High cut-off renal replacement therapy for removal of myoglobin in severe rhabdomyolysis and acute kidney injury: a case series.

摘要: Background/Aim: Rhabdomyolysis is associated with the release of myoglobin into circulation, promoting acute kidney injury (AKI). In severe rhabdomyolysis, dialysis-dependent AKI doubles mortality. Standard blood purification techniques have limited efficacy in removing myoglobin. We describe high cut-off (HCO) renal replacement therapy (RRT) as a novel approach for extracorporeal elimination rhabdomyolysis-associated AKI. Methods: With an vivo molecular at 45 kDa, HCO filters are effective (17.8 kDa). Clearances across standard and using continuous or intermittent RRT reviewed case series 11 patients rhabdomyolysis Results: Median clearance high-flux was 3.3 (interquartile range 2.3–3.9) ml/min sustained low-efficiency daily dialysis (SLEDD) batch hemodialysis (HD) 3.7 (2.9–6.7) conventional HD. Respective clearances (membrane surface area: 1.1 m2) were 21.7 (20.3–26.1) 44.2 (41.3–47.0) (HD). Corrected filter size, up to 20-fold higher obtained filters, resulting profound reduction plasma concentration. Conclusions: As approach, allows rapid removal from circulation. light pathogenic role AKI, reducing exposure may improve recovery patient outcome. Our data pave way prospective trials, addressing this issue.