Lactate Predicts Citrate Accumulation During Continuous Kidney Replacement Therapy: incidence, severity, and clinical implications

Lactate Predicts Citrate Accumulation During Continuous Kidney Replacement Therapy: incidence, severity, and clinical implications

In 911 critically ill patients on RCA-CKRT, citrate accumulation occurred in 17%. Pre-CKRT lactate strongly predicted accumulation (OR 2.34 per 1-unit increase on log scale); VIS was less discriminatory. Accumulation linked to liver dysfunction but not to shock and—after adjustment—did not increase mortality.
Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise

Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise

A randomized trial found that maintaining high intraoperative urine output (≥3 ml·kg−1·h−1 or ≥200 ml·h−1) during cytoreductive surgery and cisplatin‑based HIPEC reduced 7‑day postoperative AKI from 39.3% to 21.4% and lowered major 30‑day complications without increasing adverse events.
Predicting Early Acute Kidney Injury After Liver Transplantation: A Clinically Useful 48‑Hour Risk Model

Predicting Early Acute Kidney Injury After Liver Transplantation: A Clinically Useful 48‑Hour Risk Model

A single-center study developed and internally validated a 48‑hour post‑liver transplant AKI risk model using five readily available preoperative and intraoperative variables (HE, alcohol cirrhosis, ALBI ≥ −1.78, operation time ≥560 min, and FFP transfusion). The model showed good discrimination (AUC ≈0.76).
IXA Position Paper: Practical Roadmap for First-in-Human Porcine Kidney Xenotransplantation

IXA Position Paper: Practical Roadmap for First-in-Human Porcine Kidney Xenotransplantation

The International Xenotransplantation Association (IXA) 2025 position paper offers evidence-based recommendations for initial clinical trials of genetically engineered porcine kidney transplants for end-stage renal disease, focusing on donor genetics, immunosuppression, patient selection, infection monitoring and ethical/regulatory safeguards.