Prolonged intermittent high-volume hemofiltration as kidney replacement therapy in critically ill patients

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dc.article.number53
dc.catalogadorpva
dc.contributor.authorSepúlveda Palamara, Rodrigo Andrés
dc.contributor.authorHuidobro Espinosa, Juan Pablo
dc.contributor.authorJuanet Lecaros, Cristian Ignacio
dc.contributor.authorEspinosa, María E.
dc.contributor.authorGonzález Muñoz, Loredana Elizabeth
dc.contributor.authorRot Cisternas, Ívica Damaris
dc.contributor.authorBello, Francisca
dc.contributor.authorSalinas, Daniela
dc.contributor.authorHidalgo, Francisco
dc.contributor.authorDelgado, Pablo
dc.contributor.authorRoessler Barron, Eric
dc.date.accessioned2025-07-07T20:31:11Z
dc.date.available2025-07-07T20:31:11Z
dc.date.issued2025
dc.date.updated2025-07-06T00:06:35Z
dc.description.abstractBackground Prolonged and intermittent high-volume hemofiltration (HVHF) can be performed in extremely critical patients for hemodynamic support. In addition, it can serve as a kidney replacement therapy, given its large ultrafiltration volume. Our objective is to characterize the depuration properties of HVHF and hemodynamic tolerance. Methods This was a retrospective cohort study. All adult critical patients who received HVHF in a university hospital during 2021 were included. Demographic variables, past medical history, pre- and post-HVHF blood tests, and hemodynamic tolerance were evaluated. Results A total of 133 HVHF sessions were performed on 74 critical patients (age 61.1 ± 14.8 years, 43.2% women, and sequential organ failure assessment (SOFA) score 15.5 ± 3.8). All HVHF sessions were performed with prefilter replacement fluid, and 83.5% without anticoagulation. Time (QT) was 337 ± 86 min, with replacement flow rate (QR) at 81 ± 21 mL/kg/h. Hypotension occurred in 19.6% of the procedures at connection and 6.8% during therapy with no precipitating factor. Norepinephrine dose decreased ≥ 20% in 47.1% of the HVHF sessions. Single-pool urea Kt/V (spKt/V) was 0.52 ± 0.17. In HVHF of QT 6–8 h, spKt/V was 0.58 ± 0.17. Higher spKt/V was associated with higher QT and high QR. Post-HVHF sodium was significantly associated with sodium in the replacement fluid. Before HVHF, 18% had hyperkalemia (5.9 ± 1.1 mEq/L). Post-therapy kalemia was 4.8 ± 0.6 mEq/L. Post-HVHF potassium was associated with QR and ultrafiltration. Conclusions Prolonged and intermittent HVHF could serve as an alternative kidney replacement therapy in critically ill patients because it provides adequate control of the internal environment, allows withdrawal anticoagulation, favors patient mobility for procedures and treatments, and provides hemodynamic support.
dc.fechaingreso.objetodigital2025-07-06
dc.format.extent7 páginas
dc.fuente.origenBiomed Central
dc.identifier.citationRenal Replacement Therapy. 2025 Jul 01;11(1):53
dc.identifier.doi10.1186/s41100-025-00644-5
dc.identifier.issn2059-1381
dc.identifier.urihttps://doi.org/10.1186/s41100-025-00644-5
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/104871
dc.information.autorucEscuela de Medicina; Sepúlveda Palamara, Rodrigo Andrés; 0000-0002-9618-3686; 252768
dc.information.autorucEscuela de Medicina; Huidobro Espinosa, Juan Pablo; 0000-0002-5717-1017; 149948
dc.information.autorucEscuela de Medicina; Juanet Lecaros, Cristian Ignacio; S/I; 1052451
dc.information.autorucEscuela de Enfermería; González Muñoz, Loredana Elizabeth; S/I; 1071265
dc.information.autorucEscuela de Enfermería; Rot Cisternas, Ívica Damaris; S/I; 234370
dc.information.autorucEscuela de Medicina; Roessler Barron, Eric; S/I; 159750
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido completo
dc.publisherSpringer Nature
dc.revistaRenal Replacement Therapy
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHemofltration
dc.subjectHybrid renal replacement therapy
dc.subjectCritical illness
dc.subjectAcute kidney injury
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleProlonged intermittent high-volume hemofiltration as kidney replacement therapy in critically ill patients
dc.typeartículo
dc.volumen11
sipa.codpersvinculados252768
sipa.codpersvinculados149948
sipa.codpersvinculados1052451
sipa.codpersvinculados1071265
sipa.codpersvinculados234370
sipa.codpersvinculados159750
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