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Abstract: FR-PO047

Continuous Renal Replacement Therapy with AN69ST Membrane Reduces Plasma IL-8 in Sepsis Patients

Session Information

  • AKI: Clinical Outcomes, Trials
    November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Takahashi, Shunsuke, National Hospital Organization Kure Medical Center , Kure-shi, Japan
  • Nakashima, Ayumu, Hiroshima University, Hiroshima, Hiroshima, Japan
  • Handa, Yuki, National Hospital Organization Kure Medical Center , Kure-shi, Japan
  • Kyoda, Naoko, National Hospital Organization Kure Medical Center , Kure-shi, Japan
  • Arima, Takahiro, National Hospital Organization Kure Medical Center , Kure-shi, Japan
  • Masaki, Takao, Hiroshima University, Hiroshima, Hiroshima, Japan
Background

Polyethylenimine-coated polyacrylonitrile (AN69ST) membrane has a hydrogel structure, which enables adsorption and thereby exhibits an increased capacity for cytokine removal in continuous renal replacement therapy (CRRT). This capability is expected to improve the outcomes of severe sepsis and septic shock. IL-8 is a chemokine with a molecular weight of 8000 MW and is known as a neutrophil chemotactic factor in sepsis.

Methods

APACHE II scores after ICU admission were evaluated for 23 sepsis patients. Patients with sepsis underwent CRRT using the AN69ST membrane. Plasma IL-8 was measured at the start of CRRT and 24 hours after the start of CRRT. At the start of CRRT, plasma IL-8 was measured pre AN69ST membrane and post. Patients were divided into two groups: survival group and death group.

Results

There were 12 cases in the survival group and 11 cases in the death group. The APACHE II score was 25.0 (20.5-30.0). Plasma IL-8 at the start of CRRT was 87.3 (28.1-182.8) pg/mL and was significantly reduced to 35.9 (19.6-62.0) pg/mL 24 hours after initiation of CRRT (P < 0.01). At the start of CRRT, plasma IL-8 was significantly reduced to 31.2 (13.1-65.9) pg/mL downstream of the AN69ST membrane (P < 0.01). Logistic analysis for death was associated with age (1.15, 95%CI: 1.02-1.49, P = 0.02), and plasma IL-8 reduction rates at 24 hours after CRRT initiation (0.89, 95%CI: 0.74-0.96, P < 0.01).

Conclusion

CRRT with the AN69ST membrane reduces plasma IL-8 in sepsis patients. Our results suggest that plasma IL-8 reduction rate 24 hours after initiation of CRRT is an independent contributing factor to death.