title: High cut-off hemofiltration versus standard hemofiltration: a pilot assessment of effects on indices of apoptosis.
abstract: OBJECTIVE
  To measure plasma pro-apoptotic and pro-necrotic activity in severe acute kidney injury (AKI) patients within a randomized controlled trial of continuous veno-venous hemofiltration with high cut-off filters (CVVH-HCO) versus standard filters (CVVH-Std).
  
  
  METHODS
  We measured pro-apoptotic and pro-necrotic plasma activity by trypan blue exclusion cell viability assay, detection of DNA fragmentation, and by determination of caspase-3 activity and annexin V-based apoptosis and necrosis detection assay.
  
  
  RESULTS
  Compared to no apoptosis or necrosis after incubation with healthy plasma, 14-18% of cells showed apoptosis and 4-8% showed necrosis after incubation with plasma from AKI patients. When comparing different measures of pro-apoptotic or pro-necrotic activity, CVVH-HCO and CVVH-Std showed no differential effects on such activity, which remained high over the first 3 days of treatment. However, using annexin V-FITC, there was a significant drop in pro-apoptotic activity across the filter for the CVVH-HCO group (p = 0.043) but not for the CVVH-Std group (p = 0.327) and a significant difference between the two groups (CVVH-HCO vs. CVVH-Std p = 0.006).
  
  
  CONCLUSIONS
  Patients with severe AKI have increased pro-apoptotic and pro-necrotic activity. Although on single-pass effect assessment, CVVH-HCO was superior to CVVH-Std in decreasing annexin V-FITC-assessed pro-apoptotic activity, there was no overall attenuation of such activity during the first 3 days of treatment.
authors.affiliation: Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru, Malaysia.
authors.forename: Rafidah
authors.initials: R
authors.lastname: Atan
authors.forename: Grazia M
authors.initials: GM
authors.lastname: Virzi
authors.forename: Leah
authors.initials: L
authors.lastname: Peck
authors.forename: Amutha
authors.initials: A
authors.lastname: Ramadas
authors.forename: Alessandra
authors.initials: A
authors.lastname: Brocca
authors.forename: Glenn
authors.initials: G
authors.lastname: Eastwood
authors.forename: Suneet
authors.initials: S
authors.lastname: Sood
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.forename: Hermann
authors.initials: H
authors.lastname: Goehl
authors.forename: Markus
authors.initials: M
authors.lastname: Storr
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000628:therapy*; D000368:Aged; D017302:Annexins / Q000378:metabolism; D017209:Apoptosis; D053148:Caspase 3 / Q000378:metabolism; D002460:Cell Line; D002470:Cell Survival; D053938:DNA Fragmentation; D005260:Female; D006440:Hemofiltration / Q000379:methods* / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D017302:Annexins; D053148:Caspase 3