{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:51:35Z","timestamp":1780494695403,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T00:00:00Z","timestamp":1563753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute\u2010on\u2010chronic liver failure (ACLF) requiring intensive medical care and associated with acute kidney injury (AKI) has a mortality rate as high as 90% due to the lack of effective therapies. In this study, we assessed the effects of intermittent high\u2010flux single\u2010pass albumin dialysis (SPAD) coupled with continuous venovenous hemodialysis (CVVHD) on 28\u2010day and 90\u2010day survival and an array of clinical and laboratory parameters in patients with severe ACLF and renal insufficiency. Sixteen patients were studied. The diagnosis of ACLF and AKI was made in accordance with current EASL Clinical Practice Guidelines, including the recommendations of the International Club of Ascites. All patients received SPAD\/CVVHD treatments as the blood purification therapy to support liver, kidneys, and other organs. Five patients were transplanted and 11 were not listed for transplantation because of active alcoholism. Data at the initiation of SPAD\/CVVHD were compared with early morning data after the termination of the extracorporeal treatment phase. All patients had ACLF and renal insufficiency with 13\/16 additionally fulfilling the AKI criteria. A total of 37 SPAD\/CVVHD treatments were performed [2.3\u00a0\u00b1\u00a01.4]. The baseline MELD\u2010Na score was 37.6\u00a0\u00b1\u00a06.6 and decreased to 33.4\u00a0\u00b1\u00a08.7 after SPAD\/CVVHD (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001). In parallel, the CLIF\u2010C ACLF grade and OF score, estimated at 28\u2010 and 90\u2010day mortality, AKI stage, hepatic encephalopathy grade, and liver function tests were lowered (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001\u20130.032). The 28\u2010 and 90\u2010day survivals were 56.2% overall and 53.8% in AKI. Survival in patients not transplanted (<jats:italic>n\u00a0<\/jats:italic>=\u00a011) was 45.4%. In patients with severe ACLF and AKI, the renal replacement therapy coupled with high\u2010performance albumin dialysis improved estimated 28\u2010 and 90\u2010day survival and several key clinical and laboratory parameters. It is postulated that these results may be further improved with earlier intervention and more SPAD treatments per patient. High\u2010performance albumin dialysis improves survival and key clinical and laboratory parameters in severe ACLF and AKI.<\/jats:p>","DOI":"10.1111\/aor.13532","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T06:54:17Z","timestamp":1562136857000},"page":"91-99","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Intermittent high\u2010flux albumin dialysis with continuous venovenous hemodialysis for acute\u2010on\u2010chronic liver failure and acute kidney injury"],"prefix":"10.1111","volume":"44","author":[{"given":"Grzegorz","family":"Niewinski","sequence":"first","affiliation":[{"name":"2nd Department of Anesthesiology and Intensive Medical Care, Central Independent Public Clinical Hospital Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Raszeja\u2010Wyszomirska","sequence":"additional","affiliation":[{"name":"Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Hrenczuk","sequence":"additional","affiliation":[{"name":"Department of Surgical and Transplantation Nursing and Extracorporeal Therapies Medical University of Warsaw Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agata","family":"Rozga","sequence":"additional","affiliation":[{"name":"School of Interactive Computing Georgia Institute of Technology Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Malkowski","sequence":"additional","affiliation":[{"name":"Department of Surgical and Transplantation Nursing and Extracorporeal Therapies 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