fan Zhang, Guoli Li, Jie Yu, Yiyu Shen, Yiya Yang, Shuangshuang Fu, Kanghan Liu, Yumei Liang, Xun Luo, Yinyin Chen","doi":"10.1159/000535244","DOIUrl":"10.1159/000535244","url":null,"abstract":"Introduction: This study aimed to evaluate the characteristics and prognostic factors for coronavirus disease 2019 (COVID-19) patients on maintenance hemodialysis (HD).Methods: All admitted HD patients who were infected with SARS-CoV-2 from December 1, 2022, to January 31, 2023, were included. Patients with pneumonia were further classified into the mild, moderate, severe, and critical illness. Clinical symptoms, laboratory results, radiologic findings, treatment, and clinical outcomes were collected. Independent risk factors for progression to critical disease and in-hospital mortality were determined by the multivariate regression analysis. The receiver operating characteristic analysis with the area under the curve was used to evaluate the predictive performance of developing critical status and in-hospital mortality.Results: A total of 182 COVID-19 patients with HD were included, with an average age of the 61.55 years. Out of the total, 84 (46.1%) patients did not have pneumonia and 98 (53.8%) patients had pneumonia. Among patients with pneumonia, 48 (49.0%) had moderate illness, 26 (26.5%) severe illness, and 24 (24.5%) critical illness, respectively. Elder age [HR (95% CI): 1.07 (1.01-1.13), p <0.01], increased levels of lactate dehydrogenase (LDH) [1.01 (1.003-1.01), p <0.01], and C-reactive protein (CRP) [1.01 (1.00-1.01), p = 0.04] were risk factors for developing critical illness. Elder age [1.11 (1.03-1.19), p = 0.01], increased procalcitonin (PCT) [1.07 (1.02-1.12), p = 0.01], and LDH level [1.004 (1-1.01), p = 0.03] were factors associated with increased risk of in-hospital mortality.Conclusion: Age, CRP, PCT, and LDH can be used to predict negative clinical outcomes for HD patients with COVID-19 pneumonia.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"288-300"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396077","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}

引用次数: 0

COVID-19: The Dysregulated Response to Infection - Why Consider Polymethylmethacrylate Membrane in Hemodialysis Patients? 新冠肺炎：感染反应失调-为什么要考虑血液透析患者的聚甲基丙烯酸甲酯膜？

IF 2.2 3区医学

Blood Purification Pub Date : 2024-01-01 Epub Date: 2023-10-16 DOI: 10.1159/000533738

Andrea Spasiano, Gianmarco De Luca, Giulia Bartoli, Andrea Dello Strologo, Maria Arena, Giuseppe Grandaliano

{"title":"COVID-19: The Dysregulated Response to Infection - Why Consider Polymethylmethacrylate Membrane in Hemodialysis Patients?","authors":"Andrea Spasiano, Gianmarco De Luca, Giulia Bartoli, Andrea Dello Strologo, Maria Arena, Giuseppe Grandaliano","doi":"10.1159/000533738","DOIUrl":"10.1159/000533738","url":null,"abstract":"Since SARS-CoV-2 spread through China at the end of 2019, COVID-19 has been probably the most difficult challenge in the last decades for healthcare systems all around the world, still representing a danger for fragile patients with different comorbidities. Chronic dialysis patients affected by COVID-19 experienced severe disease with a higher mortality rate compared to the general population. Morbidity and mortality of this severe acute respiratory syndrome depend on both acute respiratory failure and systemic immunological involvement with consequent inflammation-mediated injury. Indeed, the most important determining factor of COVID-19 severity is the strength of the so-called \"cytokine storm\" associated with SARS-CoV-2 infection. Therefore, this severe infection varies clinically from an asymptomatic condition to a generalized and violent inflammatory response and acute respiratory distress syndrome, with consequent pulmonary interstitial edema and a high risk of multi-organ failure. The use of extracorporeal therapies targeting cytokine clearance to improve patients' outcomes has been widely debated, especially in end-stage kidney disease's patients on maintenance dialysis or in individuals affected by acute kidney injury admitted to intensive care units. Different studies were conducted to demonstrate how specific dialyzers could decrease the COVID-19 inflammatory state. The aim of this narrative review was to summarize main studies about this topic, focusing primarily on the role of polymethylmethacrylate dialyzer and underlining pros and cons of this sorbent.","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"373-378"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41232091","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}

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