Effect of continuous renal-replacement therapy on paraoxonase-1-related variables in patients with acute renal failure caused by septic shock

Autor: Anabel García-Heredia, Pitter Cueto, Jordi Camps, Conxita Rovira, Anna Hernández-Aguilera, Jorge Joven, Immaculada Vallverdú, Noemí Cabré, Fedra Luciano-Mateo, Elisabeth Garcia, Pedro Garrido, Isabel Fort-Gallifa
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
medicine.medical_treatment
Clinical Biochemistry
030204 cardiovascular system & hematology
Kidney
Gastroenterology
Severity of Illness Index
Serum urea
Cohort Studies
Hospitals
University
chemistry.chemical_compound
0302 clinical medicine
Urea
Longitudinal Studies
Prospective Studies
medicine.diagnostic_test
biology
General Medicine
Acute Kidney Injury
Middle Aged
Shock
Septic
Renal Replacement Therapy
Intensive Care Units
Cholesterol
Female
medicine.medical_specialty
Sepsis
03 medical and health sciences
Internal medicine
medicine
Humans
In patient
Renal replacement therapy
Aged
Creatinine
Septic shock
business.industry
Aryldialkylphosphatase
Cholesterol
HDL
Paraoxonase
Length of Stay
medicine.disease
030104 developmental biology
chemistry
Spain
biology.protein
Lipid profile
business
Biomarkers
Zdroj: Clinical biochemistry. 61
ISSN: 1873-2933
Popis: Background Acute renal failure in patients with sepsis is associated with high mortality. Studies have highlighted alterations in serum paraoxonase-1 in severe infections. However, the published literature has no insight into the clinical evolution of these parameters in patients with sepsis and acute renal failure treated with extra-renal depuration techniques. Methods We studied 25 patients with sepsis and acute renal failure who were treated with continuous renal-replacement therapy. Blood for laboratory analyses was collected at days 0, 1, 2, 5, 7, and 10. We measured serum paraoxonase-1 activity and concentration, lipid profile, aminotransferase activities, pH, and lactate, urea, creatinine and C-reactive protein concentrations. Values were compared with those of 50 healthy individuals. Results Patients with sepsis and acute renal failure had lower serum paraoxonase-1 activity, lower high-density lipoprotein cholesterol concentrations, and higher serum paraoxonase-1 concentrations than the control group. We found a significant inverse correlation between serum paraoxonase-1 concentrations and the Acute Physiology And Chronic Health Evaluation II score in survivors as well as non-survivors, and a significant inverse correlation between serum paraoxonase-1 concentrations and the Sequential Organ Failure Assessment score only in survivors. Extra-renal depuration techniques produced a further increase in this enzyme related to the duration of treatment, and to serum urea concentration. Conclusion Our results show an inverse relationship between the concentration of paraoxonase-1 and the disease severity of patients with renal failure caused by septic shock. These results highlight relationships between paraoxonase-1 and infectious diseases and sepsis, with insights into potential clinical evolution of treatment.
Databáze: OpenAIRE
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