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

Autor: Laurent Amigues, Anne Marie Dupuy, Vincent Brunot, Noémie Besnard, Marie Christine Picot, Delphine Daubin, Jean-Paul Cristol, Marion Morena, Audrey Jaussent, Kada Klouche
Přispěvatelé: Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), MORNET, Dominique
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Nephrology
Male
[SDV]Life Sciences [q-bio]
030232 urology & nephrology
030204 cardiovascular system & hematology
lcsh:RC870-923
Gastroenterology
law.invention
Cohort Studies
chemistry.chemical_compound
0302 clinical medicine
law
Prospective Studies
Prospective cohort study
ComputingMilieux_MISCELLANEOUS
biology
Acute kidney injury
On-line Hemodiafiltration
Acute Kidney Injury
Middle Aged
Inflammatory cytokines
Intensive care unit
3. Good health
Vascular endothelial growth factor
[SDV] Life Sciences [q-bio]
Intensive Care Units
Cytokines
Female
Anti-inflammatory cytokines
Inflammation Mediators
Research Article
medicine.medical_specialty
Hemodiafiltration
Vegf
Proinflammatory cytokine
03 medical and health sciences
Internal medicine
medicine
Humans
Interleukin 6
Egf
Aged
Creatinine
business.industry
lcsh:Diseases of the genitourinary system. Urology
medicine.disease
Mcp-1
Oxidative Stress
chemistry
biology.protein
business
Zdroj: BMC Nephrology
BMC Nephrology, 2017, 18 (1), pp.371. ⟨10.1186/s12882-017-0785-1⟩
BMC Nephrology, BioMed Central, 2017, 18 (1), pp.371. ⟨10.1186/s12882-017-0785-1⟩
BMC Nephrology, Vol 18, Iss 1, Pp 1-8 (2017)
ISSN: 1471-2369
Popis: Background Though 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. Methods In 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. Results Intradialytic 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. Conclusions OL-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.
Databáze: OpenAIRE
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