[Effects of high-volume hemofiltration on serum levels of tumor necrosis factor and its receptors in patients with multiple organ dysfunction syndromes].
OBJECTIVE
To investigate whether serum tumor necrosis factor-alpha (TNF-alpha) and its receptors can be removed by high-volume hemofiltration (HVHF) or continuous veno-venous hemofiltration (CVVH).


METHODS
The study was performed in 12 multiple organ dysfunstion syndrome (MODS) patients with acute renal failure (ARF). They were randomized to receive either CVVH (n=10) or HVHF (n=8). TNF-alpha and soluble tumor necrosis factor-receptor (sTNF-R1 and sTNF-R2) concentrations were measured in serum by enzyme-linked immunoadsorbent assay (ELISA).


RESULTS
Compared with that before the therapy, the average concentrations of plasma creatinine and urea were decreased significantly 8 hours after HVHF or CVVH in MODS patients with ARF (P<0.001). In patients on HVHF, the serum TNF-alpha concentrations were significantly lower 8 hours after treatment (P<0.01) compared with that before treatment, 1 hour and 4 hours after treatment. There were not significant changes in the serum TNF-alpha concentrations in patients on CVVH and the serum sTNF-R1 and sTNF-R2 concentrations in patients on CVVH or HVHF.


CONCLUSIONS
In MODS patients with ARF undergoing HVHF, the serum TNF-alpha concentrations dropped significantly, but the serum sTNF-R1 and sTNF-R2 concentrations do not change significantly. Our study suggests that HVHF may be the better option for the treatment of MODS patients.
Zhang
Jun
J
Department of Nephrology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Tao
Li-Jian
LJ
Ning
Jian-Ping
JP
Xu
Hui
H
Ai
Yu-Hang
YH
Zhao
Shuang-Ping
SP
D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D000068800:Etanercept; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000628:therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept