1
|
Zhang X, Yuan Y. Effect of replacement therapy (CRRT) and hemodialysis (IHD) on severe acute renal failure. Front Pharmacol 2023; 14:1122778. [PMID: 37547338 PMCID: PMC10400762 DOI: 10.3389/fphar.2023.1122778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/12/2023] [Indexed: 08/08/2023] Open
Abstract
Hyperkalemia, metabolic acidosis, and acute uremia are the main symptoms in patients with severe acute renal failure (SARF). Its clinical symptoms are obvious, and it is extremely harmful. It needs to take active and effective measures for treatment. CRRT refers to any extracorporeal blood purification treatment technique designed to replace impaired renal function for 24 h or nearly 24 h. Hemodialysis treatment is a treatment process in which the patient's blood is discharged from the body, passes through the dialysis membrane and dialysis machine, removes excess toxins and water in the body, corrects electrolyte and acid-base disorders, and then returns the blood to the body. In order to explore the efficacy of replacement therapy and hemodialysis in the treatment of severe acute renal failure, the data samples were randomly divided into observation group and control group, who were given conventional treatment, hemodialysis and replacement therapy, respectively. Clinical data show that after replacement therapy and hemodialysis in patients with severe acute renal failure in the observation group, the levels of parathyroid hormone, renin, and quality of life were all improved, with an improvement rate of 9.47%, which has certain promotional value.
Collapse
Affiliation(s)
- Xiangyuan Zhang
- Critical Care Medicine, Shaoyang University Affiliated Second Hospital, Shaoyang, China
| | - Yinfang Yuan
- Nephrology Department, Shaoyang University Affiliated Second Hospital, Shaoyang, China
| |
Collapse
|
2
|
Fram G, Wang DD, Malette K, Villablanca P, Kang G, So K, Basir MB, Khan A, McKinnon JE, Zervos M, O’Neill WW. Cardiac Complications Attributed to Hydroxychloroquine: A Systematic Review of the Literature Pre-COVID-19. Curr Cardiol Rev 2021; 17:319-327. [PMID: 33059567 PMCID: PMC8640856 DOI: 10.2174/1573403x16666201014144022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Hydroxychloroquine has been used for rheumatological diseases for many decades and is considered a safe medication. With the COVID-19 outbreak, there has been an increase in reports associating cardiotoxicity with hydroxychloroquine. It is unclear if the cardiotoxic profile of hydroxychloroquine is previously underreported in the literature or is it a manifestation of COVID-19 and therapeutic interventions. This manuscript evaluates the incidence of cardiotoxicity associated with hydroxychloroquine prior to the onset of COVID-19. METHODS PubMED, EMBASE, and Cochrane databases were searched for keywords derived from MeSH terms prior to April 9, 2020. Inclusion eligibility was based on appropriate reporting of cardiac conditions and study design. RESULTS A total of 69 articles were identified (58 case reports, 11 case series). The majority (84%) of patients were female, with a median age of 49.2 (range 16-92) years. 15 of 185 patients with cardiotoxic events were in the setting of acute intentional overdose. In acute overdose, the median ingestion was 17,857 ± 14,873 mg. 2 of 15 patients died after acute intoxication. In patients with long-term hydroxychloroquine use (10.5 ± 8.9 years), new onset systolic heart failure occurred in 54 of 155 patients (35%) with median cumulative ingestion of 1,493,800 ± 995,517 mg. The majority of patients improved with the withdrawal of hydroxychloroquine and standard therapy. CONCLUSION Millions of hydroxychloroquine doses are prescribed annually. Prior to the COVID-19 pandemic, cardiac complications attributed to hydroxychloroquine were uncommon. Further studies are needed to understand the impact of COVID-19 on the cardiovascular system to understand the presence or absence of potential medication interactions with hydroxychloroquine in this new pathophysiological state.
Collapse
Affiliation(s)
- Georgi Fram
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - Dee D. Wang
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - Kelly Malette
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - Pedro Villablanca
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - Guson Kang
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - Kent So
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - Mir B. Basir
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - Arfaat Khan
- Section of Cardiac Electrophysiology, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| | - John E. McKinnon
- Divison of Infectious Disease, Henry Ford Health System, Detroit, MMichigan, MI 48202, USA
| | - Marcus Zervos
- Divison of Infectious Disease, Henry Ford Health System, Detroit, MMichigan, MI 48202, USA
| | - William W. O’Neill
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, MI 48202, USA
| |
Collapse
|
3
|
Abstract
Lupus myocarditis is a serious, potentially deadly disease. When it presents as an acute or fulminant myocarditis in a patient without an established diagnosis of lupus, lupus as an etiology of the condition is not commonly suspected. Meanwhile, it has a distinct treatment which may be lifesaving. Review of the literature can shed more light as current management is mostly based on clinical experience and case reports rather than randomized control trials. In this review we are discussing this diagnostic entity, focusing on cardiogenic shock as a manifestation of lupus myocarditis, and discussing management including aggressive immunosuppression, mechanical circulatory support, and cardiac transplantation.
Collapse
|