Abstract:
BACKGROUND:Fluid balance disorders are a relevant risk factor for morbidity and mortality in critically ill patients. Volume assessment in the intensive care unit (ICU) is thus of great importance, but there are currently few methods to obtain an accurate and timely assessment of hydration status. Our aim was to evaluate the hydration status of ICU patients via bioelectric impedance vector analysis (BIVA) and to investigate the relationship between hydration and mortality. METHODS:We evaluated 280 BIVA measurements of 64 patients performed daily in the 5 days following their ICU admission. The observation period ranged from a minimum of 72 h up to a maximum of 120 h. We observed the evolution of the hydration status during the ICU stay in this population, and analyzed the relationship between mean and maximum hydration reached and mortality--both in the ICU and at 60 days--using logistic regression. RESULTS:A state of overhydration was observed in the majority of patients (70%) on admission, which persisted during the ICU stay. Patients who required continuous renal replacement therapy (CRRT) were more likely to be overhydrated starting from the 2nd day of observation. Logistic regression showed a strong and significant correlation between mean/maximum hydration reached and mortality, both independently and correcting for severity of prognosis. CONCLUSIONS:Fluid overload measured by BIVA is a frequent condition in critically ill patients--whether or not they undergo CRRT--and a significant predictor of mortality. Hence, hydration status should be considered as an additional prognosticator in the clinical management of the critically ill patient. KEY MESSAGES:(i) On the day of ICU admittance, patients showed a marked tendency to overhydration (>70% of total). This tendency was more pronounced in patients on CRRT. (ii) Hyperhydration persisted during the ICU stay. Patients who underwent CRRT showed significantly higher hyperhydration from the 2nd day of hospitalization. (iii) Nonsurvivors showed worse hyperhydration patterns in comparison to survivors in logistic univariate analysis (p < 0.05). This relationship between hydration and mortality is confirmed even when controlling for the effect of a worse prognosis approximated by any of three ICU scoring systems (APACHE II, SAPS II and SOFA). Mean and maximum hydration levels present a stronger correlation with mortality than with mean and maximum cumulative fluid balance reached during the observation period.
journal_name
Blood Purifjournal_title
Blood purificationauthors
Basso F,Berdin G,Virzì GM,Mason G,Piccinni P,Day S,Cruz DN,Wjewodzka M,Giuliani A,Brendolan A,Ronco Cdoi
10.1159/000356366subject
Has Abstractpub_date
2013-01-01 00:00:00pages
192-9issue
3-4eissn
0253-5068issn
1421-9735pii
000356366journal_volume
36pub_type
杂志文章abstract::The central dialysis fluid delivery system (CDDS) has been working exclusively in Japan since 1970, a fact which proves that CDDS is useful in the multi-patient treatment with in-center regular hemodialysis. It is a cost-effective, labor-saving and time-tested system with 40 years of experience. Microbial safety is im...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000213494
更新日期:2009-01-01 00:00:00
abstract::The biological processes governing vascular endothelial cell health are complex and highly redundant. The mechanisms involved in cell injury and repair remain an area of intense study. This paper attempts to review current knowledge regarding hormones such as vitamin D, erythropoietin and aldosterone within the contex...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000089436
更新日期:2006-01-01 00:00:00
abstract::While recent developments have allowed greater insight into the vascular pathobiology and intimal hyperplasia, very few of these advances have led to improved clinical care of hemodialysis vascular accesses. Indeed the most common procedure for the treatment of access stenosis and thrombosis is the same model for the ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000245650
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of end-stage renal disease (ESRD). Little is known about outcomes after in-center nocturnal hemodialysis (NHD) treatment in ADPKD patients with ESRD. OBJECTIVES:This study aimed to evaluate the effects of in-center NHD ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000503679
更新日期:2020-01-01 00:00:00
abstract::Therapeutic plasma exchange (TPE) in neonates and small infants is a treatment method at the forefront that may become a potentially life-saving procedure in a wide array of severe conditions. Indications for TPE in the pediatric population have been mainly derived from adult literature, with neonatal hyperbilirubinem...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000470827
更新日期:2017-01-01 00:00:00
abstract::Clinical trials using very low protein supply supplemented with amino acid or keto acid preparations have shown the possibility of slowing the rate of decline of renal function in patients with advanced chronic renal failure together with preservation of nutritional status. The possible mechanisms by which this effect...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,评审
doi:10.1159/000169557
更新日期:1988-01-01 00:00:00
abstract::The number of geriatric patients on dialysis is increasing. This is due to demographic factors, a wider acceptance of elderly patients on dialysis, and an earlier start of dialysis in this patient group. Recent studies have questioned the effect of dialysis on quality of life in elderly patients with severe comorbidit...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000334153
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The mortality rate of peritoneal dialysis (PD) patients is still high and controversies persist regarding the mortality predictor. This study was designed to identify the predictability of the extracellular water/intracellular water ratio (E/I) on mortality in PD patients. METHODS:227 incident PD patients w...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000101699
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND/AIMS:The objective of this study is to evaluate the relation between sclerostin, arterial stiffness, and cardiovascular events (CVE) in hemodialysis patients (HD). METHODS:Sclerostin level and carotid-femoral pulse wave velocity (PWV) in 97 HD patients and sclerostin level in 40 controls were measured. RES...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000487223
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Calcium (Ca) is an essential element that plays a critical role in many biological processes. In dialysis patients, the regulation of Ca balance is highly complex, given the absence of kidney function, endocrine disturbances and the use of drugs such as phosphate binders, vitamin D analogues, and calcimimeti...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000494584
更新日期:2019-01-01 00:00:00
abstract::Chronic kidney disease (CKD) is associated with multiple detrimental consequences to the cardiovascular and musculoskeletal systems. The effects of CKD are even more significant when they begin in childhood as they affect growth and (neuro-) development as well. The division into stages of CKD serves as a guideline fo...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000321850
更新日期:2011-01-01 00:00:00
abstract::Guidelines have been developed in nephrology and medicine developed to assist practitioners and patients in making decisions about healthcare for specific clinical circumstances. There has been a proliferation of guidelines over the last decade in all areas of medicine, including nephrology. Many of the nephrology gui...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000110568
更新日期:2008-01-01 00:00:00
abstract::Acute kidney injury (AKI) is a common complication in pediatric and neonatal intensive care units (ICU). Renal replacement therapy (RRT) is frequently needed in children in whom supportive therapy is not enough to satisfy their metabolic demands or to be able to provide adequate nutrition. The decision to begin dialys...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000345186
更新日期:2013-01-01 00:00:00
abstract::In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000169411
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Wilson's disease (WD) can present in a fulminant form with hepatocellular dysfunction, hemolysis and multiorgan failure (Wilson's crisis). We present a previously healthy young woman with severe WD whose WD severity score was 13. A score >11 indicates a poor chance of survival and liver transplantation will ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000218090
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Dialysis patients have higher cardiovascular events rate than patients with normal renal function. Hyperhomocysteinemia, a risk factor for cardiovascular disease, is frequently detected in dialysis patients. Vitamin B supplementation lowers hyperhomocysteinemia, but it is unknown whether it reduces cardiovas...
journal_title:Blood purification
pub_type: 杂志文章,随机对照试验
doi:10.1159/000093680
更新日期:2006-01-01 00:00:00
abstract:AIMS:The aim of the study was to clarify the relationship between serum ferritin and infectious risks. METHODS:We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. RESULTS:Kaplan-Meier analys...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000445424
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The number of patients receiving renal replacement therapy (RRT) increases annually and worldwide. Differences in the RRT incidence, prevalence, and modality vary between regions and countries for reasons yet to be clarified. AIMS:Gain a better understanding of the association between hemodialysis (HD)-rela...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000368980
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND/AIMS:We derived a novel equation for calculating weekly urea standard Kt/V (stdKt/V) during hemodialysis (HD) based on urea mass removed, comparable to the approach during peritoneal dialysis. METHODS:Theoretical consideration of urea mass balance during HD led to the following equation for stdKt/V, namely,...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000493178
更新日期:2019-01-01 00:00:00
abstract::Optimal iron level in hemodialysis patients remains a subject of debate. The reticulocyte hemoglobin content (CHr) is believed to reflect the concentration of iron required in the most recent hematopoiesis in the bone marrow. CHr is not influenced by any factors that measure direct hemoglobin (Hb) of reticulocytes and...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000496641
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMM...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000452703
更新日期:2017-01-01 00:00:00
abstract::Medicare pays 80% of the cost of dialysis treatment and associated medications. Congress directed the Centers for Medicare and Medicaid Services (CMS) to develop both a process of regular and more or less "automatic" updates of composite rate setting and "bundling" as much of the laboratory and ancillary medications a...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000096390
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Citrate anticoagulation offers several advantages in comparison to conventional anticoagulation. Most algorithms for regional citrate-calcium anticoagulation are based on citrate and calcium chloride infusion coupled in a fixed proportion to the blood flow without considering the hematocrit (Hct)/plasma flow...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000332394
更新日期:2012-01-01 00:00:00
abstract::The greatest benefit of PD ist the continuous maintenance of a stable electrolyte and acid-base balance, as well as a continuous solute, sodium and water removal. Moreover, PD is effective in preserving residual renal function (RRF). However, when RRF declines, complications will occur if not compensated for by an inc...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000081871
更新日期:2004-01-01 00:00:00
abstract::Hyporesponsiveness to erythropoietin stimulating agents (ESAs) is a condition associated with increased mortality. Even after identifying the condition, the causes are difficult to treat and only partially reversible in end-stage renal disease patients. Thus, the role of more recent hemodialysis (HD) techniques in imp...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000485314
更新日期:2018-01-01 00:00:00
abstract::While the optimal vascular conduit for hemodialysis is undeniably an arterialized autogenous subcutaneous vein, only a minority of end-stage renal disease patients can count on such access: the remainder require implantation of a biomaterial conduit. This paper will briefly survey current biografts used for hemodialys...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000170148
更新日期:1994-01-01 00:00:00
abstract::While acute kidney injury (AKI) has been poorly defined historically, a decade of effort has culminated in a standardized, consensus definition. In parallel, electronic health records (EHRs) have been adopted with greater regularity, clinical informatics approaches have been refined, and the field of EHR-enabled care ...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000458751
更新日期:2017-01-01 00:00:00
abstract::The recent Kidney Disease Outcomes Quality Initiative (K/DOQI) classification of chronic kidney disease (CKD) includes transplant recipients. Although there are important differences between kidney transplant recipients (KTRs) and patients with native kidney disease, the inclusion of KTRs along with other CKD patients...
journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000067871
更新日期:2003-01-01 00:00:00
abstract:PURPOSE:This study was aimed at evaluating the efficacy and safety of regional citrate anticoagulation (RCA) versus no-anticoagulation continuous venovenous hemofiltration (CVVH) in acute severe hypernatremia patients with increased bleeding risk. MATERIALS AND METHODS:Acute severe hypernatremia patients with high ble...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000502937
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND/AIMS:There is a clear association between one allele of the interleukin-1 receptor-antagonist gene (IL-1RN) and inflammatory diseases in which IL-1 is implicated. We evaluated patient survival and technique survival of peritoneal dialysis (PD) patients, while analyzing independent risk factors, in a PD progr...
journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000088988
更新日期:2005-01-01 00:00:00