On-line hemodiafiltration did not induce an overproduction of oxidative stress and inflammatory cytokines in intensive care unit-acute kidney injury

BMC Nephrology

Research Article

Anne Marie Dupuy¹  Jean Paul Cristol²  Marion Morena²  Marie Christine Picot³  Audrey Jaussent³  Laurent Amigues⁴  Noémie Besnard⁴  Delphine Daubin⁴  Vincent Brunot⁴  Kada Klouche⁵ 

[1] Departments of Biochemistry, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France;Departments of Biochemistry, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France;Lapeyronie University Hospital. PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France;Departments of Medical statistics, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France;Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France;Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France;Lapeyronie University Hospital. PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France;

关键词: Acute kidney injury;    On-line Hemodiafiltration;    Oxidative stress;    Inflammatory cytokines;    Anti-inflammatory cytokines;    Egf;    Vegf;    Mcp-1;   

DOI  :  10.1186/s12882-017-0785-1

 received in 2017-03-01, accepted in 2017-12-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThough on-line intermittent hemodiafiltration (OL-IHDF) is a routine therapy for chronic dialysis patients, it is not yet widespread used in critically ill patients. This study was undergone to evaluate efficiency and tolerance of OL-IHDF and to appreciate inflammatory consequences of its use in intensive care unit (ICU)-acute kidney injury (AKI) patients.MethodsIn this prospective cohort study conducted in a medical academic ICU in France, 30 AKI patients who underwent OL-IHDF were included. OL-HDF used an ultrapure water production: AQ 1250 line with double reverse osmosis, a generator 5008 with a 1.8m2 dialyzer with Polysulfone membrane (Fresenius Medical Care). Tolerance and efficiency of OL-IHDF were evaluated as well as its inflammatory risk by the measurement of plasma concentrations of proinflammatory (Interleukin 6, IL1β, IL8, Interferon γ) and anti-inflammatory (IL4, IL10) cytokines, Epidermal growth factor (EGF), Vascular Endothelial growth factor (VEGF) and Macrophage Chemoattractive Protein-1 (MCP-1) before and after sessions.ResultsIntradialytic hypotensive events were observed during 27/203 OL-IHDF sessions accounting for a mal-tolerated session’s rate at 13.3%. Mean delivered urea Kt/V per session was 1.12 ± 0.27 with a percentage of reduction for urea, creatinine, β2-microglobulin and cystatine C at 61.6 ± 8.8%, 55.3 ± 6.7%, 51.5 ± 8.7% and 44.5 ± 9.8% respectively. Production of superoxide anion by leukocytes, mean levels of pro- and anti-inflammatory cytokines and plasmatic concentrations of EGF, VEGF and MCP-1 did not differ before and after OL-IHDF sessions. We observed however a significant decrease of mean TNFα plasmatic concentrations from 8.2 ± 5.8 to 4.8 ± 3.5 pg/ml at the end of OL-IHDF.ConclusionsOL-IHDF was not associated with an increase in pro and anti-inflammatory cytokines, oxidative stress or EGF, VEGF and MCP-1 in AKI patients and seems therefore a secure and feasible modality in ICUs.

【 授权许可】

CC BY   
© The Author(s). 2017