PubMed Health⌕ Search

Biomedical subjects

R C Albright

Publications and source records attributed to R C Albright.

5 recordsLinked to original sources
PubMed2001

Charcoal hemofiltration for hepatic veno-occlusive disease after hematopoietic stem cell transplantation.

Hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation (HSCT) results in considerable morbidity and mortality. No therapy has been shown to be uniformly effective. Several studies have highlighted the pivotal role of endothelial injury and the hemostatic system in the pathogenesis of HVOD. Charcoal hemofiltration has been shown to be effective for adsorbing circulating bilirubin and other protein-bound toxins and for supporting patients in hepatic failure. We describe two adult patients with severe, biopsy-proven HVOD (peak bilirubin levels, more than 50 mg/dl in both cases) after HSCT who were successfully treated with charcoal hemofiltration after other treatments failed (including defibrotide in one patient). Both patients were heavily treated before they underwent either autologous (melphalan and total body irradiation conditioning) or allogeneic (cyclophosphamide and total body irradiation conditioning) HSCT. Additional studies are warranted to confirm this preliminary observation and investigate the mechanism of action.

Adult↗
PubMed2001

Acute renal failure: a practical update.

Acute renal failure (ARF) affects almost all medical specialties. Its occurrence seems to be increasing in hospitalized patients. A structured approach to the evaluation and management of ARF would facilitate rapid diagnosis and treatment in most patients. Appreciation for the multiple drugs that affect renal function is especially important. Exclusion of urinary outflow obstruction and administration of therapies that improve renal perfusion should be given top priority with respect to managing ARF. Dialytic intervention for ARF is required when otherwise irreversible pathophysiologic derangements of electrolyte homeostasis, fluid balance, and uremic solute control are imminent. This article provides a brief review and update on the clinical evaluation and management of ARF.

Acute Kidney Injury↗
PubMed2000

Treatment of lithium intoxication with continuous venovenous hemodiafiltration.

Lithium intoxication is an important complication of its frequent use and narrow therapeutic index. Intermittent hemodialysis has been the treatment of choice when emergent extracorporeal lithium clearance is indicated, but postdialysis rebound elevations in lithium concentration with recurrent toxicity have been documented. We report a case of intentional acute on chronic lithium intoxication in which continuous venovenous hemodiafiltration was successfully used. This modality offers the advantage of slow sustained removal of lithium without hemodynamic instability or rebound elevations in lithium concentration.

Antimanic Agents↗
PubMed2000

Patient survival and renal recovery in acute renal failure: randomized comparison of cellulose acetate and polysulfone membrane dialyzers.

OBJECTIVE: To investigate survival and renal recovery after dialysis in patients with acute renal failure with use of synthetic membranes compared with substituted cellulose membranes. PATIENTS AND METHODS: We prospectively studied survival and recovery of renal function of 66 patients with acute renal failure who required intermittent hemodialysis. Patients were randomized to exclusive treatment with either cellulose acetate (CA) or polysulfone (PS) hemodialysis membranes. Additionally, markers of biocompatibility (complement, leukocyte counts, cytokine concentration) were measured at initiation and 1 hour after initiation of dialysis among 10 patients equally distributed between the CA and PS groups. RESULTS: The cohorts were indistinguishable with respect to age, sex, presence of diabetes mellitus, Acute Physiology and Chronic Health Evaluation II scores, percentage in the intensive care unit (ICU), and adequacy of dialysis. Survival (76% CA, 73% PS; P=.78) and recovery of renal function at 30 days (58% CA, 39% PS; P=.14) were not statistically different in the 2 groups. Among 26 CA patients and 27 PS patients treated in the ICU, survival was not statistically different (73% CA, 67% PS; P=.61); however, the proportion of patients recovering renal function suggested a benefit favoring CA membranes (65% CA, 37% PS; P=.04). Additionally, markers of biocompatibility were not significantly different between groups among the 10 patients equally distributed between the CA and PS groups. CONCLUSIONS: Overall clinical outcomes among patients with acute renal failure treated with CA hemodialysis membranes and those treated with PS membranes were not significantly different. The observed advantage favoring renal recovery among this ICU population treated with CA hemodialysis membranes warrants further investigation.

Acute Kidney Injury↗