heparitin-sulfate and Acute-Kidney-Injury

heparitin-sulfate has been researched along with Acute-Kidney-Injury* in 9 studies

Reviews

3 review(s) available for heparitin-sulfate and Acute-Kidney-Injury

ArticleYear
Heparanase in Acute Kidney Injury.
    Advances in experimental medicine and biology, 2020, Volume: 1221

    Recent years have brought about fledgling realization of the role played by heparanase in the pathogenesis of diverse diseases including kidney diseases and, specifically, acute kidney injury. Human heparanase-1 is critically and uniquely engaged in cleavage of heparan sulfate, an integral part of glycocalyx and extracellular matrix where it harbors distinct growth factors, cytokines, and other biologically active molecules. The enzyme is induced and activated in acute kidney injury regardless of its causes, ischemic, nephrotoxic, septic or transplantation-related. This event unleashes a host of sequelae characteristic of the pathogenesis of acute kidney injury, such as induction and reinforcement of innate immune responses, predisposition to thrombosis, activation of monocytes/macrophages and remodeling of the extracellular matrix, thus setting up the stage for future fibrotic complications and development of chronic kidney disease. We briefly discuss the emerging therapeutic strategies of inhibiting heparanase, as well as the diagnostic value of detecting products of heparanase activity for prognostication and treatment.

    Topics: Acute Kidney Injury; Cytokines; Glucuronidase; Heparitin Sulfate; Humans

2020
Anticoagulation options for patients with heparin-induced thrombocytopenia requiring renal support in the intensive care unit.
    Contributions to nephrology, 2007, Volume: 156

    World wide, heparins are the most commonly used anticoagulants for renal replacement therapy (RRT). In the intensive care unit (ICU) keeping the RRT circuit patent is more difficult than during routine outpatient hemodialysis, as ICU patients typically have sepsis and/or inflammation resulting in activation of the procoagulant pathways, with reduced antithrombin. One important cause of repeated RRT circuit clotting is heparin-induced thrombocytopenia (HIT), which should not be overlooked in patients with a reduced platelet count. If HIT is clinically suspected then all heparins should be withdrawn, and the patient systemically anticoagulated with either a direct thrombin inhibitor, such as argatroban and/or hirudin, or the heparinoid danaparoid. The availability and licensing of these alternative anticoagulants varies from country to country. Argatroban has to be continuously infused, which is an advantage for continuous RRT, but not for intermittent RRT, and can be monitored by activated partial thromboplastin time. Hirudin has a prolonged half life, which is extended by hirudin antibodies, and requires specialist monitoring to prevent over anticoagulation. Although the half life of danaparoid is increased in renal failure, it can be given as boluses for intermittent and continuous RRT, or by continuous infusion during continuous RRT, but requires factor Xa monitoring.

    Topics: Acute Kidney Injury; Anticoagulants; Arginine; Chondroitin Sulfates; Dermatan Sulfate; Extracorporeal Circulation; Heparin; Heparitin Sulfate; Hirudin Therapy; Humans; Intensive Care Units; Pipecolic Acids; Renal Replacement Therapy; Sulfonamides; Thrombocytopenia

2007
Anticoagulation in continuous renal replacement therapy.
    Contributions to nephrology, 2004, Volume: 144

    Topics: Acute Kidney Injury; Anticoagulants; Chondroitin Sulfates; Citrates; Critical Illness; Dermatan Sulfate; Drug Combinations; Heparin; Heparin, Low-Molecular-Weight; Heparitin Sulfate; Hirudin Therapy; Humans; Prostaglandins; Renal Replacement Therapy; Sodium Citrate

2004

Other Studies

6 other study(ies) available for heparitin-sulfate and Acute-Kidney-Injury

ArticleYear
Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia.
    Blood purification, 2014, Volume: 38, Issue:2

    Early clinical signs of heparin induced thrombocytopenia (HIT) are nonspecific and include a sudden drop in the number of platelets as well as formation of arterial and venous thromboses. Regional citrate anticoagulation (RCA) is increasingly used as a very effective modality to prevent filter clotting during renal replacement therapy (RRT). We report the first case where repeated premature filter clotting despite RCA indicated a manifestation of HIT.. A 71-year old woman admitted to the ICU for a compartment syndrome of the leg developed septic shock with acute kidney injury requiring continuous veno-venous hemodialysis (CVVHD). Because of unexpected and repeated premature filter clotting during CVVHD using RCA, HIT was suspected.. The diagnosis of HIT was confirmed by the presence of IgG antibodies against heparin and platelet factor (PF) 4 complexes and six points in the 4T score. Discontinuation of heparin administration and initiation of systemic anticoagulation with danaparoid sodium resulted in the normalization of platelet count and hemofilter lifetime.. RCA does not seem to be sufficient to prevent hemofilter clotting during HIT. Thus, in case of repeated premature filter clotting despite RCA, one should suspect HIT and prompt diagnostic workup as well as a switch to alternative anticoagulation.

    Topics: Acute Kidney Injury; Aged; Anticoagulants; Chondroitin Sulfates; Citrates; Dermatan Sulfate; Equipment Failure; Female; Heparin; Heparitin Sulfate; Humans; Immunoglobulin G; Platelet Factor 4; Renal Dialysis; Shock, Septic; Thrombocytopenia; Thrombosis

2014
Acute ischemic injury to the renal microvasculature in human kidney transplantation.
    American journal of physiology. Renal physiology, 2010, Volume: 299, Issue:5

    Increased understanding of the pathophysiology of ischemic acute kidney injury in renal transplantation may lead to novel therapies that improve early graft function. Therefore, we studied the renal microcirculation in ischemically injured kidneys from donors after cardiac death (DCD) and in living donor kidneys with minimal ischemia. During transplant surgery, peritubular capillaries were visualized by sidestream darkfield imaging. Despite a profound reduction in creatinine clearance, total renovascular resistance of DCD kidneys was similar to that of living donor kidneys. In contrast, renal microvascular perfusion in the early reperfusion period was 42% lower in DCD kidneys compared with living donor kidneys, which was accounted for by smaller blood vessel diameters in DCD kidneys. Furthermore, DCD kidneys were characterized by smaller red blood cell exclusion zones in peritubular capillaries and by greater production of syndecan-1 and heparan sulfate (main constituents of the endothelial glycocalyx) compared with living donor kidneys, providing strong evidence for glycocalyx degradation in these kidneys. We conclude that renal ischemia and reperfusion is associated with reduced capillary blood flow and loss of glycocalyx integrity. These findings form the basis for development of novel interventions to prevent ischemic acute kidney injury.

    Topics: Acute Kidney Injury; Adolescent; Adult; Capillaries; Endothelium, Vascular; Female; Glycocalyx; Heparitin Sulfate; Humans; Ischemia; Kidney Function Tests; Kidney Transplantation; Living Donors; Male; Middle Aged; P-Selectin; Renal Circulation; Reperfusion Injury; Syndecan-1; Young Adult

2010
[Heparin induced thrombocytopenia and anticoagulation in renal replacemant therapy].
    Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, 2008, Volume: 43, Issue:4

    The decision for an anticoagulant for renal replacement therapy (RRT) in patients with acute renal failure and heparin-induced thrombocytopenia (HIT) has to be made carefully. Based on results from the literature argatroban is favoured in patients without hepatic dysfunction, referring to its short halftime and easy feasable monitoring. In the case of coexsisting hepatic disorder, danaparoid provides a safe alternative therapy. However, long halftime and the difficult elimination of the substance are unfavourable. Lepirudin represents another possible anticoagulant therapy. Bleeding complications and monitoring of the ecarin clotting time imposes limitations. Experiences with bivalirudin, fondaparinux and prostaglandines are limited and future trials will have to determine the significance of their application in RRT in HIT patients. Furthermore it has to be proven whether the combination of alternative anticoagulants with citrate prolongates circuit halftime of CVVH.

    Topics: Acute Kidney Injury; Anticoagulants; Arginine; Blood Coagulation Tests; Chondroitin Sulfates; Citrates; Critical Care; Dermatan Sulfate; Diagnostic Errors; Dose-Response Relationship, Drug; Epoprostenol; Fondaparinux; Hemofiltration; Heparin; Heparin, Low-Molecular-Weight; Heparitin Sulfate; Hirudins; Humans; Iloprost; Pipecolic Acids; Polysaccharides; Recombinant Proteins; Sodium Citrate; Sulfonamides; Thrombocytopenia; Thrombosis

2008
Heparin-induced thrombocytopenia (HIT) and thrombosis in a haemodialysis-dependent patient with systemic vasculitis.
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 1998, Volume: 13, Issue:12

    Topics: Acute Kidney Injury; Aged; Anticoagulants; Chondroitin Sulfates; Dermatan Sulfate; Drug Combinations; Hemorrhage; Heparin; Heparitin Sulfate; Humans; Lung Diseases; Male; Phlebography; Renal Dialysis; Thrombocytopenia; Venous Thrombosis

1998
Heparin-induced thrombocytopenia type II: perioperative management using danaparoid in a coronary artery bypass patient with renal failure.
    The Thoracic and cardiovascular surgeon, 1997, Volume: 45, Issue:6

    An 84-year-old patient with heparin-induced thrombocytopenia (HIT), global cardiac decompensation, and acute renal failure underwent a cardiosurgical intervention using an extracorporeal circuit. For systemic anticoagulation danaparoid (Orgaran) was applied as a heparin substitute preoperatively and maintained for systemic anticoagulation during ECC despite it being eliminated by the kidney. The postoperative recovery was prolonged due to bleeding complications. During cardiopulmonary bypass (216 min) the target level of anti-factor Xa was 1.5 UI/ml. This required continuous infusion and an occasional bolus of danaparoid. Coagulation in the extracorporeal circuit was observed twice at plasma levels below 1.4 IU/ml. There were no thromboembolic or neurologic events. We did not retransfuse blood from the extracorporeal circuit or the cardiotomy reservoir after bypass, but because elimination of danaparoid was impaired in this patient and there is no neutraliser available antifactor Xa postoperatively exceeded 0.6 IU/ml for 30 hours. Diffuse bleeding with tamponade resulted. Weaning the patient from the respirator was achieved 12 hours after the last re-exploration. From the 4th postoperative day 750 IU of danaparoid were administered twice daily subcutaneously for thrombosis prevention. On the 6th postoperative day discharge from the ICU was possible. We conclude that the application of danaparoid for cardiopulmonary bypass in patients suffering from acute renal failure may be complicated by hemorrhage.

    Topics: Acute Kidney Injury; Aged; Aged, 80 and over; Anticoagulants; Chondroitin Sulfates; Coronary Artery Bypass; Coronary Disease; Dermatan Sulfate; Drug Combinations; Female; Heparin; Heparinoids; Heparitin Sulfate; Humans; Thrombocytopenia

1997
Use of a new heparinoid as anticoagulant during acute haemodialysis of patients with bleeding complications.
    Lancet (London, England), 1983, Apr-23, Volume: 1, Issue:8330

    Org 10172, a new, natural heparinoid, was used as the sole anticoagulant in twelve patients with acute or acute-on-chronic renal failure, who underwent haemodialysis 55 times. All patients had either intercurrent bleeding or a high risk of severe haemorrhagic complications if given standard heparin therapy. After a single loading dose of 300-600 mg of Org 10172, plasma anti-Xa levels in the range 0.42 - 0.93 U/ml were achieved. All haemodialysis runs were completed without adverse side-effects. There were no haemorrhagic complications and deposition of 125I-fibrinogen on the renal dialysis membrane was successfully inhibited in the 4 patients in whom this was studied. Org 10172 seems to prevent thrombosis during renal haemodialysis. It may have a lower risk/benefit ratio than other anticoagulants, such as heparin, in patients at high risk of haemorrhagic complications undergoing haemodialysis.

    Topics: Acute Kidney Injury; Adult; Aged; Blood Platelet Disorders; Chondroitin Sulfates; Dermatan Sulfate; Drug Evaluation; Female; Fibrinolytic Agents; Glycosaminoglycans; Hemorrhage; Heparitin Sulfate; Humans; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Risk

1983