One cases of Super Low Efficiency Dialysis with filtration (SPLED-f) was useful for acute kidney injury

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  • 急性腎障害に対して超低効率血液濾過透析（Super Low Efficiency Dialysis with filtration：SPLED-f）が有用であった1例
  • 症例報告 急性腎障害に対して超低効率血液濾過透析(Super Low Efficiency Dialysis with filtration : SPLED-f)が有用であった1例
  • ショウレイ ホウコク キュウセイジンショウガイ ニ タイシテ チョウテイコウリツ ケツエキ ロカ トウセキ(Super Low Efficiency Dialysis with filtration : SPLED-f)ガ ユウヨウ デ アッタ 1レイ

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Abstract

<p>A 69-year-old male was admitted to the hospital with a diagnosis of acute coronary syndrome. Coronary angiography demonstrated 100% stenosis of the left anterior descending artery segment 6, and percutaneous coronary intervention was thus performed. Subsequently, the patient developed a urinary tract infection, which exacerbated congestive heart failure, complicated by acute kidney injury (AKI), cardiogenic pulmonary edema, and sepsis. The patient was then placed on artificial ventilation due to difficulty breathing, and continuous hemodiafiltration (CHDF) was initiated to treat the AKI. However, frequent hemofilter clotting made it difficult to continue with CHDF. Therefore, Super Low Efficiency Dialysis with filtration (SPLED-f) was instituted. Using VPS-11HA (1.1m2) as a dialyzer, SPLED-f was administered for 7 hours daily, using a blood flow rate （QB） of 100mL/min, dialysate flow rate (QD) of 2,500mL/h, and ultrafiltration rate (Qf) of 500mL/h. After completing the 18th session of SPLED-f, the patient could be weaned from the artificial ventilator and switched to intermittent hemodialysis. While minimizing hemodynamic changes with SPLED-f, we were able to effectively maintain fluid balance, correct electrolyte abnormalities, remove uremic toxins and improve metabolic acidosis, resulting in satisfactory progress for this patient. SPLED-f may be considered as a treatment option for patients in whom a reduction in anticoagulant dosage is desired due to hemorrhagic diathesis, those in whom continuous renal replacement therapy is not feasible due to facility limitations.</p>

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