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The effect of renal replacement therapy and antibiotic dose on antibiotic concentrations in critically ill patients : data from the Multinational Sampling Antibiotics in Renal Replacement Therapy study Ghent University

Jason A Roberts, Gavin Joynt, Anna Lee, Gordon Choi, Rinaldo Bellomo, Salmaan Kanji, M Yugan Mudaliar, Sandra L Peake, Dianne Stephens, Fabio Silvio Taccone, et al.
Background. The optimal dosing of antibiotics in critically ill patients receiving renal replacement therapy (RRT) remains unclear. In this study, we describe the variability in RRT techniques and antibiotic dosing in critically ill patients receiving RRT and relate observed trough antibiotic concentrations to optimal targets. Methods. We performed a prospective, observational, multinational, pharmacokinetic study in 29 intensive care units from ...

Patients' perceptions of information and education for renal replacement therapy : an independent survey by the European Kidney Patients' Federation on information and support on renal replacement therapy Ghent University

Wim Van Biesen, Sabine N van der Veer, Mark Murphey, Olga Loblova, Simon Davies
Background: Selection of an appropriate renal replacement modality is of utmost importance for patients with end stage renal disease. Previous studies showed provision of information to and free modality choice by patients to be suboptimal. Therefore, the European Kidney Patients' Federation (CEAPIR) explored European patients' perceptions regarding information, education and involvement on the modality selection process. Methods: CEAPIR ...

Beta-lactam antibiotic dosing during continuous renal replacement therapy: how can we optimize therapy? Ghent University

Mieke Carlier
Correct antibiotic treatment is of utmost importance to treat infections in critically ill patients, not only in terms of spectrum and timing but also in terms of dosing. However, this is a real challenge for the clinician because the pathophysiology (such as shock, augmented renal clearance, and multiple organ dysfunction) has a major impact on the pharmacokinetics of hydrophilic antibiotics. The presence of extra-corporal circuits, such as ...

A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guidelines on acute kidney injury, part 2: renal replacement therapy Ghent University

Achim Jörres, Stefan John, Andrew Lewington, Pieter M ter Wee, Raymond Vanholder, Wim Van Biesen, James Tattersall
This paper provides an endorsement of the KDIGO guideline on acute kidney injury; more specifically, on the part that concerns renal replacement therapy. New evidence that has emerged since the publication of the KDIGO guideline was taken into account, and the guideline is commented on from a European perspective. Advice is given on when to start and stop renal replacement therapy in acute kidney injury; which modalities should be preferentially ...

Extracorporeal Carbon Dioxide Removal During Continuous Renal Replacement Therapy as Adjunctive Therapy Vrije Universiteit Brussel

Rita Jacobs, Adriaan Sablon, Herbert Spapen

Lung-protective ventilation targeting low tidal volumes and plateau pressures is the mainstay of therapy in patients with ARDS. This ventilation strategy limits pulmonary strain, inflammation, and injury, but it may be associated with profound hypercapnic acidosis. In such conditions, extracorporeal CO2 removal can attenuate or normalize hypercapnia and may even facilitate ultraprotective ventilation. Almost half of patients with ARDS develop ...

Applying pharmacokinetic/pharmacodynamic principles for optimizing antimicrobial therapy during continuous renal replacement therapy Vrije Universiteit Brussel

Patrick Honoré, Rita Jacobs, Elisabeth De Waele, Herbert Spapen

Continuous renal replacement therapy (CRRT) is progressively supplanting intermittent haemodialysis (IHD) in critically ill patients. Although CRRT indeed offers more appropriate haemodynamic, fluid, and metabolic stability, concern is rising about its impact on concomitant drugs and, in particular, antimicrobial treatment. Antimicrobial dose recommendations have been elaborated to avoid drug accumulation and toxicity in patients undergoing ...

Modification of Nutrition Therapy During Continuous Renal Replacement Therapy in Critically Ill Pediatric Patients Vrije Universiteit Brussel

Joop Jonckheer, Klaar Vergaelen, Herbert Spapen, Elisabeth De Waele

INTRODUCTION: Nutrition is an important part of treatment in critically ill children. Clinical guidelines for nutrition adaptations during continuous renal replacement therapy (CRRT) are lacking. We collected and evaluated current knowledge on this topic and provide recommendations.

METHODS: Questions were produced to guide the literature search in the PubMed database.

RESULTS: Evidence is scarce and extrapolation from adult ...

Acute renal failure with need for renal replacement therapy as a complication of zoonotic S-zooepidemicus infection: case report and review of the literature KU Leuven

Evelyne Lerut
Streptococcus zooepidemicus is an animal commensal with the potential of zoonotic transmission through ingestion of contaminated dairy products, leading to outbreaks of Post-Streptococcal Glomerulonephritis (PSGN). We report for the first time acute renal failure with need for renal replacement therapy, as a complication of S. zooepidemicus bacteremia resulting from direct horse to human transmission in a young adult. Both clinical disease ...

Long-term outcome in ICU patients with acute kidney injury treated with renal replacement therapy : a prospective cohort study Ghent University

Wouter De Corte, Annemieke Dhondt, Raymond Vanholder, Jan De Waele, Johan Decruyenaere, Veerle Sergoyne, Joke Vanhalst, STEFAAN CLAUS, Eric Hoste
Background: In intensive care unit (ICU) patients, acute kidney injury treated with renal replacement therapy (AKI-RRT) is associated with adverse outcomes. The aim of this study was to evaluate variables associated with long-term survival and kidney outcome and to assess the composite endpoint major adverse kidney events (MAKE; defined as death, incomplete kidney recovery, or development of end-stage renal disease treated with RRT) in a cohort ...