[Evaluation of continuous venous-venous hemofiltration combined with coupled plasma filtration adsorption for treatment of systemic inflammation response syndrome with acute renal failure].
OBJECTIVE
To evaluate the clinical efficacy of continuous venous-venous hemofiltration (CVVH) combined with coupled plasma filtration adsorption (CPFA) in the management of systemic inflammation response syndrome (SIRS) complicated by acute renal failure (ARF).


METHODS
Thirty patients with SIRS complicated by ARF (including 25 with severe acute pancreatitis, 2 with colonic perforation with infection, and 3 with acute infective endocarditis) were randomly divided into CVVH plus CPFA group (n=14) and CVVH alone group (n=16). The APACHE II score, mean arterial pressure, PaO2/FiO2, TNF-alpha and IL-10 were detected prior to or after the intervention. The feasibility and tolerance of CVVH plus CPFA and the therapy-related adverse reactions were evaluated.


RESULTS
The two groups showed no significant differences in the baseline clinical characteristics (P>0.05). The mean arterial pressure and PaO2/FiO2 increased significantly after treatment as compared with the control (P<0.05), with TNF-alpha being reduced and IL-10 elevated. In CVVH plus CPFA group, APACHEII score improved significantly after 10 days (P<0.05). No therapy-related adverse reactions were noted, suggesting good tolerance of CVVH plus CPFA.


CONCLUSIONS
CVVH combined with CPFA is an effective and safe method for improving the clinical outcome of patients with SIRS and ARF.
Zhang
Bin
B
Department of Nephrology, Guangdong General Hospital, Southern Medical University, Guangzhou 510080, China. zhangbinyes@yahoo.com.cn
Shi
Wei
W
He
Chao-sheng
CS
Liang
Xing-ling
XL
Liu
Shuang-xin
SX
Liang
Yong-zheng
YZ
D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy*; D000328:Adult; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome