Cytokine Clearances in Critically Ill Patients on Continuous Renal Replacement Therapy

Blood Purif. 2018;46(4):315-322. doi: 10.1159/000492025. Epub 2018 Aug 14.

Abstract

Background/aims: We sought to quantify any differences in cytokine clearance between continuous venovenous hemofiltration (CVVH-convective) compared to continuous venovenous hemodialysis (CVVHD-diffusive).

Methods: We conducted a 20 patient, multicenter, prospective, open-label randomized trial (CVVH or CVVHD) at continuous renal -replacement therapy (CRRT) initiation. Blood, urine, and effluent were collected at 0, 4, 24, and 48 h after initiation of CRRT. Serum electrolytes, cytokines levels, and clearances were measured. Cytokines studies included IL-1β, IL-1RA, IL-6, IL-10, and TNFα.

Results: We randomized 20 patients to receive CRRT. After 4 h of CRRT there was no difference in total cytokine levels or change in cytokine concentrations across the 2 groups. With the exception of IL-1 RA, all cytokines levels decreased across patient groups regardless of modality. There was no significant difference in cytokine concentration across CRRT modality for any time point.

Conclusion: Within the first 4 h of CRRT initiation, there is no significant difference between cytokine or solute clearance between CVVH and CVVHD.

Keywords: Acute kidney injury; Continuous renal replacement therapy; Cytokines; Interleukin-1beta; Interleukin-6; Tumor necrosis factor.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Kidney Injury / blood*
  • Acute Kidney Injury / therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Critical Illness
  • Cytokines / blood*
  • Female
  • Hemofiltration*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis*

Substances

  • Cytokines