Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
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Randomized Controlled Trial Comparative Study
Enhanced vascular endothelial growth factor and inflammatory cytokine removal with online hemodiafiltration over high-flux hemodialysis in sepsis-related acute kidney injury patients.
Hypercytokinemia plays a central role in pathogenesis and is related to the high mortality in sepsis-related acute kidney injury (AKI). Besides the established cytokines, vascular endothelial growth factor (VEGF) is demonstrated as an important factor in enhancing vascular leakage in sepsis. This prospective randomized trial was conducted to compare the efficacy of cytokine removal between online hemodiafiltration (HDF), which combines convective and diffusive solute removal, and high-flux hemodialysis (HD). ⋯ Online HDF revealed better renal recovery and shorter length of hospitalization than high-flux HD. In conclusion, online HDF in sepsis-related AKI could provide significantly better removal of VEGF and other cytokines and these were associated with better renal outcome than high-flux HD. Thus, online HDF would offer a potential role in hypercytokinemic state in sepsis-related AKI.