Cytokine removal under hemodiafiltration with endogenous reinfusion in acute kidney injury secondary to angioimmunoblastic T-cell lymphoma: a case report.
Angioimmunoblastic T-cell lymphoma shows a high release of cytokines. Different blood purification techniques are employed to control hypercytokinemia. Here we investigated the effects of intermittent supra-hemodiafiltration with endogenous reinfusion on cytokine removal in a patient presenting with acute kidney injury. After the first day of chemotherapy for angioimmunoblastic T-cell lymphoma, a 78-year-old male patient developed acute kidney injury and systemic inflammatory response syndrome due to massive release of inflammatory cytokines. Three sessions of supra-hemodiafiltration were performed. Blood samples for evaluation of renal function and inflammatory mediators were collected at the beginning and the end of each dialytic session. A marked improvement of clinical state and renal function was associated to a significant reduction of inflammatory markers. Our results suggest that renal replacement therapy with supra-hemodiafiltration may remove a wide spectrum of inflammatory mediators and uremic toxins involved in acute kidney injury and systemic inflammatory response syndrome.
Department of Internal Medicine, Nephrology and Hypertension, University of Rome Tor Vergata, Rome, Italy. staffolani@aferesi.it
Emiliano
E
Staffolani
Rebeca
R
Nicolais
Simone
S
Manca di Villahermosa
Diego
D
Galli
Massimiliano
M
Postorino
Nicola
N
Di Daniele
D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D000368:Aged; D001774:Blood Chemical Analysis; D016207:Cytokines / Q000097:blood*; D017583:Hemodiafiltration; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications*; D008297:Male
D016207:Cytokines