Effectiveness of continuous plasma filtration combined with plasma adsorption for the septic acute kidney injury

Objective To investigate the effectiveness of continuous plasma filtration combined with plasma adsorption in the treatment of acute renal injury caused by sepsis. Methods 124 cases of septic AKI were randomly divided into experimental group and control group (62 cases in each group). The control group was given continuous hemofiltration treatment for 24~72 h and 150~180 ml/min of blood fluid, and the experimental group was given continuous plasma filtration (24~72 h) combined with plasma adsorption (3 h) and 150~180 ml/min of blood fluid. The 28-day survival rate, ICU stay and ventilator dependent time were compared between two groups, and the levels of IL-6, TNF-alpha, IL-1beta, IL-10, blood creatinine and blood urea nitrogen, vital signs, oxygenation index, white blood cell count, APACHE Ⅱ score were compared before and after treatment. Results The levels of IL-6, TNF-alpha, IL-1beta, IL-10, blood creatinine and blood urea nitrogen, vital signs, oxygenation index, white blood cell count, and APACHE Ⅱ score were significantly improved after treatment in the two groups. The 28-day survival rate in the experimental group (72.58%) was significantly higher than in the control group (46.77%). ICU stay (15.69±3.51 vs 18.92±3.27 days) and ventilator dependent time (4.68±3.10 vs 6.83±3.21 days) were significantly shorter in the experimental group than in the control group (P<0.05). The levels of IL-6 (62.63±45.25 vs 112.38±66.23 ng/ml), TNF-alpha (23.62±4.27 vs 34.82±5.29 ng/ml) and IL-1 beta (32.52±8.32 vs 46.15±9.52 ng/mL) and IL-10 (295.21±106.28 vs 361.78±102.03 ng/ml) in the experimental group after treatment were significantly lower than in the control group (P<0.05). Blood creatinine (61.47±10.65 vs 79.30±11.75 μmol/L) and blood urea nitrogen (8.69±3.61 vs 14.06±3.76 mmol/L) were significantly reduced, vital signs were significantly improved, white blood cell count (11.80±4.51×10⁹/L vs 14.53±5.09×10⁹/L) and APACHE Ⅱ score (11.62±3.71 vs 14.36±3.52) significantly increased, and the oxygenation index (362.56±98.25 vs 82.84±105.38) significantly decreased in the experimental group after treatment as compared with those in the control group (P<0.05). Conclusions Continuous plasma filtration combined with plasma adsorption therapy can effectively reduce the level of inflammatory cytokines in patients with septic AKI, alleviate inflammation and improve the prognosis of patients.