Keyword: Hemodiafiltration
2 results found.
Congress Abstract
Central Asian Journal of Nephrology, 2(2, Suppl. 1), 2026, cajn_A30, https://doi.org/10.63946/cajn/19535
ABSTRACT:
Introduction: Catheter-related bloodstream infections remain a major cause of morbidity in patients receiving maintenance dialysis. Management becomes particularly challenging in kidney transplant recipients with failed allografts because of persistent immunosuppression, severe systemic inflammation, and a high risk of thrombotic complications. Hemoadsorption has emerged as a promising adjunctive extracorporeal therapy for sepsis by reducing circulating inflammatory mediators. We present a case of successful integration of HA-330 hemoadsorption into the treatment of severe catheter-related sepsis in a patient with end-stage kidney disease.
Case Presentation: A 28-year-old woman with kidney failure secondary to glomerular disease underwent living-donor kidney transplantation in 2014. Following allograft rejection in 2024, she resumed maintenance hemodialysis. She was admitted with fever, weakness, chest pain, and signs of systemic infection. Blood cultures obtained from peripheral blood and the dialysis catheter grew Staphylococcus haemolyticus. Diagnostic evaluation revealed catheter-related sepsis, a fixed right atrial thrombus, bilateral pneumonia, severe anemia, and end-stage kidney disease requiring renal replacement therapy.
The patient received broad-spectrum antimicrobial treatment, anticoagulation, blood transfusions, and extracorporeal support. Two sessions of HA-330 hemoadsorption were performed in combination with hemodiafiltration
A marked reduction in inflammatory biomarkers was observed during treatment. C-reactive protein decreased from 335.1 to 28.7 mg/L (91% reduction), procalcitonin from 98.2 to 1.48 ng/mL (98.5% reduction). Leukocyte count decreased from 18.4×10⁹/L to 8.6×10⁹/L (Table №1). Follow-up echocardiography demonstrated a reduction of the right atrial thrombus from 30×14 mm to 16×11 mm. Repeat blood cultures were sterile, and the patient showed significant clinical improvement with resolution of systemic inflammatory manifestations.
The patient was discharged in stable condition for continuation of maintenance hemodialysis.
Conclusion: This case demonstrates the potential value of HA-330 hemoadsorption as an adjunct to standard therapy in severe catheter-related sepsis among dialysis patients with failed kidney transplants. Combined hemoadsorption and hemodiafiltration may contribute to clinical stabilization and recovery in complex septic conditions, warranting further investigation in larger patient cohorts.
Case Presentation: A 28-year-old woman with kidney failure secondary to glomerular disease underwent living-donor kidney transplantation in 2014. Following allograft rejection in 2024, she resumed maintenance hemodialysis. She was admitted with fever, weakness, chest pain, and signs of systemic infection. Blood cultures obtained from peripheral blood and the dialysis catheter grew Staphylococcus haemolyticus. Diagnostic evaluation revealed catheter-related sepsis, a fixed right atrial thrombus, bilateral pneumonia, severe anemia, and end-stage kidney disease requiring renal replacement therapy.
The patient received broad-spectrum antimicrobial treatment, anticoagulation, blood transfusions, and extracorporeal support. Two sessions of HA-330 hemoadsorption were performed in combination with hemodiafiltration
A marked reduction in inflammatory biomarkers was observed during treatment. C-reactive protein decreased from 335.1 to 28.7 mg/L (91% reduction), procalcitonin from 98.2 to 1.48 ng/mL (98.5% reduction). Leukocyte count decreased from 18.4×10⁹/L to 8.6×10⁹/L (Table №1). Follow-up echocardiography demonstrated a reduction of the right atrial thrombus from 30×14 mm to 16×11 mm. Repeat blood cultures were sterile, and the patient showed significant clinical improvement with resolution of systemic inflammatory manifestations.
The patient was discharged in stable condition for continuation of maintenance hemodialysis.
Conclusion: This case demonstrates the potential value of HA-330 hemoadsorption as an adjunct to standard therapy in severe catheter-related sepsis among dialysis patients with failed kidney transplants. Combined hemoadsorption and hemodiafiltration may contribute to clinical stabilization and recovery in complex septic conditions, warranting further investigation in larger patient cohorts.
Congress Abstract
Central Asian Journal of Nephrology, 2(2, Suppl. 1), 2026, cajn_A36, https://doi.org/10.63946/cajn/19518
ABSTRACT:
Background: Acute kidney injury (AKI) is a major contributor to morbidity and mortality in critically ill children, and rhabdomyolysis is an important yet underrecognized trigger of severe AKI after major trauma. Continuous veno-venous hemodiafiltration (CVVHDF) allows simultaneous correction of fluid, electrolyte and acid–base disturbances together with clearance of myoglobin and inflammatory mediators in hemodynamically unstable patients. Data on adequately dosed, prolonged CVVHDF in adolescents with combined trauma-induced rhabdomyolysis and septic acute kidney injury remain limited. We report a case of severe RIFLE-Failure AKI in a polytrauma adolescent successfully managed with 15 days of continuous renal replacement therapy.
Case Presentation: A 13-year-old boy (weight 85–90 kg) was admitted to the pediatric intensive care unit after severe polytrauma sustained in a road traffic accident and underwent intramedullary osteosynthesis of long-bone fractures. On postoperative day 3 he developed a hardware-associated abscess with systemic inflammatory response and sepsis, complicated by traumatic rhabdomyolysis and severe AKI, RIFLE-Failure stage: anuria, metabolic acidosis, hyperkalemia and rising azotemia. Baseline values were creatinine 567 µmol/L, potassium 6.16 mmol/L, pH 7.28, AST 7001 U/L and ALT 5591 U/L.
CVVHDF was initiated on postoperative day 3 via an internal jugular venous catheter, using a MultiFiltrate® platform (Fresenius Medical Care): blood flow 200 mL/min, dialysate and replacement fluid each 1500 mL/h, ultrafiltration 100 mL/h, corresponding to an effluent dose of approximately 34–36 mL/kg/h. Anticoagulation was maintained with unfractionated heparin 1250 U/h under laboratory monitoring. Therapy continued for 15 days without catheter- or circuit-related complications. Progressive correction of acidosis, hyperkalemia, azotemia and cytolysis markers was achieved (Table 1), and diuresis recovered to 1150 mL/day by day 15, allowing discontinuation of extracorporeal support; the patient was transferred from the intensive care unit to a specialized ward.
Conclusion: This case demonstrates that adequately dosed, prolonged CVVHDF (≈35 mL/kg/h) can safely and effectively reverse life-threatening metabolic derangements and achieve complete renal recovery in an adolescent with trauma-induced rhabdomyolysis and septic RIFLE-Failure acute kidney injury. Early initiation on postoperative day 3, uncomplicated vascular access and close monitoring supported an uneventful 15-day course. The case underscores the role of timely, adequately dosed continuous renal replacement therapy as a bridge to renal recovery in pediatric trauma patients with combined rhabdomyolysis and sepsis-associated acute kidney injury.
Case Presentation: A 13-year-old boy (weight 85–90 kg) was admitted to the pediatric intensive care unit after severe polytrauma sustained in a road traffic accident and underwent intramedullary osteosynthesis of long-bone fractures. On postoperative day 3 he developed a hardware-associated abscess with systemic inflammatory response and sepsis, complicated by traumatic rhabdomyolysis and severe AKI, RIFLE-Failure stage: anuria, metabolic acidosis, hyperkalemia and rising azotemia. Baseline values were creatinine 567 µmol/L, potassium 6.16 mmol/L, pH 7.28, AST 7001 U/L and ALT 5591 U/L.
CVVHDF was initiated on postoperative day 3 via an internal jugular venous catheter, using a MultiFiltrate® platform (Fresenius Medical Care): blood flow 200 mL/min, dialysate and replacement fluid each 1500 mL/h, ultrafiltration 100 mL/h, corresponding to an effluent dose of approximately 34–36 mL/kg/h. Anticoagulation was maintained with unfractionated heparin 1250 U/h under laboratory monitoring. Therapy continued for 15 days without catheter- or circuit-related complications. Progressive correction of acidosis, hyperkalemia, azotemia and cytolysis markers was achieved (Table 1), and diuresis recovered to 1150 mL/day by day 15, allowing discontinuation of extracorporeal support; the patient was transferred from the intensive care unit to a specialized ward.
Conclusion: This case demonstrates that adequately dosed, prolonged CVVHDF (≈35 mL/kg/h) can safely and effectively reverse life-threatening metabolic derangements and achieve complete renal recovery in an adolescent with trauma-induced rhabdomyolysis and septic RIFLE-Failure acute kidney injury. Early initiation on postoperative day 3, uncomplicated vascular access and close monitoring supported an uneventful 15-day course. The case underscores the role of timely, adequately dosed continuous renal replacement therapy as a bridge to renal recovery in pediatric trauma patients with combined rhabdomyolysis and sepsis-associated acute kidney injury.