The Effect of Continuous Renal Replacement Therapy with the AN69ST Membrane on Inflammatory Markers and the Level of Consciousness of Hemodialysis Patients with Stroke: Comparison with Hemodialysis with Low Blood Flow Rate
| Autor: | Hiroyuki Horio, Hitomi Kikuchi, Kazuhiko Hashimura, Takafumi Nakagawa, Tomohiro Matsui |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Consciousness medicine.medical_treatment Acrylic Resins Peritoneal dialysis Level of consciousness Clinical Protocols Coated Materials Biocompatible Renal Dialysis White blood cell Medicine Humans Renal replacement therapy Stroke Aged Inflammation Acrylonitrile business.industry Glasgow Coma Scale Stroke Rehabilitation General Medicine Blood flow Middle Aged medicine.disease Renal Replacement Therapy medicine.anatomical_structure Treatment Outcome Anesthesia Health Care Surveys Female Hemodialysis business Biomarkers |
| Zdroj: | Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki). 39(2-3) |
| ISSN: | 1857-9345 |
| Popis: | Introduction: Hemodialysis (HD) with low blood flow rate, continuous renal replacement therapy (CRRT), and peritoneal dialysis are recommended for patients with stroke complications to prevent intracranial hypertension because of the low diffusion capacity of the brain barrier. However, detailed guidelines are not currently available; thus, there is an urgent need to establish such guidelines. Material and Methods: We developed a novel protocol for performing CRRT with the AN69ST membrane, which has excellent adsorption capacity for various cytokines. The objective of this study was to compare the effect of the novel protocol with that of the current standard protocol, i.e. hemodialysis with low blood flow rate. To compare the effect of hemodialysis with low blood flow (HD group, n=27) and CRRT with AN69ST membrane (CRRT group, n=8), we measured the following consciousness and blood inflammatory parameters in patients with stroke complications at baseline and after 1 week of treatment: Glasgow Coma Scale (GCS) score, C-reactive protein (CRP) levels, and white blood cell (WBC) and platelet count. Results: After 1 week, the total GCS score did not improve in the HD group, but improved significantly in the CRRT group (HD group: 13.1±3.0 to 13.3±3.1, p=0.5508, CRRT group: 8.9±3.9 to 11.5±3.9, p=0.0313). Improvement in the CRRT group was significantly higher than in the HD group (p=0.0039). CRP levels did not change significantly in either the HD (3.8±5.5 to 5.3±4.3 n.s.) or CRRT groups (7.7±10.0 to 3.7±3.2 n.s.); however, they tended to increase in the HD group and decrease in the CRRT group. No significant changes were observed in WBC and platelet counts after 1 week of treatment in either group. Conclusion: CRRT with the AN69ST membrane might have a beneficial effect on the consciousness level and inflammation of patients with stroke. |
| Databáze: | OpenAIRE |
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