The effect of continuous venovenous hemofiltration on neutrophil gelatinase-associated lipocalin plasma levels in patients with septic acute kidney injuryReportar como inadecuado




The effect of continuous venovenous hemofiltration on neutrophil gelatinase-associated lipocalin plasma levels in patients with septic acute kidney injury - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Nephrology

, 17:154

Clinical Research

Abstract

BackgroundIt is known that continuous venonenous hemofiltration CVVH does not affect the plasma level of neutrophil gelatinase-associated lipocalin pNGAL in acute kidney injury AKI patients. However, because of the unique pathophysiology underlying AKI caused by sepsis, the effect of CVVH on pNGAL in this clinical setting is less certain. The purpose of this study was to determine the effect of CVVH on pNGAL in sepsis-induced AKI patients.

MethodsBetween August 1, 2014, and December 31, 2014, 42 patients with sepsis-induced AKI underwent CVVH in the general intensive care unit of our institution and were consecutively enrolled in this study. Prefilter, postfilter, and ultrafiltrate pNGAL measurements were taken at the initiation of continuous renal replacement therapy CRRT and repeated after 2, 4, 8, and 12 h T0, T2h, T4h, T8h, and T12h, respectively. The mass transfer, plasma clearance, and sieving coefficient were calculated based on the mass conservation principle.

ResultsFollowing CVVH initiation, we found that pNGAL in the ultrafiltrate decreased significantly P = 0.013; however, levels at the inlet and outlet showed no significant change P > 0.05 for both. Furthermore, there was no change in the total mass removal rate, total mass adsorption rate, and plasma clearance over time P > 0.05 for all, and a significant decrease in the sieving coefficient P = 0.007 was seen.

ConclusionsThe results of this study show a limited effect of CVVH on pNGAL in sepsis-induced AKI patients. This suggests that pNGAL may be used as an indicator of renal progression in these patients. However, a larger study to confirm these findings is needed.

Trial registrationClinicalTrials.gov, NCT02536027. Retrospectively registered on 20th August 2015.

KeywordsAcute kidney injury Continuous venovenous hemofiltration Neutrophil gelatinase-associated lipocalin Sepsis AbbreviationsAKIAcute kidney injury

APACHE IIAcute physiology and chronic health evaluation II

CRRTContinuous renal replacement therapy

CVVHContinuous venovenous hemofiltration

ICUIntensive care unit

NGALNeutrophil gelatinase-associated lipocalin

SOFASequential organ failure assessment

UFRUltrafiltration rate

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Autor: Xingui Dai - Tao Li - Zhenhua Zeng - Chunlai Fu - Shengbiao Wang - Yeping Cai - Zhongqing Chen

Fuente: https://link.springer.com/







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