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The Elimination of Low-Molecular-Weight Proteins in Patients with Isolated Acute Renal Failure

https://doi.org/10.15360/1813-9779-2010-5-40

Abstract

Objective: to study the effectiveness of some types of semipermeable dialysis membranes and replacement therapy techniques in patients with isolated acute renal failure (iARF). Subjects and methods: Eighty-nine patients aged 24 to 67 years, who received intensive and replacement/maintenance therapy, were examined. The patients were divided into 3 groups in accordance with their condition rated by the APACHE III scale, from the used dialysis membranes and renal replacement/maintenance therapy options. Results. By varying the permeability of a membrane, its area and the volume of convection, we can control the rate of substance elimination, which is similar to that of test markers having a molecular weight of 100 to 15000 Da. Conclusion. Adequate replacement therapy for iARF is possible only when high-flux, high-permeability dia-lyzers are applied. The indices of hemodialysis/hemodiafiltration adequacy in terms of urea cannot be determinants in patients with iARF. The achievement of elimination of low-molecular-weight proteins — markers of uremic intoxication to 30—35% and/or an increase in effective albumin concentrations as a summary marker of toxicity by 16—20% is of much more importance. Key words: isolated acute renal failure, uremic toxins, hemodialysis, hemodiafiltration.

References

1. Melnikov V. Y., Molitoris B. A.

2. Delannoy B., Floccard B., Thiolierre F. et al.Six-month outcome in acute kidney injury requiring renal replacement therapy in the ICU: a multicentre prospective study. Intensive Care Med. 2009; 35 (11): 1907—1915.

3. Бабаев М. А., Еременко А. А., Винницкий Л. И., Бунятян К. А.Причины возникновения полиорганной недостаточности при кардио-хирургических операциях в условиях искусственного кровообращения. Общая реаниматология 2010; VI (3): 76—81.

4. Ivanov A. I., Korolenko E. A., Korolik E. V. et al.Chronic liver and renal diseases differently affect structure of human serum albumin. Arch. Biochem. Biophys. 2002; 408 (1): 69—77.

5. Мороз В. В., Новосельцев И. Л., Хорошилов С. Е.Кинетика/^ — микроглобулина во время гемодиализа. Мат-лы Междунар. симпозиума «Реаниматология на рубеже 21 века». М.; 1996. 314—31

6. Гланц С.Медико-биологическая статистика. М.: Практика; 1998. 459.

7. Knaus W. A., Wagner D. P., Draper E. A.The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991; 100 (6): 1619—1636.

8. Leypoldt J. K.Kinetics of ^2-Microglobulin and рhosphate during ^modialysis: Effects of rceatment frequency and duration. Semin. Dial. 2005; 18 (5): 401—40

9. Ricci Z., CruzD., Ronco C.The RIFLE criteria and mortality in acute kidney injury: A systematic review. Kidney Int. 2008; 73 (5): 538—546.

10. Owen W. F., Lew N. L., Liu Y. et al.The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. N. Eng. J. Med. 1993; 329 (14): 1001 — 1006.

11. Passadakis P. S., Oreopoulos D. G.Peritoneal dialysis in patients with acute renal failure. Adv. Perit. Dial. 2007; 23: 7—16.

12. Locatelli F., Martin-Malo A., Hannedouche T. et al.Effect of membrane permeability on survival of hemodialysis patients. J. Am. Soc. Nephrol. 2009; 20 (3): 645—654.

13. Пилотович В. С., Калачик О. В.Сосудистые доступы для гемодиализа. Хроническая болезнь почек. Методы заместительной почечной терапии М.: Медицинская литература; 2009. 65.


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For citations:


Yampolsky M.A., Zabolotskikh I.B., Yampolsky A.F. The Elimination of Low-Molecular-Weight Proteins in Patients with Isolated Acute Renal Failure . General Reanimatology. 2010;6(5):40. (In Russ.) https://doi.org/10.15360/1813-9779-2010-5-40

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ISSN 1813-9779 (Print)
ISSN 2411-7110 (Online)