Hyperosmolar solutions in continuous renal replacement therapy for hyperosmolar acute renal failure: a preliminary report.
Hyperosmolar solutions in continuous renal replacement therapy for hyperosmolar acute renal failure: a preliminary report.
复制标题
高渗性急性肾衰竭连续肾脏替代治疗中的高渗性解决方案：初步报告。
DOI：
10.1097/01.pcc.0000154954.24129.f7
复制
发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Brophy,PatrickD
中科院分区：
文献类型：
--
作者：
McBryde,KevinD;Bunchman,TimothyE;Kudelka,TimothyL;Pasko,DeborahA;Brophy,PatrickD
目的：为了证明高渗性透析和前滤器置换液解决方案的连续性肾脏替代治疗在纠正高渗性疾病的急性renal failure.Data Source的有效性：一个机构审查委员会批准的儿科急性肾功能衰竭数据库在密歇根大学CS莫特儿童Hospital.Study选择：三名患者被确定符合纳入标准。在开始肾脏替代治疗时，平均血清钠浓度和血浆渗透压分别为158 mmol/L和357 mOsm/kg。透析液或置换液的钠和/或葡萄糖浓度最初增加，随后降低，以影响溶液的计算渗透压，从而控制患者测量的血浆渗透压的下降速率。此外，记录透析液或置换液的钠和葡萄糖浓度，并计算溶液的渗透压。数据合成：这三名患者经历了他们的血清钠浓度和血浆渗透压的平均下降率为0.5 mmol/L/hr和1.6 mOsm/kg/hr.Conclusions：高渗性透析或预滤器置换液溶液可以影响血清钠和血浆渗透压在高渗性急性肾功能衰竭的情况下缓慢下降。
Objective:To demonstrate the efficacy of hyperosmolar dialysis and prefilter replacement fluid solutions for continuous renal replacement therapies in the correction of hyperosmolar disorders in acute renal failure.Data Source:An Institutional Review Board-approved pediatric acute renal failure database at the University of Michigan CS Mott Children’s Hospital.Study Selection:Three patients were identified meeting the inclusion criteria. The mean serum sodium concentration and plasma osmolality were 158 mmol/L and 357 mOsm/kg, respectively, at the time of initiation of renal replacement therapy. The sodium and/or dextrose concentrations of the dialysate or replacement fluids initially were increased and subsequently decreased to affect the solutions’ calculated osmolalities in an effort to control the rate of decline of the patients’ measured plasma osmolalities.Data Extraction:The case patients’ serum sodium concentrations and plasma osmolalities were measured. Additionally, the sodium and dextrose concentrations of the dialysate or replacement fluid were recorded and the solutions’ osmolalities calculated.Data Synthesis:The three patients experienced a mean rate of reduction of their serum sodium concentration and plasma osmolality of 0.5 mmol/L/hr and 1.6 mOsm/kg/hr, respectively.Conclusions:Hyperosmolar dialysis or prefilter replacement fluid solutions can affect a slow decline in both the serum sodium and plasma osmolality in cases of hyperosmolar acute renal failure.