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- W1601775544 abstract "Abstract The kinetics of myoglobin in severe rhabdomyolysis and dialysis‐dependent myoglobinuric acute kidney injury ( Mb ‐ AKI ) is still not well elucidated, and more detailed knowledge could improve the now empiric use of rapid extracorporeal myoglobin removal by high cut‐off ( HCO ) hemodialysis treatments. Eighteen adult patients with severe dialysis‐dependent Mb ‐ AKI (median serum concentration of myoglobin 57.4 mg/L) participated in the prospective clinical study, assessing myoglobin kinetics during HCO hemodiafiltration ( HCO HDF ). High initial serum concentrations of myoglobin (median 57.4 mg/L), together with protracted myoglobin appearance in the blood, indicated a large accumulation of myoglobin in body fluids. Extra‐renal endogenous metabolic myoglobin clearance was delayed, with a slow exponential fall in serum myoglobin (t½ 35 h). A mean myoglobin clearance of 90–94 mL/min, a reduction ratio of 80%, and a rapid exponential fall (t½ 1 h) in serum and dialysate myoglobin were achieved by HCO HDF . Half of the cumulative myoglobin removal was accomplished in 3–5 h, with an additional removal of 7% each hour thereafter. A 2.4‐fold rebound in serum myoglobin followed the HCO procedures. Large amounts of myoglobin are released into the circulation, and its endogenous metabolic clearance in dialysis‐dependent Mb ‐ AKI is slow. Owing to its rapid and highly efficient myoglobin elimination, HCO HDF may represent a valuable tool in the initial management of severe Mb ‐ AKI , with a potential for earlier application in the future." @default.
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- W1601775544 date "2013-08-01" @default.
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- W1601775544 title "Some Kinetic Considerations in High Cut-Off Hemodiafiltration for Acute Myoglobinuric Renal Failure" @default.
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- W1601775544 doi "https://doi.org/10.1111/1744-9987.12085" @default.
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