The following is a summary of “Kidney REPLACEment therapies in patients with acute kidney injury and RHABDOmyolysis (ReplaceRhabdo): a pilot trial,” published in the January 2025 issue of Nephrology by Weidhase et al.
Rhabdomyolysis often leads to acute kidney injury (AKI) due to the nephrotoxic effects of myoglobin. Rapid myoglobin removal is critical.
Researchers conducted a retrospective study to compare kidney replacement therapies (KRT) for myoglobin elimination in AKI.
They conducted a prospective randomized single-center study on 15 patients with rhabdomyolysis and severe AKI requiring KRT, randomized 1:1:1 into continuous venovenous hemofiltration (CVVH), CVVHD-HCO, or CVVHD using a high-flux dialyzer in combination with the adsorber CytoSorb (CVVHD-CS) groups. They measured serum myoglobin, urea, creatinine, β2-microglobulin, interleukin-6, and albumin at 1, 6, 12, and 24 hours after initiating KRT.
The results showed no significant difference in median myoglobin clearance among KRT modes over 24 hours. CVVHD-CS achieved higher myoglobin elimination in the first hours but declined over time. Simulations indicated the highest clearance with CVVHD-HCO and CS combined, using a 12-hour adsorber exchange.
Investigators found that all tested modes effectively eliminated myoglobin. Time-dependent performance improved with more frequent adsorber exchanges in combination with KRT.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-03945-3
