Efficacy of Online Hemodiafiltrationlysis in Cytokine Removal

Chulalongkorn University

Status: Completed

Conditions: Acute Kidney Injury; Sepsis

Treatments: Procedure: On-line hemodiafiltration; Procedure: High-flux Hemodialysis

Study type: Interventional

Funder types: Other

Identifiers

NCT01791712

KJWW367/53

Details and patient eligibility

About

Following the concept of "peak concentration hypothesis", which suggest the cutting peak of pro- and anti-inflammatory mediators would result in restoring a situation of immunohomeostasis. The investigators conducted the prospective randomized controlled trial aimed to compare the clearance efficacy between on-line hemodiafiltration and high-flux hemodialysis in sepsis-related acute kidney injury patients. The lowering cytokines level during sepsis is postulated to improved outcomes in sepsis.

Full description

1. Blood samples were taken from patients before and at the end of 4-hour in the first dialysis session. The percentage of reductions were calculated from the before and ending samples. The values of postfilter samples were corrected for changes in plasma volume, based on hemoglobin (Hb) of prefilter.
2. VEGF and other cytokines (IL-6, IL-8, IL-10, and TNF-α) were determined in the plasma separated from EDTA blood. After collection, plasma separation was achieved by centrifugation for 10 min at 1,500 g. Immediately after separation, the samples were stored at -70 ºC until further analysis.
3. All determinations were carried out in duplicate. The panels of cytokines (VEGF, IL-6, IL-8, IL-10, and TNF-α) were measured using the Luminex xMap-based multiplex technology. Assays were performed using the MILLIPLEX MAP (multi-analyte panels) 5-plex Cytokine Kit (Millipore, Billerica, MA) on the Luminex® instrument according to the manufacturer's procedure.

Enrollment: 28 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Sepsis
• acute kidney injury (RIFLE classification F)
• Age more than 18

Exclusion criteria

• Hemodynamic instability
• Whom written informed consent could not be obtained

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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28 participants in 2 patient groups

On-line hemodiafiltration

Experimental group

Description:

On-line hemodiafiltration is a type of renal replacement therapy that was assigned as the intervention to compare with the control arm

Treatment:

Procedure: On-line hemodiafiltration

High-flux hemodialysis (control)

Active Comparator group

Description:

The standard high-flux hemodialysis is the routine renal replacement therapy in sepsis-related acute kidney injury patients and is assigned as the intervention for the control group.

Treatment:

Procedure: High-flux Hemodialysis