Effects of HV-CRRT on PCT, TNF-α, IL-4, IL-6, IL-8 and IL-10 in patients with pancreatitis complicated by acute renal failure

Abstract

The aim of the study was to investigate the effects of high-volume continuous renal replacement therapy (HV-CRRT) on procalcitonin (PCT), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6, IL-8 and IL-10 in acute pancreatitis complicated by acute renal failure. Eighty-six patients with acute pancreatitis complicated with acute renal failure were selected from September 2014 to September 2016 in our hospital, and were treated by continuous veno-venous hemofiltration (CVVH). The patients were randomly divided into the observation group, treated by the HV-CVVH model with a displacement rate of 4 l/h, and the control group, treated by the normal capacity model with a displacement rate of 2 l/h. The levels of PCT, TNF-α, IL-4, IL-6, IL-8, and IL-10 in serum were measured by ELISA before and 2, 6 and 12 h after treatment, and 12 h after CVVH. The serum PCT and TNF-α levels in the two groups were decreased at 2 h after treatment. The lowest levels appeared at 6 h after treatment, and then recovered, but remained lower than those before treatment (p<0.05). The levels of IL-4, IL-6, IL-8 and IL-10, as well as PCT and TNF-α in the two groups were significantly lower than those before treatment, and the decreases in the observation group were more obvious than those in the control group (p<0.05). In conclusion, compared with the standard volume method, HV-CRRT can more effectively remove various inflammatory factors and reduce the levels of serum PCT for the treatment of pancreatitis complicated by acute renal failure. Additionally, replacement of the blood filter at appropriate time-points can improve the treatment efficacy.

Kidney Replacement Therapy in COVID-19 Induced Kidney Failure and Septic Shock: A Pediatric Continuous Renal Replacement Therapy [PCRRT] Position on Emergency Preparedness With Resource Allocation

“…In terms of CKRT modality, we propose the use of high flow (HF) CVVHDF in critically ill COVID-19 pediatric patients as HF-CVVHDF is able to boost the non-specific removal of the circulatory cytokine peaks in both the pro- and the anti-inflammatory side in accordance to the “peak concentration hypothesis” ( 40 ). Furthermore, a study by Liu et al demonstrated that high-flow CKRT was significantly more effective in clearance of inflammatory cytokines (such as IL-4, IL-6, TNF-α) due to the increased blood flow in comparison to conventional CKRT ( p < 0.05) ( 41 ). The authors recommended that use of HF-CKRT increased the effective adsorption area of the synthetic membrane leading to higher clearance ( 41 ).…”

Development and validation of a predictive model for predicting acute kidney injury in patients with acute pancreatitis

“…In recent years, blood purification treatment plays a significant role in the comprehensive treatment of acute pancreatitis [23,24]. It has been reported that early hemofiltration could improve the treatment efficacy and decrease mortality rate in patients with pancreatitis complicated by acute renal failure [25,26]. Therefore, early identification of acute kidney injury in the course of acute pancreatitis would be of great value in helping clinicians triage patients to the appropriate level of care and guide clinical practice in the management of acute pancreatitis.…”

Cardiac depression in severe acute pancreatitis: development mechanisms and possible treatment approaches. Review

“…Как было упомянуто выше, способом воздействия на цитокины и бактериальные эндотоксины являются методы экстракорпорального очищения крови, и в первую очередьгемофильтрация, гемосорбция и плазмаферез. Данные исследований подтверждают, что очищение крови путем гемофильтрации способно снизить концентрацию провоспалительных цитокинов и активность эндотоксина [34,35]. Метаанализ исследований, посвященных эффективности применения высокообъемной гемофильтрации, показал достоверное улучшение ряда по-казателей при ОП, в том числе снижение летальности и уменьшение оценки по шкале APACHE II [36].…”