Effects of hemodialysis combined with hemoperfusion on severe acute pancreatitis

Li, Zhenhe; Wang, Guixia; Zhen, Guodong; Zhang, Yuliang; Liu, Jiaqiang; Liu, Shanmei

doi:10.5152/tjg.2018.17415

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…Previous studies have found that CVVH combined with HP can clear various inflammatory mediators more effectively than CVVH alone [21]. Li et al [22] also suggested that CVVH combined with HP could better remove toxic metabolites and inflammatory mediators in SAP than HP alone, and it not only shortens the time of symptoms disappearing but also decreases the incidence of complications and the mortality. Based on clinical experience and previous studies, PIRRT combined with HP (PIRRT + HP) is theoretically more effective in treating AP.…”

Section: Discussionmentioning

confidence: 99%

Prolonged Intermittent Renal Replacement Therapy Combined with Hemoperfusion Can Improve Early Recovery of Moderate and Severe Acute Pancreatitis, Especially in Patients with Acute Kidney Injury

et al. 2022

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Introduction: The aim of this study was to investigate the efficacy of prolonged intermittent renal replacement therapy (PIRRT) plus hemoperfusion (HP) in treating moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP). Methods: A total of 105 MSAP and SAP patients were enrolled. Sixty of them received routine internal medical therapy (control group), and 45 received PIRRT and HP in addition to routine internal medical therapy (PIRRT + HP group). The vital signs, laboratory results, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score were compared between the two groups before treatment and on the 3rd and 7th days of treatment. Results: No deaths or treatment-related serious adverse reactions occurred in both groups. After 3 and 7 days of treatment, the APACHE II score decreased more significantly in the PIRRT + HP group than in the control group (3 days: 5.47 [±3.30] vs. 7.53 [±3.89], p = 0.005. 7 days: 4.82 [±3.49] vs. 6.87 [±3.54], p = 0.004). After 3 days of treatment, the inflammatory combination parameters systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) in the PIRRT + HP group decreased more significantly than those in the control group (SII: 1,239.00 [737.80–1,769.00] vs. 2,013.00 [1,260.00–3,167.00], p = 0.001. NLR: 8.78 [±4.52] vs. 11.88 [±7.30], p = 0.009). After 7 days of treatment, SII, NLR, and hypersensitive C-reactive protein decreased significantly compared with baseline, but no statistical differences between the two groups were observed. AST in both groups remained stable with treatment. There was no significant difference in baseline creatinine between the two groups of AKI patients, but after 3 and 7 days of treatment, the proportion of acute kidney injury (AKI) patients in the PIRRT + HP group whose creatinine decreased by 50% from baseline or fell to the normal range was significantly higher than that in the control group (p < 0.05). Conclusion: PIRRT + HP therapy could not only improve the general conditions, as measured by APACHE II score, but also reduce the inflammatory cascade of patients with acute pancreatitis. For MSAP and SAP patients complicated with AKI, this therapy may accelerate the recovery of renal function.

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Section: Discussionmentioning

confidence: 99%

Prolonged Intermittent Renal Replacement Therapy Combined with Hemoperfusion Can Improve Early Recovery of Moderate and Severe Acute Pancreatitis, Especially in Patients with Acute Kidney Injury

et al. 2022

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“…Accumulation of β2-MG and metabolic disorder of uremic patients may produce a large amount of PTH, which is involved in the occurrence and development of renal diseases (29,30). Cr and BUN belong to small molecular toxins and are one of the important factors causing uremic symptoms and complications (7,31,32). Inflammation is a vital factor that causes the occurrence or aggravation of various diseases, and is also crucial in the pathogenesis of complications in uremic patients (33).…”

Section: Discussionmentioning

confidence: 99%

“…Hemodialysis can remove blood urea nitrogen (BUN), creatinine (Cr) and bilirubin. In addition, it is mainly effective in removing internal wastes and adjusting acid-base balance through the principle of semipermeable membrane dialysis (7). Hemoperfusion can adsorb inflammatory mediators, such as interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor-α and prothrombin-activating factor, to reduce inflammatory reaction (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…Hemoperfusion can adsorb inflammatory mediators, such as interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor-α and prothrombin-activating factor, to reduce inflammatory reaction (8)(9)(10). Hemodialysis combined with hemoperfusion can make up for each other and play different roles, thus achieving high efficiency in removing various toxins and maintaining water-electrolyte balance in the body (5,7). Although blood purification technology and drug therapy have made progress, the mortality of chronic kidney disease remains very high (5).…”

Section: Introductionmentioning

confidence: 99%

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Changes of miR‑155 expression in serum of uremic patients before and after treatment and risk factors analysis

Li¹,

Qiu²,

Tian³

et al. 2020

Exp Ther Med

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The aim of the present study was to investigate the changes of miR-155 expression in the serum of uremic patients before and after treatment and analyze the risk factors of efficacy. A total of 116 uremic patients admitted to the People's Hospital of Chengyang (Qingdao, China) were enrolled in the study as the uremia group, and were treated by hemodialysis combined with hemoperfusion, and 127 healthy subjects who underwent health examination during the same period were selected as the normal group. Reverse transcription quantitative PCR was used to detect the serum miR-155 levels of all the subjects in the two groups before treatment and those of uremia patients after treatment. The changes of clinically related indicators and inflammatory factors in uremic patients before and after treatment and their correlation with miR-155 were investigated. The risk factors affecting the efficacy of treatment were analyzed. Serum miR-155 levels in the uremia group were higher than those in the normal group (P<0.001); the miR-155 level in patients after treatment was significantly lower than that before treatment (P<0.001), and it was positively correlated with efficacy (r= 0.6873, P<0.05). The serum miR-155 level in the invalid group was higher than that in the effective group, and the sensitivity and specificity of miR-155 for predicting the efficacy before treatment were 64.71 and 87.88%, respectively. After treatment, the sensitivity and specificity of miR-155 for evaluating the efficacy were 76.47 and 88.89%, respectively. Clinically related indicators and inflammatory factor levels in uremic patients decreased significantly after treatment, and the expression levels before and after treatment were significantly correlated with miR-155. Clinically related indicators, inflammatory factors and miR-155 were all risk factors affecting efficacy. The expression level of miR-155 in serum was significantly upregulated. Findings of this study suggest that monitoring miR-155 may reflect the efficacy and inflammatory state effectively.

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“…Indeed, HP targets molecules that tend to be more difficult to remove with conventional HD or with continuous RRTs (CRRT) and has the capacity to remove molecules with MW up to 30,000 Da depending on the characteristics of the sorbent material [ 31 ]. When combined with HD/CRRT, the sorbent can be placed before or after the dialyzer and enhance the removal of middle molecules that are not sufficiently removed by HD, such as B2M [ 32 ].…”

Section: Technical Aspects Of Hemoperfusionmentioning

confidence: 99%

Expanding the potential therapeutic options of hemoperfusion in the era of improved sorbent biocompatibility

Damianaki¹,

Stambolliu²,

Alexakou³

et al. 2023

Kidney Res Clin Pract

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Hemoperfusion has been considered a promising adjuvant treatment for chronic diseases and some acute states when specific removal of pathogenic factors from the bloodstream is desired. Over the years, advances in adsorption materials (e.g., new synthetic polymers, biomimetic coating, and matrixes with novel structures) have renewed scientific interest and expanded the potential therapeutic indications of hemoperfusion. There is growing evidence to suggest a prominent place for hemoperfusion as an adjuvant treatment in the setting of sepsis or severe coronavirus disease 2019 and as a therapeutic option for chronic complications associated with accumulated uremic toxins in patients with end-stage renal disease. This literature review will describe the principles, therapeutic perspectives, and the emerging role of hemoperfusion as a complementary therapy for patients with kidney disease.

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Effects of hemodialysis combined with hemoperfusion on severe acute pancreatitis

Abstract: ABSTRACT

Cited by 10 publications

References 19 publications

Prolonged Intermittent Renal Replacement Therapy Combined with Hemoperfusion Can Improve Early Recovery of Moderate and Severe Acute Pancreatitis, Especially in Patients with Acute Kidney Injury

Prolonged Intermittent Renal Replacement Therapy Combined with Hemoperfusion Can Improve Early Recovery of Moderate and Severe Acute Pancreatitis, Especially in Patients with Acute Kidney Injury

Changes of miR‑155 expression in serum of uremic patients before and after treatment and risk factors analysis

Expanding the potential therapeutic options of hemoperfusion in the era of improved sorbent biocompatibility

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