Actualización en el uso de terapias de reemplazo renal continuo (TRRC) en el paciente critico

Autores/as

Palabras clave:

lesión renal aguda, unidad cuidados intensivos , diálisis, terapias continuas

Resumen

En los últimos años en pacientes críticos ha existido controversia con las técnicas de terapias de reemplazo renal existente asociado a la modalidad de elección, dosis y tiempo de inicio. Las terapias de reemplazo renal continua (TRRC) surgen como una estrategia sustituta potencial para la hemodiálisis convencional o diálisis peritoneal en pacientes en estado crítico quienes cursan con lesión renal aguda.
La TRRC es la opción de tratamiento más adecuada e indicada en pacientes hemodinamicamente inestables. En el presente articulo hacemos una revisión de su uso, indicación y posicionamiento en el paciente crítico.

Citas

(1) Ronco C. Evolution of Technology for Continuous Renal Replacement Therapy: Forty Years of Improvements. Contrib Nephrol. 2017;189:114-23.

(2) Samoni S, Husain-Syed F, Villa G, Ronco C. Continuous Renal Replacement Therapy in the Critically Ill Patient: From Garage Technology to Artificial Intelligence. J Clin Med. 29 de diciembre de 2021;11(1):172.

(3) Kellum JA, Romagnani P, Ashuntantang G, Ronco C, Zarbock A, Anders HJ. Acute kidney injury. Nat Rev Dis Primer. 15 de julio de 2021;7(1):52.

(4) Aitken E, Carruthers C, Gall L, Kerr L, Geddes C, Kingsmore D. Acute kidney injury: outcomes and quality of care. QJM Mon J Assoc Physicians. abril de 2013;106(4): 323-32.

(5) Legrand M, Darmon M, Joannidis M, Payen D. Management of renal replacement therapy in ICU patients: an international survey. Intensive Care Med. enero de 2013;39(1):101-8.

(6) Kramer P, Schrader J, Bohnsack W, Grieben G, Gröne HJ, Scheler F. Continuous arteriovenous haemofiltration. A new kidney replacement therapy. Proc Eur Dial Transpl Assoc Eur Dial Transpl Assoc. 1981;18:743-9.

(7) Husain-Syed F, Ricci Z, Brodie D, Vincent JL, Ranieri VM, Slutsky AS, et al. Extracorporeal organ support (ECOS) in critical illness and acute kidney injury: from native to artificial organ crosstalk. Intensive Care Med. septiembre de 2018;44(9):1447-59.

(8) Valdenebro M, Martín-Rodríguez L, Tarragón B, Sánchez- Briales P, Portolés J. Renal replacement therapy in critically ill patients with acute kidney injury: 2020 nephrologist’s perspective. Nefrologia. 2021;41(2):102-14.

(9) Brunet S, Leblanc M, Geadah D, Parent D, Courteau S, Cardinal J. Diffusive and convective solute clearances during continuous renal replacement therapy at various dialysate and ultrafiltration flow rates. Am J Kidney Dis Off J Natl Kidney Found. septiembre de 1999;34(3): 486-92.

(10) Sosa-Medellín MÁ, Luviano-García JA. Continuous renal replacement therapy. Concepts, indications and basic aspects of its program. Med Interna México. 25 de abril de 2018;34(2):288-98.

(11) Pedrini LA, De Cristofaro V, Pagliari B, Samà F. Mixed predilution and postdilution online hemodiafiltration compared with the traditional infusion modes. Kidney Int. noviembre de 2000;58(5):2155-65.

(12) Neri M, Villa G, Garzotto F, Bagshaw S, Bellomo R, Cerda J, et al. Nomenclature for renal replacement therapy in acute kidney injury: basic principles. Crit Care Lond Engl. 10 de octubre de 2016;20(1):318.

(13) Macedo E, Mehta RL. Continuous Dialysis Therapies: Core Curriculum 2016. Am J Kidney Dis Off J Natl Kidney Found. octubre de 2016;68(4):645-57.

(14) Ronco C. IRRIVIANS Are Forever. Blood Purif. 2015;39(4): I-V.

(15) Boyle M, Baldwin I. Understanding the continuous renal replacement therapy circuit for acute renal failure support: a quality issue in the intensive care unit. AACN Adv Crit Care. 2010;21(4):367-75.

(16) Villa G, Neri M, Bellomo R, Cerda J, De Gaudio AR, De Rosa S, et al. Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients: practical applications. Crit Care Lond Engl. 10 de octubre de 2016;20(1):283.

(17) Guirao Moya A, Esteban Sánchez ME, Fernández Gaute N, Murga González A, Vergara Diez L, Martínez García MP, et al. [Pressure monitoring in continuous renal replace- ment therapy]. Enferm Intensiva. 2010;21(1):28-33.

(18) Zhang L, Tanaka A, Zhu G, Baldwin I, Eastwood GM, Bellomo R. Patterns and Mechanisms of Artificial Kidney Failure during Continuous Renal Replacement Therapy. Blood Purif. 2016;41(4):254-63.

(19) Lewington AJP. Renal replacement therapy in the critically ill patient with acute kidney injury. Hemodial Int. 2007;11(s2):S39-43.

(20) Yoon BR, Leem AY, Park MS, Kim YS, Chung KS. Optimal timing of initiating continuous renal replacement therapy in septic shock patients with acute kidney injury. Sci Rep. 19 de agosto de 2019;9(1):11981.

(21) Clark WR, Leblanc M, Ricci Z, Ronco C. Quantification and Dosing of Renal Replacement Therapy in Acute Kidney Injury: A Reappraisal. Blood Purif. 2017;44(2):140-55.

(22) Davies HT, Leslie GD. Intermittent versus continuous renal replacement therapy: a matter of controversy. Intensive Crit Care Nurs. octubre de 2008;24(5):269-85.

(23) Gotch FA, Sargent JA, Keen ML. Whither goest Kt/V? Kidney Int Suppl. agosto de 2000;76:S3-18.

(24) Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet Lond Engl. 1 de julio de 2000;356(9223):26-30.

(25) Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-184.

(26) Bagshaw SM, Chakravarthi MR, Ricci Z, Tolwani A, Neri M, De Rosa S, et al. Precision Continuous Renal Replacement Therapy and Solute Control. Blood Purif. 2016;42(3):238-47.

(27) Fayad AI, Buamscha DG, Ciapponi A. Intensity of continuous renal replacement therapy for acute kidney injury. Cochrane Database Syst Rev. 4 de octubre de 2016;10(10):CD010613.

(28) Vásquez Jiménez E, Anumudu SJ, Neyra JA. Dose of Continuous Renal Replacement Therapy in Critically Ill Patients: A Bona Fide Quality Indicator. Nephron. 2021;145(2):91-8.

(29) Paganini EP. Dialysis is not dialysis is not dialysis! Acute dialysis is different and needs help! Am J Kidney Dis Off J Natl Kidney Found. noviembre de 1998;32(5):832-3.

(30) Kanagasundaram NS, Greene T, Larive AB, Daugirdas JT, Depner TA, Garcia M, et al. Prescribing an equilibrated intermittent hemodialysis dose in intensive care unit acute renal failure. Kidney Int. diciembre de 2003; 64(6):2298-310.

(31) Carson RC, Kiaii M, MacRae JM. Urea clearance in dysfunctional catheters is improved by reversing the line position despite increased access recirculation. Am J Kidney Dis Off J Natl Kidney Found. mayo de 2005; 45(5):883-90.

(32) Ahmed AR, Obilana A, Lappin D. Renal Replacement Therapy in the Critical Care Setting. Crit Care Res Pract. 2019;2019:6948710.

(33) Augustine JJ, Sandy D, Seifert TH, Paganini EP. A rando- mized controlled trial comparing intermittent with continuous dialysis in patients with ARF. Am J Kidney Dis Off J Natl Kidney Found. diciembre de 2004;44(6): 1000-7.

(34) Shawwa K, Kompotiatis P, Jentzer JC, Wiley BM, Williams AW, Dillon JJ, et al. Hypotension within one-hour from starting CRRT is associated with in-hospital mortality. J Crit Care. diciembre de 2019;54:7-13.

(35) Karkar A, Ronco C. Prescription of CRRT: a pathway to optimize therapy. Ann Intensive Care. 6 de marzo de 2020;10(1):32.

(36) Cho AY, Yoon HJ, Lee KY, Sun IO. Clinical characteristics of sepsis-induced acute kidney injury in patients under- going continuous renal replacement therapy. Ren Fail. noviembre de 2018;40(1):403-9.

(37) Kim IY, Kim S, Ye BM, Kim MJ, Kim SR, Lee DW, et al. Effect of fluid overload on survival in patients with sepsis-induced acute kidney injury receiving conti- nuous renal replacement therapy. Sci Rep. 16 de febrero de 2023;13(1):2796.

(38) Bagshaw SM, George C, Bellomo R, ANZICS Database Management Committee. Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care Lond Engl. 2008;12(2):R47.

(39) Romagnoli S, Ricci Z, Ronco C. CRRT for sepsis-induced acute kidney injury. Curr Opin Crit Care. diciembre de 2018;24(6):483-92.

(40) Marx G. Fluid therapy in sepsis with capillary leakage. Eur J Anaesthesiol. junio de 2003;20(6):429-42.

(41) Hall A, Crichton S, Dixon A, Skorniakov I, Kellum JA, Ostermann M. Fluid removal associates with better out- comes in critically ill patients receiving continuous renal replacement therapy: a cohort study. Crit Care Lond Engl. 1 de junio de 2020;24(1):279.

(42) Tian H, Sun T, Hao D, Wang T, Li Z, Han S, et al. The optimal timing of continuous renal replacement therapy for patients with sepsis-induced acute kidney injury. Int Urol Nephrol. octubre de 2014;46(10):2009-14.

(43) Ronco C, Tetta C, Mariano F, Wratten ML, Bonello M, Bordoni V, et al. Interpreting the mechanisms of continuous renal replacement therapy in sepsis: the peak concentration hypothesis. Artif Organs. septiembre de 2003;27(9):792-801.

(44) Tandukar S, Palevsky PM. Continuous Renal Replace- ment Therapy: Who, When, Why, and How. Chest. marzo de 2019;155(3):626-38.

(45) Kim IY, Kim S, Ye BM, Kim MJ, Kim SR, Lee DW, et al. Procalcitonin decrease predicts survival and recovery from dialysis at 28 days in patients with sepsis-induced acute kidney injury receiving continuous renal replace- ment therapy. PloS One. 2022;17(12):e0279561.

(46) Premuzic V, Basic-Jukic N, Jelakovic B, Kes P. Differences in CVVH vs. CVVHDF in the management of sepsis- induced acute kidney injury in critically ill patients. J Artif Organs Off J Jpn Soc Artif Organs. diciembre de 2017;20(4):326-34.

(47) Wang G, He Y, Guo Q, Zhao Y, He J, Chen Y, et al. Continuous renal replacement therapy with the ad- sorptive oXiris filter may be associated with the lower 28-day mortality in sepsis: a systematic review and meta- analysis. Crit Care Lond Engl. 9 de julio de 2023;27(1):275.

(48) Yessayan L, Yee J, Frinak S, Szamosfalvi B. Continuous Renal Replacement Therapy for the Management of Acid-Base and Electrolyte Imbalances in Acute Kidney Injury. Adv Chronic Kidney Dis. mayo de 2016;23(3): 203-10.

(49) Fall P, Szerlip HM. Continuous renal replacement therapy: cause and treatment of electrolyte complications. Semin Dial. 2010;23(6):581-5.

(50) Chen S, Yee J, Chiaramonte R. Safely correct hypo- natremia with continuous renal replacement therapy: A flexible, all-purpose method based on the mixing paradigm. Physiol Rep. enero de 2023;11(1):e15496.

(51) Mujahidin, Teuku Y, N DA. Continuous Renal Replacement Therapy: A Review. J Anesthesiol Clin Res. 2020;1(2): 63-77.

(52) Rosner MH, Connor MJ. Management of Severe Hyponatremia with Continuous Renal Replacement Therapies. Clin J Am Soc Nephrol CJASN. 7 de mayo de 2018;13(5):787-9.

(53) Houzé P, Baud FJ, Raphalen JH, Winchenne A, Moreira S, Gault P, et al. Continuous renal replacement therapy in the treatment of severe hyperkalemia: An in vitro study. Int J Artif Organs. febrero de 2020;43(2):87-93.

(54) Yu G, Tao S, Jin Y, Li W, Hu Z, Fang X. Ultrasound dynamic monitoring of IVCD to guide application of CRRT in patients with renal failure combined with acute heart failure. Sci Rep. 18 de agosto de 2022;12(1):14041.

(55) Braüse M, Deppe CE, Hollenbeck M, Ivens K, Schoebel FC, Grabensee B, et al. Congestive heart failure as an indication for continuous renal replacement therapy. Kidney Int. 1 de noviembre de 1999;56:S95-8.

(56) Sharma A, Hermann DD, Mehta RL. Clinical benefit and approach of ultrafiltration in acute heart failure. Cardiology. 2001;96(3-4):144-54.

(57) Rempher KJ. Continuous renal replacement therapy for management of overhydration in heart failure. AACN Clin Issues. noviembre de 2003;14(4):512-9.

(58) Gao L, Bian Y, Cao S, Sang W, Zhang Q, Yuan Q, et al. Development and Validation of a Simple-to-Use Nomo- gram for Predicting In-Hospital Mortality in Patients With Acute Heart Failure Undergoing Continuous Renal- Replacement Therapy. Front Med. 2021;8:678252.

(59) Zhang M, Li J. Continuous Renal Replacement Therapy for Hypertension Complicated by Refractory Heart Failure: An Analysis of Safety and Nursing Highlights. Comput Math Methods Med. 2022;2022:7951744.

(60) Premuzic V, Basic-Jukic N, Jelakovic B, Kes P. Continuous Veno-Venous Hemofiltration Improves Survival of Patients With Congestive Heart Failure and Cardiorenal Syndrome Compared to Slow Continuous Ultrafiltration. Ther Apher Dial Off Peer-Rev J Int Soc Apher Jpn Soc Apher Jpn Soc Dial Ther. junio de 2017;21(3):279-86.

(61) Holubek WJ, Hoffman RS, Goldfarb DS, Nelson LS. Use of hemodialysis and hemoperfusion in poisoned patients. Kidney Int. noviembre de 2008;74(10):1327-34.

(62) Kim Z, Goldfarb DS. Continuous renal replacement therapy does not have a clear role in the treatment of poisoning. Nephron Clin Pract. 2010;115(1):c1-6.

(63) Cabrera VJ, Shirali AC. We use Continuous Renal Re- placement Therapy for Overdoses and Intoxications. Semin Dial. julio de 2016;29(4):275-7.

(64) Leblanc M, Raymond M, Bonnardeaux A, Isenring P, Pichette V, Geadah D, et al. Lithium poisoning treated by high-performance continuous arteriovenous and venovenous hemodiafiltration. Am J Kidney Dis Off J Natl Kidney Found. marzo de 1996;27(3):365-72.

(65) Beckmann U, Oakley PW, Dawson AH, Byth PL. Efficacy of continuous venovenous hemodialysis in the treat- ment of severe lithium toxicity. J Toxicol Clin Toxicol. 2001;39(4):393-7.

(66) Bunchman TE, Ferris ME. Management of toxic ingestions with the use of renal replacement therapy. Pediatr Nephrol Berl Ger. abril de 2011;26(4):535-41.

(67) Mirrakhimov AE, Barbaryan A, Gray A, Ayach T. The Role of Renal Replacement Therapy in the Management of Pharmacologic Poisonings. Int J Nephrol. 30 de noviembre de 2016;2016:e3047329.

(68) Forni LG, Hilton PJ. Continuous hemofiltration in the treatment of acute renal failure. N Engl J Med. 1 de mayo de 1997;336(18):1303-9.

Descargas

Publicado

2023-12-15

Cómo citar

1.
Rodríguez-Yanez T, Daza-Arnedo R, Rodelo Barrios D, Patiño Patiño J, Osorio Rodriguez E, Díaz Suárez E, Montes Vargas JP, Rico-Fontalvo J. Actualización en el uso de terapias de reemplazo renal continuo (TRRC) en el paciente critico. Rev. Soc. Parag. Nefrol. [Internet]. 15 de diciembre de 2023 [citado 15 de mayo de 2024];1(1):45-52. Disponible en: https://revista.spn.org.py/index.php/rspn/article/view/11

Número

Sección

Artículo de Revisión