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NARRATIVE REVIEW
Care of the chronic dialysis patient in the intensive care unit: a state-of-the-art review
Critical Care Science. 2025;37:e20250130
02-18-2025
Abstract
NARRATIVE REVIEWCare of the chronic dialysis patient in the intensive care unit: a state-of-the-art review
Critical Care Science. 2025;37:e20250130
02-18-2025DOI 10.62675/2965-2774.20250130
Views104See moreABSTRACT
Chronic dialysis patients account for a high proportion of intensive care unit admissions. The prevalent dialysis population is growing worldwide, accompanied by increasing medical complexity and comorbidities. Critical care physicians must be familiar with the unique clinical characteristics of this patient group. There is relatively little evidence specifically concerning the assessment and treatment of critically unwell individuals on long-term dialysis. This narrative review explores the approach to the management of chronic dialysis patients in the intensive care unit.
Views104
Abstract
NARRATIVE REVIEWCare of the chronic dialysis patient in the intensive care unit: a state-of-the-art review
Critical Care Science. 2025;37:e20250130
02-18-2025DOI 10.62675/2965-2774.20250130
Views104See moreABSTRACT
Chronic dialysis patients account for a high proportion of intensive care unit admissions. The prevalent dialysis population is growing worldwide, accompanied by increasing medical complexity and comorbidities. Critical care physicians must be familiar with the unique clinical characteristics of this patient group. There is relatively little evidence specifically concerning the assessment and treatment of critically unwell individuals on long-term dialysis. This narrative review explores the approach to the management of chronic dialysis patients in the intensive care unit.
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ORIGINAL ARTICLE
Factors associated with carbon dioxide transfer in an experimental model of severe acute kidney injury and hypoventilation during high bicarbonate continuous renal replacement therapy and oxygenation membrane support
- Yuri de Albuquerque Pessoa dos Santos
, - Luis Carlos Maia Cardozo Junior ,
- Pedro Vitale Mendes ,
- Bruno Adler Maccagnan Pinheiro Besen ,
- Marcelo Park
06-19-2024
Abstract
ORIGINAL ARTICLEFactors associated with carbon dioxide transfer in an experimental model of severe acute kidney injury and hypoventilation during high bicarbonate continuous renal replacement therapy and oxygenation membrane support
Critical Care Science. 2024;36:e20240005en
06-19-2024DOI 10.62675/2965-2774.20240005-en
- Yuri de Albuquerque Pessoa dos Santos ,
- Luis Carlos Maia Cardozo Junior ,
- Pedro Vitale Mendes ,
- Bruno Adler Maccagnan Pinheiro Besen ,
- Marcelo Park
Views62ABSTRACT
Objective
To investigate the factors influencing carbon dioxide transfer in a system that integrates an oxygenation membrane in series with high-bicarbonate continuous veno-venous hemodialysis in hypercapnic animals.
Methods
In an experimental setting, we induced severe acute kidney injury and hypercapnia in five female Landrace pigs. Subsequently, we initiated high (40mEq/L) bicarbonate continuous veno-venous hemodialysis with an oxygenation membrane in series to maintain a pH above 7.25. At intervals of 1 hour, 6 hours, and 12 hours following the initiation of continuous veno-venous hemodialysis, we performed standardized sweep gas flow titration to quantify carbon dioxide transfer. We evaluated factors associated with carbon dioxide transfer through the membrane lung with a mixed linear model.
Results
A total of 20 sweep gas flow titration procedures were conducted, yielding 84 measurements of carbon dioxide transfer. Multivariate analysis revealed associations among the following (coefficients ± standard errors): core temperature (+7.8 ± 1.6 °C, p < 0.001), premembrane partial pressure of carbon dioxide (+0.2 ± 0.1/mmHg, p < 0.001), hemoglobin level (+3.5 ± 0.6/g/dL, p < 0.001), sweep gas flow (+6.2 ± 0.2/L/minute, p < 0.001), and arterial oxygen saturation (-0.5 ± 0.2%, p = 0.019). Among these variables, and within the physiological ranges evaluated, sweep gas flow was the primary modifiable factor influencing the efficacy of low-blood-flow carbon dioxide removal.
Conclusion
Sweep gas flow is the main carbon dioxide removal-related variable during continuous veno-venous hemodialysis with a high bicarbonate level coupled with an oxygenator. Other carbon dioxide transfer modulating variables included the hemoglobin level, arterial oxygen saturation, partial pressure of carbon dioxide and core temperature. These results should be interpreted as exploratory to inform other well-designed experimental or clinical studies.
Keywords:Acute Kidney InjuryAnimalBicarbonatesCarbon dioxideRenal replacement therapyRespiratory insufficiencySee moreViews62Abstract
ORIGINAL ARTICLEFactors associated with carbon dioxide transfer in an experimental model of severe acute kidney injury and hypoventilation during high bicarbonate continuous renal replacement therapy and oxygenation membrane support
Critical Care Science. 2024;36:e20240005en
06-19-2024DOI 10.62675/2965-2774.20240005-en
- Yuri de Albuquerque Pessoa dos Santos ,
- Luis Carlos Maia Cardozo Junior ,
- Pedro Vitale Mendes ,
- Bruno Adler Maccagnan Pinheiro Besen ,
- Marcelo Park
Views62ABSTRACT
Objective
To investigate the factors influencing carbon dioxide transfer in a system that integrates an oxygenation membrane in series with high-bicarbonate continuous veno-venous hemodialysis in hypercapnic animals.
Methods
In an experimental setting, we induced severe acute kidney injury and hypercapnia in five female Landrace pigs. Subsequently, we initiated high (40mEq/L) bicarbonate continuous veno-venous hemodialysis with an oxygenation membrane in series to maintain a pH above 7.25. At intervals of 1 hour, 6 hours, and 12 hours following the initiation of continuous veno-venous hemodialysis, we performed standardized sweep gas flow titration to quantify carbon dioxide transfer. We evaluated factors associated with carbon dioxide transfer through the membrane lung with a mixed linear model.
Results
A total of 20 sweep gas flow titration procedures were conducted, yielding 84 measurements of carbon dioxide transfer. Multivariate analysis revealed associations among the following (coefficients ± standard errors): core temperature (+7.8 ± 1.6 °C, p < 0.001), premembrane partial pressure of carbon dioxide (+0.2 ± 0.1/mmHg, p < 0.001), hemoglobin level (+3.5 ± 0.6/g/dL, p < 0.001), sweep gas flow (+6.2 ± 0.2/L/minute, p < 0.001), and arterial oxygen saturation (-0.5 ± 0.2%, p = 0.019). Among these variables, and within the physiological ranges evaluated, sweep gas flow was the primary modifiable factor influencing the efficacy of low-blood-flow carbon dioxide removal.
Conclusion
Sweep gas flow is the main carbon dioxide removal-related variable during continuous veno-venous hemodialysis with a high bicarbonate level coupled with an oxygenator. Other carbon dioxide transfer modulating variables included the hemoglobin level, arterial oxygen saturation, partial pressure of carbon dioxide and core temperature. These results should be interpreted as exploratory to inform other well-designed experimental or clinical studies.
Keywords:Acute Kidney InjuryAnimalBicarbonatesCarbon dioxideRenal replacement therapyRespiratory insufficiencySee more
- Yuri de Albuquerque Pessoa dos Santos
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ORIGINAL ARTICLE
Accuracy of the persistent AKI risk index in predicting acute kidney injury in patients admitted to the intensive care unit for acute respiratory failure
- João Raphael Zanlorensi Glir ,
- Rafaella Stradiotto Bernardelli ,
- Amanda Christina Kozesinski-Nakatani ,
- Rafael Alexandre de Oliveira Deucher ,
- Mirella Cristine de Oliveira , [ ... ],
- Álvaro Réa-Neto
12-22-2023
Abstract
ORIGINAL ARTICLEAccuracy of the persistent AKI risk index in predicting acute kidney injury in patients admitted to the intensive care unit for acute respiratory failure
Critical Care Science. 2023;35(3):302-310
12-22-2023DOI 10.5935/2965-2774.20230141-en
- João Raphael Zanlorensi Glir ,
- Rafaella Stradiotto Bernardelli ,
- Amanda Christina Kozesinski-Nakatani ,
- Rafael Alexandre de Oliveira Deucher ,
- Mirella Cristine de Oliveira ,
- Álvaro Réa-Neto
Views50ABSTRACT
Objective:
To evaluate the accuracy of the persistent AKI risk index (PARI) in predicting acute kidney injury within 72 hours after admission to the intensive care unit, persistent acute kidney injury, renal replacement therapy, and death within 7 days in patients hospitalized due to acute respiratory failure.
Methods:
This study was done in a cohort of diagnoses of consecutive adult patients admitted to the intensive care unit of eight hospitals in Curitiba, Brazil, between March and September 2020 due to acute respiratory failure secondary to suspected COVID-19. The COVID-19 diagnosis was confirmed or refuted by RT-PCR for the detection of SARS-CoV-2. The ability of PARI to predict acute kidney injury at 72 hours, persistent acute kidney injury, renal replacement therapy, and death within 7 days was analyzed by ROC curves in comparison to delta creatinine, SOFA, and APACHE II.
Results:
Of the 1,001 patients in the cohort, 538 were included in the analysis. The mean age was 62 ± 17 years, 54.8% were men, and the median APACHE II score was 12. At admission, the median SOFA score was 3, and 83.3% had no renal dysfunction. After admission to the intensive care unit, 17.1% had acute kidney injury within 72 hours, and through 7 days, 19.5% had persistent acute kidney injury, 5% underwent renal replacement therapy, and 17.1% died. The PARI had an area under the ROC curve of 0.75 (0.696 - 0.807) for the prediction of acute kidney injury at 72 hours, 0.71 (0.613 - 0.807) for renal replacement therapy, and 0.64 (0.565 - 0.710) for death.
Conclusion:
The PARI has acceptable accuracy in predicting acute kidney injury within 72 hours and renal replacement therapy within 7 days of admission to the intensive care unit, but it is not significantly better than the other scores.
Keywords:Acute Kidney InjuryCoronavirus infectionsCOVID-19deathintensive care unitsmortalityprognosisRenal replacement therapyRespiratory insufficiencySARS-CoV-2See moreViews50Abstract
ORIGINAL ARTICLEAccuracy of the persistent AKI risk index in predicting acute kidney injury in patients admitted to the intensive care unit for acute respiratory failure
Critical Care Science. 2023;35(3):302-310
12-22-2023DOI 10.5935/2965-2774.20230141-en
- João Raphael Zanlorensi Glir ,
- Rafaella Stradiotto Bernardelli ,
- Amanda Christina Kozesinski-Nakatani ,
- Rafael Alexandre de Oliveira Deucher ,
- Mirella Cristine de Oliveira ,
- Álvaro Réa-Neto
Views50ABSTRACT
Objective:
To evaluate the accuracy of the persistent AKI risk index (PARI) in predicting acute kidney injury within 72 hours after admission to the intensive care unit, persistent acute kidney injury, renal replacement therapy, and death within 7 days in patients hospitalized due to acute respiratory failure.
Methods:
This study was done in a cohort of diagnoses of consecutive adult patients admitted to the intensive care unit of eight hospitals in Curitiba, Brazil, between March and September 2020 due to acute respiratory failure secondary to suspected COVID-19. The COVID-19 diagnosis was confirmed or refuted by RT-PCR for the detection of SARS-CoV-2. The ability of PARI to predict acute kidney injury at 72 hours, persistent acute kidney injury, renal replacement therapy, and death within 7 days was analyzed by ROC curves in comparison to delta creatinine, SOFA, and APACHE II.
Results:
Of the 1,001 patients in the cohort, 538 were included in the analysis. The mean age was 62 ± 17 years, 54.8% were men, and the median APACHE II score was 12. At admission, the median SOFA score was 3, and 83.3% had no renal dysfunction. After admission to the intensive care unit, 17.1% had acute kidney injury within 72 hours, and through 7 days, 19.5% had persistent acute kidney injury, 5% underwent renal replacement therapy, and 17.1% died. The PARI had an area under the ROC curve of 0.75 (0.696 - 0.807) for the prediction of acute kidney injury at 72 hours, 0.71 (0.613 - 0.807) for renal replacement therapy, and 0.64 (0.565 - 0.710) for death.
Conclusion:
The PARI has acceptable accuracy in predicting acute kidney injury within 72 hours and renal replacement therapy within 7 days of admission to the intensive care unit, but it is not significantly better than the other scores.
Keywords:Acute Kidney InjuryCoronavirus infectionsCOVID-19deathintensive care unitsmortalityprognosisRenal replacement therapyRespiratory insufficiencySARS-CoV-2See more
- João Raphael Zanlorensi Glir
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Case Report
Extracorporeal carbon dioxide removal with continuous renal replacement therapy. Case description and literature review
Revista Brasileira de Terapia Intensiva. 2020;32(1):143-148
05-08-2020
Abstract
Case ReportExtracorporeal carbon dioxide removal with continuous renal replacement therapy. Case description and literature review
Revista Brasileira de Terapia Intensiva. 2020;32(1):143-148
05-08-2020DOI 10.5935/0103-507X.20200020
Views6See moreABSTRACT
In recent years and due, in part, to technological advances, the use of extracorporeal carbon dioxide removal systems paired with the use of extracorporeal membrane oxygenation has resurfaced. However, studies are lacking that establish its indications and evidence to support its use. These systems efficiently eliminate carbon dioxide in patients with hypercapnic respiratory failure using small-bore cannula, usually double-lumen cannula with a small membrane lung surface area. Currently, we have several systems with different types of membranes and sizes. Pump-driven veno-venous systems generate fewer complications than do arteriovenous systems. Both require systemic anticoagulation. The “lung-kidney” support system, by combining a removal system with hemofiltration, simultaneously eliminates carbon dioxide and performs continuous extrarenal replacement. We describe our initial experience with a combined system for extracorporeal carbon dioxide removal-continuous extrarenal replacement in a lung transplant patients with hypercapnic respiratory failure, barotrauma and associated acute renal failure. The most important technical aspects, the effectiveness of the system for the elimination of carbon dioxide and a review of the literature are described.
Views6Abstract
Case ReportExtracorporeal carbon dioxide removal with continuous renal replacement therapy. Case description and literature review
Revista Brasileira de Terapia Intensiva. 2020;32(1):143-148
05-08-2020DOI 10.5935/0103-507X.20200020
Views6See moreABSTRACT
In recent years and due, in part, to technological advances, the use of extracorporeal carbon dioxide removal systems paired with the use of extracorporeal membrane oxygenation has resurfaced. However, studies are lacking that establish its indications and evidence to support its use. These systems efficiently eliminate carbon dioxide in patients with hypercapnic respiratory failure using small-bore cannula, usually double-lumen cannula with a small membrane lung surface area. Currently, we have several systems with different types of membranes and sizes. Pump-driven veno-venous systems generate fewer complications than do arteriovenous systems. Both require systemic anticoagulation. The “lung-kidney” support system, by combining a removal system with hemofiltration, simultaneously eliminates carbon dioxide and performs continuous extrarenal replacement. We describe our initial experience with a combined system for extracorporeal carbon dioxide removal-continuous extrarenal replacement in a lung transplant patients with hypercapnic respiratory failure, barotrauma and associated acute renal failure. The most important technical aspects, the effectiveness of the system for the elimination of carbon dioxide and a review of the literature are described.
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Case Report
Rituximab use for lymphoplasmacytic lymphoma during continuous renal replacement therapy
Revista Brasileira de Terapia Intensiva. 2019;31(2):258-261
06-27-2019
Abstract
Case ReportRituximab use for lymphoplasmacytic lymphoma during continuous renal replacement therapy
Revista Brasileira de Terapia Intensiva. 2019;31(2):258-261
06-27-2019DOI 10.5935/0103-507X.20190040
Views56ABSTRACT
Rituximab safety and efficacy in patients with renal impairment have not been established, nor have the effects of hemodialysis on serum rituximab level. There are only a few published case reports assessing serum rituximab level pre- and postdialysis. No data have been published regarding the usage of rituximab in patients with continuous renal replacement therapy. The authors present a case of a 59-year-old female patient who presented with paraneoplastic tetraparesis. She was admitted to the intensive care unit due to alveolar hemorrhage with respiratory failure and acute kidney injury requiring continuous renal replacement therapy. After a diagnostic workup, the diagnosis of lymphoplasmacytic lymphoma was established. Therapy with rituximab and cyclophosphamide was started. Rituximab levels were determined in serum and dialysate. No rituximab was found in the dialysate. The patient died after 2 months in the intensive care unit from nosocomial pneumonia due to multidrug-resistant Pseudomonas aeruginosa.
Keywords:critical careLymphomaPolyradiculoneuropathyrenal insufficiencyRenal replacement therapyRituximabSee moreViews56Abstract
Case ReportRituximab use for lymphoplasmacytic lymphoma during continuous renal replacement therapy
Revista Brasileira de Terapia Intensiva. 2019;31(2):258-261
06-27-2019DOI 10.5935/0103-507X.20190040
Views56ABSTRACT
Rituximab safety and efficacy in patients with renal impairment have not been established, nor have the effects of hemodialysis on serum rituximab level. There are only a few published case reports assessing serum rituximab level pre- and postdialysis. No data have been published regarding the usage of rituximab in patients with continuous renal replacement therapy. The authors present a case of a 59-year-old female patient who presented with paraneoplastic tetraparesis. She was admitted to the intensive care unit due to alveolar hemorrhage with respiratory failure and acute kidney injury requiring continuous renal replacement therapy. After a diagnostic workup, the diagnosis of lymphoplasmacytic lymphoma was established. Therapy with rituximab and cyclophosphamide was started. Rituximab levels were determined in serum and dialysate. No rituximab was found in the dialysate. The patient died after 2 months in the intensive care unit from nosocomial pneumonia due to multidrug-resistant Pseudomonas aeruginosa.
Keywords:critical careLymphomaPolyradiculoneuropathyrenal insufficiencyRenal replacement therapyRituximabSee more -
ORIGINAL ARTICLE
Existing capacity for renal replacement therapy and site-specific practices for managing acute kidney injury at centers participating in the BaSICS trial
Revista Brasileira de Terapia Intensiva. 2018;30(3):264-285
01-01-2018
Abstract
ORIGINAL ARTICLEExisting capacity for renal replacement therapy and site-specific practices for managing acute kidney injury at centers participating in the BaSICS trial
Revista Brasileira de Terapia Intensiva. 2018;30(3):264-285
01-01-2018DOI 10.5935/0103-507X.20180058
Views37See moreABSTRACT
Objective:
To investigate the existing capacity for renal replacement therapy and site-specific practices for managing acute kidney injury at centers participating in the BaSICS trial.
Methods:
A questionnaire was provided to the chairs of 61 intensive care units enrolled in a randomized clinical trial in Brazil. A total of 124 physicians completed the questionnaire.
Results:
Approximately 15% of the patients admitted to the analyzed intensive care units received renal replacement therapy at the time of data collection. At least one renal replacement method was available in all of the analyzed units. Continuous methods were available more frequently at the private units than at the public units. The time from indication to onset of treatment was longer at the public units than at private units. The main obstacles to treatment initiation at public intensive care units were related to the availability of equipment and personnel, while the main bottleneck at private units was the nephrologist assessment. A considerable proportion of the participants stated that they would change their approach to renal replacement therapy if there were no limitations on the availability of methods in their units.
Conclusion:
There was wide variation in the availability of resources for renal replacement therapy and in the management of acute kidney injury in Brazilian intensive care units. This information should be taken into account when planning clinical trials focused on this topic in Brazil.
Views37Abstract
ORIGINAL ARTICLEExisting capacity for renal replacement therapy and site-specific practices for managing acute kidney injury at centers participating in the BaSICS trial
Revista Brasileira de Terapia Intensiva. 2018;30(3):264-285
01-01-2018DOI 10.5935/0103-507X.20180058
Views37See moreABSTRACT
Objective:
To investigate the existing capacity for renal replacement therapy and site-specific practices for managing acute kidney injury at centers participating in the BaSICS trial.
Methods:
A questionnaire was provided to the chairs of 61 intensive care units enrolled in a randomized clinical trial in Brazil. A total of 124 physicians completed the questionnaire.
Results:
Approximately 15% of the patients admitted to the analyzed intensive care units received renal replacement therapy at the time of data collection. At least one renal replacement method was available in all of the analyzed units. Continuous methods were available more frequently at the private units than at the public units. The time from indication to onset of treatment was longer at the public units than at private units. The main obstacles to treatment initiation at public intensive care units were related to the availability of equipment and personnel, while the main bottleneck at private units was the nephrologist assessment. A considerable proportion of the participants stated that they would change their approach to renal replacement therapy if there were no limitations on the availability of methods in their units.
Conclusion:
There was wide variation in the availability of resources for renal replacement therapy and in the management of acute kidney injury in Brazilian intensive care units. This information should be taken into account when planning clinical trials focused on this topic in Brazil.
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Review Article
Early versus delayed initiation of renal replacement therapy for acute kidney injury: an updated systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials
Revista Brasileira de Terapia Intensiva. 2018;30(3):376-384
01-01-2018
Abstract
Review ArticleEarly versus delayed initiation of renal replacement therapy for acute kidney injury: an updated systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials
Revista Brasileira de Terapia Intensiva. 2018;30(3):376-384
01-01-2018DOI 10.5935/0103-507X.20180054
Views46ABSTRACT
Objective:
To evaluate whether early initiation of renal replacement therapy is associated with lower mortality in patients with acute kidney injury compared to delayed initiation.
Methods:
We performed a systematic review and meta-analysis of randomized controlled trials comparing early versus delayed initiation of renal replacement therapy in patients with acute kidney injury without the life-threatening acute kidney injury-related symptoms of fluid overload or metabolic disorders. Two investigators extracted the data from the selected studies. The Cochrane Risk of Bias Tool was used to assess the quality of the studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to test the overall quality of the evidence.
Results:
Six randomized controlled trials (1,292 patients) were included. There was no statistically significant difference between early and delayed initiation of renal replacement therapy regarding the primary outcome (OR 0.82; 95%CI, 0.48 - 1.42; p = 0.488), but there was an increased risk of catheter-related bloodstream infection when renal replacement therapy was initiated early (OR 1.77; 95%CI, 1.01 - 3.11; p = 0.047). The quality of evidence generated by our meta-analysis for the primary outcome was considered low due to the risk of bias of the included studies and the heterogeneity among them.
Conclusion:
Early initiation of renal replacement therapy is not associated with improved survival. However, the quality of the current evidence is low, and the criteria used for -early- and -delayed- initiation of renal replacement therapy are too heterogeneous among studies.
Keywords:Acute Kidney InjuryCritically illMeta-analysisRandomized controlled trialRenal replacement therapysystematic reviewSee moreViews46Abstract
Review ArticleEarly versus delayed initiation of renal replacement therapy for acute kidney injury: an updated systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials
Revista Brasileira de Terapia Intensiva. 2018;30(3):376-384
01-01-2018DOI 10.5935/0103-507X.20180054
Views46ABSTRACT
Objective:
To evaluate whether early initiation of renal replacement therapy is associated with lower mortality in patients with acute kidney injury compared to delayed initiation.
Methods:
We performed a systematic review and meta-analysis of randomized controlled trials comparing early versus delayed initiation of renal replacement therapy in patients with acute kidney injury without the life-threatening acute kidney injury-related symptoms of fluid overload or metabolic disorders. Two investigators extracted the data from the selected studies. The Cochrane Risk of Bias Tool was used to assess the quality of the studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to test the overall quality of the evidence.
Results:
Six randomized controlled trials (1,292 patients) were included. There was no statistically significant difference between early and delayed initiation of renal replacement therapy regarding the primary outcome (OR 0.82; 95%CI, 0.48 - 1.42; p = 0.488), but there was an increased risk of catheter-related bloodstream infection when renal replacement therapy was initiated early (OR 1.77; 95%CI, 1.01 - 3.11; p = 0.047). The quality of evidence generated by our meta-analysis for the primary outcome was considered low due to the risk of bias of the included studies and the heterogeneity among them.
Conclusion:
Early initiation of renal replacement therapy is not associated with improved survival. However, the quality of the current evidence is low, and the criteria used for -early- and -delayed- initiation of renal replacement therapy are too heterogeneous among studies.
Keywords:Acute Kidney InjuryCritically illMeta-analysisRandomized controlled trialRenal replacement therapysystematic reviewSee more
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Review Articles
Biomarkers of renal recovery after acute kidney injury
Revista Brasileira de Terapia Intensiva. 2017;29(3):373-381
01-01-2017
Abstract
Review ArticlesBiomarkers of renal recovery after acute kidney injury
Revista Brasileira de Terapia Intensiva. 2017;29(3):373-381
01-01-2017DOI 10.5935/0103-507X.20170051
Views88ABSTRACT
Novel biomarkers can be suitable for early acute kidney injury diagnosis and the prediction of the need for dialysis. It remains unclear whether such biomarkers may also play a role in the prediction of recovery after established acute kidney injury or in aiding the decision of when to stop renal support therapy. PubMed, Web of Science and Google Scholar were searched for studies that reported on the epidemiology of renal recovery after acute kidney injury, the risk factors of recovery versus non-recovery after acute kidney injury, and potential biomarkers of acute kidney injury recovery. The reference lists of these articles and relevant review articles were also reviewed. Final references were selected for inclusion in the review based on their relevance. New biomarkers exhibited a potential role in the early diagnosis of acute kidney injury recovery. Urine HGF, IGFBP-7, TIMP-2 and NGAL may improve our ability to predict the odds and timing of recovery and eventually renal support withdrawal. Acute kidney injury recovery requires more study, and its definition needs to be standardized to allow for better and more powerful research on biomarkers because some of them show potential for the prediction of acute kidney injury recovery.
Keywords:Acute Kidney InjuryBiomarkerscritical careintensive carerenal insufficiencyRenal replacement therapySee moreViews88Abstract
Review ArticlesBiomarkers of renal recovery after acute kidney injury
Revista Brasileira de Terapia Intensiva. 2017;29(3):373-381
01-01-2017DOI 10.5935/0103-507X.20170051
Views88ABSTRACT
Novel biomarkers can be suitable for early acute kidney injury diagnosis and the prediction of the need for dialysis. It remains unclear whether such biomarkers may also play a role in the prediction of recovery after established acute kidney injury or in aiding the decision of when to stop renal support therapy. PubMed, Web of Science and Google Scholar were searched for studies that reported on the epidemiology of renal recovery after acute kidney injury, the risk factors of recovery versus non-recovery after acute kidney injury, and potential biomarkers of acute kidney injury recovery. The reference lists of these articles and relevant review articles were also reviewed. Final references were selected for inclusion in the review based on their relevance. New biomarkers exhibited a potential role in the early diagnosis of acute kidney injury recovery. Urine HGF, IGFBP-7, TIMP-2 and NGAL may improve our ability to predict the odds and timing of recovery and eventually renal support withdrawal. Acute kidney injury recovery requires more study, and its definition needs to be standardized to allow for better and more powerful research on biomarkers because some of them show potential for the prediction of acute kidney injury recovery.
Keywords:Acute Kidney InjuryBiomarkerscritical careintensive carerenal insufficiencyRenal replacement therapySee more
Renal replacement therapy Archives - Critical Care Science (CCS)
