Kidney Week

Abstract: PO1131

Use of Cytokine Adsorbing Membranes in Patients with Acute Renal Failure in Intensive Care Units

Session Information

• Hemodialysis and Frequent Dialysis - 2
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Jakopin, Eva, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Eva Jakopin,

• Hren, Martin, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Martin Hren,

• Stropnik Galuf, Tina, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Tina Stropnik Galuf,

• Knehtl, Masa, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Masa Knehtl,

• Zorman, Tadej, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Tadej Zorman,

• Vodošek Hojs, Nina, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Nina Vodošek Hojs,

• Ekart, Robert, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Robert Ekart,

• Hojs, Radovan, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Radovan Hojs,

• Bevc, Sebastjan, Univerzitetni Klinicni Center Maribor, Maribor, Maribor, Slovenia

Sebastjan Bevc,

Background

Use of cytokine adsorbents has been proposed as a novel therapeutic approach in sepsis management. Our aim was to evaluate laboratory markers, clinical parameters and SOFA (Sequential Organ Failure Assessment) score in patients who were treated with cytokine adsorbing membrane (CytoSorb®, CytoSorbents Corp. New Jersey, USA) and continuous veno-venous haemodialysis.

Methods

We included adult patients with septic shock and acute renal failure. We retrospectively collected laboratory results (leukocytes, thrombocytes, C-reactive protein, procalcitonin, lactate, urea, creatinine, bilirubin, PaO₂), clinical parameters (mean arterial pressure (MAP), FiO2, residual diuresis), SOFA score and vasopressor use at the beginning and at the end of the procedure.

Results

We included 69 patients, 51 men, aged 56.6 ± 15 years. 51 patients had 1 procedure, 14 patients had 2 procedures, 3 patients had 3 procedures and 1 patient had 4 procedures. Median time from admission to initiation of procedure was 47 hours, median treatment time was 23.6 hours.
We discovered significant improvement in procalcitonin (35.36 ± 37.33 ng/mL vs. 24.25 ± 31.18 ng/mL; p<0.001), creatinine (345.06 ± 174.65 μmol/L vs. 233.11 ± 108.82 μmol/L; p<0.0001), SOFA score (14.20 ± 2.64 vs. 12.69 ± 3.52; p<0.001) and FiO₂ (48.17 ± 21.17 % vs. 44.63 ± 21.45 %; p=0.020).
Patients with more than 1 procedure showed statistically significant reduction in lactate level (5.40 ± 4.74 mmol/L vs. 2.46 ± 1.74 mmol/L; p=0.010) and vasopressin dose (1.26 ± 1.61 vs. 0.88 ± 3.2 IU/h; p=0.022).

Conclusion

We observed potential beneficial effect of adsorptive membrane use in septic patients. According to our results two or more procedures were associated with improved laboratory markers and lower vasopressor requirement.