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Some kinetic considerations in high cut-off hemodiafiltration for acute myoglobinuric renal failure [Elektronski vir]Premru, Vladimir, 1954- ...The kinetics of myoglobin in severe rhabdomyolysis and dialysis-dependent myoglobinuric acute kidney injury (Mb-AKI) is still not well elucidated, and more detailed knowledge could improve the now ... empiric use of rapid extracorporeal myoglobin removal by high cut-off (HCO) hemodialysis treatments. Eighteen adult patients with severe dialysis-dependent Mb-AKI (median serum concentration of myoglobin 57.4mg/L) participated in the prospective clinical study, assessing myoglobin kinetics during HCO hemodiafiltration (HCO HDF). High initial serum concentrations of myoglobin (median 57.4mg/L), together with protracted myoglobin appearance in the blood, indicated a large accumulation of myoglobin in body fluids. Extra-renal endogenous metabolic myoglobin clearance was delayed, with a slow exponential fall in serum myoglobin (t 35h). A mean myoglobin clearance of 9094mL/min, a reduction ratio of 80%, and a rapid exponential fall (t 1h) in serum and dialysate myoglobin were achieved by HCO HDF. Half of the cumulative myoglobin removal was accomplished in 35h, with an additional removal of 7% each hour thereafter. A 2.4-fold rebound in serum myoglobin followed the HCO procedures. Large amounts of myoglobin are released into the circulation, and its endogenous metabolic clearance in dialysis-dependent Mb-AKI is slow. Owing to its rapid and highly efficient myoglobin elimination, HCO HDF may represent a valuable tool in the initial management of severe Mb-AKI, with a potential for earlier application in the future.Source: Special issue [Elektronski vir] : contributions from the 5th Slovenian Congress of Nephrology with international participation (str. 396-401)Type of material - conference contributionPublish date - 2013Language - englishCOBISS.SI-ID - 981676
Author
Premru, Vladimir, 1954- |
Kovač, Janko |
Buturović-Ponikvar, Jadranka |
Ponikvar, Rafael
Topics
acute renal failure |
hemodiafiltration |
high cut-off |
kinetics |
myoglobin
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Database name | Field | Year |
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Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
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Premru, Vladimir, 1954- | 16238 |
Kovač, Janko | 15406 |
Buturović-Ponikvar, Jadranka | 10649 |
Ponikvar, Rafael | 01987 |
Source: Personal bibliographies
and: SICRIS
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