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Title: High cut-off hemofiltration versus standard hemofiltration: effect on plasma cytokines
Austin Authors: Atan, Rafidah;Peck, Leah ;Visvanathan, Kumar;Skinner, Narelle;Eastwood, Glenn M ;Bellomo, Rinaldo ;Storr, Markus;Goehl, Hermann
Affiliation: Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
St. Vincent's Hospital, University of Melbourne, Fitzroy, Victoria, Australia
Gambro Dialysatoren GmbH, Research & Development, Hechingen, Germany
Issue Date: 11-Nov-2016
Date: 2016
Publication information: The International Journal of Artificial Organs 2016; 39(9): 479-486
Abstract: To study the effects of continuous veno-venous hemofiltration (CVVH) with high cut-off filters (CVVH-HCO) on plasma cytokine levels, sieving coefficient and clearance compared to CVVH using standard filters (CVVH-Std) in a nested cohort within a double-blind randomized controlled trial in severe acute kidney injury (AKI) patients. We measured plasma and post-filter levels of IL-6, TNF-alpha, IL-8, IL-1 beta, RANTES, IL-10, IFN-gamma and IFN-alpha in both study groups. We also measured cytokine levels in the ultrafiltrate and calculated sieving coefficients and clearances. By 72 hours of treatment, IL-6 had decreased during both treatments (p = 0.009 and 0.005 respectively). In contrast, IL-10 had decreased with CVVH-Std (p = 0.03) but not CVVH-HCO (p = 0.135). None of the other cytokines showed changes over time. There were also no significant between group differences in plasma levels for each cytokine over the 72-hour treatment period. For all cytokines combined, however, the median sieving coefficient was higher for CVVH-HCO (0.31 vs. 0.16; p = 0.042) as was the mass removal rate by ultrafiltration (p = 0.027). While overall combined cytokine levels had fallen to 62.2% of baseline at 72 hours for CVVH-HCO (p<0.0001) and to 75.9% of baseline with CVVH-Std (p = 0.008) there were no between group differences. CVVH-HCO achieved greater combined sieving coefficient and mass removal rate by ultrafiltration for a group of key cytokines than CVVH-Std. However, this effect did not differentially lower their plasma level over the first 72 hours. Our study does not support the use of CVVH-HCO to lower cytokines in critically ill patients with AKI.
DOI: 10.5301/ijao.5000527
Journal: The International Journal of Artificial Organs
PubMed URL: 27834446
PubMed URL:
Type: Journal Article
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