Intensity of dialysis dose in acute kidney injury (AKI) might benefit critically ill patients. The aim of this study was to evaluate the effect of intermittent hemodialysis (IHD) dose on mortality in patients with AKI. Methods: Prospective observational study was performed on AKI patients treated with IHD. The delivered dialysis dose per session was calculated based on single-pool Kt/V urea. Patients were allocated in two groups according to the weekly delivered median Kt/V: higher intensity dialysis dose (HID: Kt/V higher than median) and lower intensity dialysis dose (LID: Kt/V lower than median). Thereafter, AKI patients were divided according to the presence or absence of sepsis and urine output. Clinical and lab characteristics and survival of AKI patients were compared. Results: A total of 121 AKI patients were evaluated. Forty-two patients did not present with sepsis and 45 did not present with oliguria. Mortality rate after 30 days was lower in the HID group without sepsis (14.3% × 47.6%; p = 0.045) and without oliguria (31.8% × 69.5%; p = 0.025). Survival curves also showed that the HID group had higher survival rate when compared with the LID group in non-septic and non-oliguric patients (p = 0.007 and p = 0.003, respectively). Conclusion: Higher dialysis doses can be associated with better survival of less seriously ill AKI patients.

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The use of citrate as regional anticoagulation in the sustained low extended dialysis (SLED) in cancer patients with coagulation disorders tends to be much used, yet it is important to note that particularities which may be subject those patients with multiple clinical factors complicating. Aims: Check the clinical and laboratory characteristics of cancer patients using trisodium citrate in SLEDs; check the particularities of cancer dialysis patients using regional anticoagulation and assess the need for calcium replacement EV in SLED with regional citrate anticoagulation.

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Iodinated contrast has been one of the most prescribed and used drugs in contrast imaging techniques and interventional procedures. However, some subjects may develop contrast-induced nephropathy (CIN) especially those in advanced chronic kidney disease (CKD). Diagnostic criterion is based on increasing 48h creatinine after receiving iodine. Given the fact that there is no specific treatment for CIN, prevention should be considered. Uncountable actions should be taken, including: reducing the dose, using a low-osmolar substance, avoiding dehydration and other nephrotoxic drugs. Currently, prevention has been based on using saline solution. A recent paper showed that for patients with stage 3 and 4 of CKD sodium bicarbonate did not provided greater benefit when compared to a saline solution, as well as comparing acetylcysteine to placebo. Regarding to gadolinium, besides nephrotoxicity is irrelevant, there is a risk for developing Nephrogenic Systemic Fibrosis (NSF) which may occur in those with GFR <60mL/min, particularly appears at a GFR <30mL/min. Current gadolinium use guidelines are related to patients with stage 5 (GFR <15mL/min) according to which they should undergo hemodialysis after examination.

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