Extended Daily Dialysis in Acute Kidney Injury Patients: Metabolic and Fluid Control and Risk Factors for Death

Intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT) are used as Acute Kidney Injury (AKI) therapy and have certain advantages and disadvantages. Extended daily dialysis (EDD) has emerged as an alternative to CRRT in the management of hemodynamically unstable AKI patients, mainly in developed countries.Objectives: We hypothesized that EDD is a safe option for AKI treatment and aimed to describe metabolic and fluid control of AKI patients undergoing EDD and identify complications and risk factors associated with death.Study Selection: This is an observational and retrospective study describing introduction of EDD at our institution. A total of 231 hemodynamically unstable AKI patients (noradrenalin dose between 0.3 and 1.0 ucg/kg/min) were assigned to 1367 EDD session. EDD consisted of 6-8 h of HD 6 days a week, with blood flow of 200 ml/min, dialysate flows of 300 ml/min.Data Synthesis: Mean age was 60.6 +/- 15.8 years, 97.4% of patients were in the intensive care unit, and sepsis was the main etiology of AKI (76.2). BUN and creatinine levels stabilized after four sessions at around 38 and 2.4 mg/dl, respectively. Fluid balance decreased progressively and stabilized around zero after five sessions. Weekly delivered Kt/V was 5.94 +/- 0.7. Hypotension and filter clotting occurred in 47.5 and 12.4% of treatment session, respectively. Regarding AKI outcome, 22.5% of patients presented renal function recovery, 5.6% of patients remained on dialysis after 30 days, and 71.9% of patients died. Age and focus abdominal sepsis were identified as risk factors for death. Urine output and negative fluid balance were identified as protective factors.Conclusions: EDD is effective for AKI patients, allowing adequate metabolic and fluid control. Age, focus abdominal sepsis, and lower urine output as well as positive fluid balance after two EDD sessions were associated significantly with death.

Involvement of the median preoptic nucleus in blood pressure control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Loss of the Ability to Control Right-to-Left Shunt Does Not Influence the Metabolic Responses to Temperature Change or Long-Term Fasting in the South American Rattlesnake Crotalus durissus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Validation of analytical methodology for quantification of cefazolin sodium pharmaceutical dosage form by high performance liquid chromatography to be applied for quality control in pharmaceutical industry

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Control of instabilities in non-Newtonian free surface fluid flows

Free surface flows in inclined channels can develop periodic instabilities that are propagated downstream as shock waves with well-defined wavelengths and amplitudes. Such disturbances are called roll waves and are common in channels, torrential lava, landslides, and avalanches. The prediction and detection of such waves over certain types of structures and environments are useful for the prevention of natural risks. In this work, a mathematical model is established using a theoretical approach based on Cauchy's equations with the Herschel-Bulkley rheological model inserted into the viscous part of the stress tensor. This arrangement can adequately represent the behavior of muddy fluids, such as water-clay mixture. Then, taking into account the shallow water and the Rankine-Hugoniot's (shock wave) conditions, the equation of the roll wave and its properties, profile, and propagation velocity are determined. A linear stability analysis is performed with an emphasis on determining the condition that allows the generation of such instabilities, which depends on the minimum Froude number. A sensitivity analysis on the numerical parameters is performed, and numerical results including the influence of the Froude number, the index flow and dimensionless yield stress on the amplitude, the wavelength of roll waves and the propagation velocity of roll waves are shown. We show that our numerical results were in agreement with Coussot's experimental results (1994).

An unequivocal normalization-based paradigm to solve dynamic economic and emission active-reactive OPF (optimal power flow)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Despacho ótimo de potências ativa e reativa de sistema elétricos multi-áreas considerando restrições físicas, econômicas e ambientais =: Envronmentally constrained active-reactive optimal power flow-a compromising strategy for economic-emission dispatch and a multi-area paradigm

Pós-graduação em Engenharia Elétrica - FEIS

Adaptation of sensorimotor coupling in postural control Is impaired by sleep deprivation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Systemic blood flow relations in conscious South American rattlesnakes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Simple and clean determination of tetracyclines by flow injection analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)