Hemoperfusion in critically ill patients with acute kidney injury. Report of three cases
Keywords:
hemoperfusion, acute kidney injury, critical care unit, mortality, sepsis, hemodialysis, renal dialysis
Abstract
Hemoperfusion is a technique for extracorporeal clearance of medium and large molecular weight molecules, lipophilic and highly bound to plasma proteins based on the physical principle of adsorption. It can be used in isolation or in combination with other techniques such as conventional hemodialysis, hybrid hemodialysis or continuous renal replacement therapy. Three patients (two with severe pancreatitis and one with leptospirosis-associated sepsis) in which hemoperfusion combined with conventional hemodialysis in the Intensive Care Unit are reported. All three cases developed in addition to acute kidney injury. Significant clearance of uremic toxins and proinflammatory cytokines is evident, in addition to other molecules such as digestive enzymes and creatine phosphokinase. The future of this innovative adsor
References
1) Gurland HJ, Davison AM, Bonomini V, Falkenhagen D, Hansens S, Kishimoto T, et al. Definitions and terminology in biocompatibility. Nephrol Dial Transplant. 1994;9(Suppl. 2):4-10.
2) Muirhead EE, Reid AF. A resin artificial kidney. J Lab Clin Med. 1948;33(7):841-4.
3) Daurgidas JT, Blaker PG, Ing TS. Manual de diálisis. 5a ed. Barcelona: Wolters Kluwer, 2015.
4) Ankawi G, Fan W, Pomarè Montin D, Lorenzin A, Neri M, Caprara C, et al. A new series of sorbent devices for multiple clinical purposes: current evidence and future directions. Blood Purif. 2019;47(1-3):94-100. doi: 10.1159/000493523.
5) Li Z, Wang G, Zhen G, Zhang Y, Liu J, Liu S. Effects of hemodialysis combined with hemoperfusion on severe acute pancreatitis. Turk J Gastroenterol. 2018;29(2):198-202. doi: 10.5152/tjg.2018.17415.
6) Pomarè Montin D, Ankawi G, Lorenzin A, Neri M, Caprara C, Ronco C. Biocompatibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion. Blood Purif. 2018;46(3):187-95. doi: 10.1159/000489921.
7) Honoré PM, De Bels D, Barreto Gutierrez L, Spapen HD. Hemoadsorption therapy in the critically ill: solid base but clinical haze. Ann Intensive Care. 2019;9(1):22. doi: 10.1186/s13613-019-0491-1.
8) Liu LY, Zhu YJ, Li XL, Liang YF, Liang ZP, Xia YH. Blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration for patients with multiple organ dysfunction syndrome. World J Emerg Med. 2012;3(1):44-8. doi: 10.5847/wjem.j.issn.1920-8642.2012.01.008.
9) Hato T, Dagher PC. How the innate immune system senses trouble and causes trouble. Clin J Am Soc Nephrol. 2015;10(8):1459-69. doi: 10.2215/CJN.04680514.
10) Weisheit CK, Engel DR, Kurts C. Dendritic cells and macrophages: sentinels in the kidney. Clin J Am Soc Nephrol. 2015;10(10):1841-51. doi: 10.2215/CJN.07100714.
11) Tsujimoto H, Ono S, Hiraki S, Majima T, Kawarabayashi N, Sugasawa H, et al. Hemoperfusion with polymyxin B-immobilized fibers reduced the number of CD16+ CD14+ monocytes in patients with septic shock. J Endotoxin Res. 2004;10(4):229-37. doi: 10.1179/096805104225005814.
12) Wang YT, Fu JJ, Li XL, Li YR, Li CF, Zhou CY. Effects of hemodialysis and hemoperfusion on inflammatory factors and nuclear transcription factors in peripheral blood cell of multiple organ dysfunction syndrome. Eur Rev Med Pharmacol Sci. 2016;20(4):745-50.
13) Sato N, Kojima K, Horio Y, Goto E, Masunaga A, Ichiyasu H, et al. Successful treatment of severe amiodarone pulmonary toxicity with polymyxin B-immobilized fiber column direct hemoperfusion. Chest. 2013;143(4):1146-50. doi: 10.1378/chest.12-0994.
14) Li WH, Yin YM, Chen H, Wang XD, Yun H, Li H, et al. Curative effect of neutral macroporous resin hemoperfusion on treating hemodialysis patients with refractory uremic pruritus. Medicine (Baltimore). 2017;96(12):e6160. doi: 10.1097/MD.0000000000006160.
15) Schädler D, Pausch C, Heise D, Meier-Hellmann A, Brederlau J, Weiler N, et al. The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. PLoS One. 2017;12(10):e0187015. doi: 10.1371/journal.pone.0187015.
16) Huang Z, Wang SR, Su W, Liu JY. Removal of humoral mediators and the effect on the survival of septic patients by hemoperfusion with neutral microporous resin column. Ther Apher Dial. 2010;14(6):596-602. doi: 10.1111/j.1744-9987.2010.00825.x.
17) Hong B, Ling Z, Songmin H, Tao Z, Ruichao Y. Continuous venovenous hemofiltration and hemoperfusion in successful treatment of a patient with crush syndrome and acute pancreatitis. Ren Fail. 2012;34(3):383-6. doi: 10.3109/0886022X.2011.647370.
18) Hu XB, Gao HB, Liao ME, He MR. The use of HA330-II microporous resin plasma adsorption in the treatment of chronic severe hepatitis. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007;19(12):760-1.
2) Muirhead EE, Reid AF. A resin artificial kidney. J Lab Clin Med. 1948;33(7):841-4.
3) Daurgidas JT, Blaker PG, Ing TS. Manual de diálisis. 5a ed. Barcelona: Wolters Kluwer, 2015.
4) Ankawi G, Fan W, Pomarè Montin D, Lorenzin A, Neri M, Caprara C, et al. A new series of sorbent devices for multiple clinical purposes: current evidence and future directions. Blood Purif. 2019;47(1-3):94-100. doi: 10.1159/000493523.
5) Li Z, Wang G, Zhen G, Zhang Y, Liu J, Liu S. Effects of hemodialysis combined with hemoperfusion on severe acute pancreatitis. Turk J Gastroenterol. 2018;29(2):198-202. doi: 10.5152/tjg.2018.17415.
6) Pomarè Montin D, Ankawi G, Lorenzin A, Neri M, Caprara C, Ronco C. Biocompatibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion. Blood Purif. 2018;46(3):187-95. doi: 10.1159/000489921.
7) Honoré PM, De Bels D, Barreto Gutierrez L, Spapen HD. Hemoadsorption therapy in the critically ill: solid base but clinical haze. Ann Intensive Care. 2019;9(1):22. doi: 10.1186/s13613-019-0491-1.
8) Liu LY, Zhu YJ, Li XL, Liang YF, Liang ZP, Xia YH. Blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration for patients with multiple organ dysfunction syndrome. World J Emerg Med. 2012;3(1):44-8. doi: 10.5847/wjem.j.issn.1920-8642.2012.01.008.
9) Hato T, Dagher PC. How the innate immune system senses trouble and causes trouble. Clin J Am Soc Nephrol. 2015;10(8):1459-69. doi: 10.2215/CJN.04680514.
10) Weisheit CK, Engel DR, Kurts C. Dendritic cells and macrophages: sentinels in the kidney. Clin J Am Soc Nephrol. 2015;10(10):1841-51. doi: 10.2215/CJN.07100714.
11) Tsujimoto H, Ono S, Hiraki S, Majima T, Kawarabayashi N, Sugasawa H, et al. Hemoperfusion with polymyxin B-immobilized fibers reduced the number of CD16+ CD14+ monocytes in patients with septic shock. J Endotoxin Res. 2004;10(4):229-37. doi: 10.1179/096805104225005814.
12) Wang YT, Fu JJ, Li XL, Li YR, Li CF, Zhou CY. Effects of hemodialysis and hemoperfusion on inflammatory factors and nuclear transcription factors in peripheral blood cell of multiple organ dysfunction syndrome. Eur Rev Med Pharmacol Sci. 2016;20(4):745-50.
13) Sato N, Kojima K, Horio Y, Goto E, Masunaga A, Ichiyasu H, et al. Successful treatment of severe amiodarone pulmonary toxicity with polymyxin B-immobilized fiber column direct hemoperfusion. Chest. 2013;143(4):1146-50. doi: 10.1378/chest.12-0994.
14) Li WH, Yin YM, Chen H, Wang XD, Yun H, Li H, et al. Curative effect of neutral macroporous resin hemoperfusion on treating hemodialysis patients with refractory uremic pruritus. Medicine (Baltimore). 2017;96(12):e6160. doi: 10.1097/MD.0000000000006160.
15) Schädler D, Pausch C, Heise D, Meier-Hellmann A, Brederlau J, Weiler N, et al. The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. PLoS One. 2017;12(10):e0187015. doi: 10.1371/journal.pone.0187015.
16) Huang Z, Wang SR, Su W, Liu JY. Removal of humoral mediators and the effect on the survival of septic patients by hemoperfusion with neutral microporous resin column. Ther Apher Dial. 2010;14(6):596-602. doi: 10.1111/j.1744-9987.2010.00825.x.
17) Hong B, Ling Z, Songmin H, Tao Z, Ruichao Y. Continuous venovenous hemofiltration and hemoperfusion in successful treatment of a patient with crush syndrome and acute pancreatitis. Ren Fail. 2012;34(3):383-6. doi: 10.3109/0886022X.2011.647370.
18) Hu XB, Gao HB, Liao ME, He MR. The use of HA330-II microporous resin plasma adsorption in the treatment of chronic severe hepatitis. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007;19(12):760-1.
Published
2021-03-25
How to Cite
1.
Cruz Llanos LE, Valenzuela Córdova CR, León Rabanal CP, Cieza Zevallos JA. Hemoperfusion in critically ill patients with acute kidney injury. Report of three cases. Rev Nefrol Dial Traspl. [Internet]. 2021Mar.25 [cited 2024May15];41(1):48-4. Available from: http://www.revistarenal.org.ar/index.php/rndt/article/view/617
Section
Case Report
Copyright (c) 2021 Revista de Nefrología, Diálisis y Trasplante
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
