Effect of hemodialysis with plasma-based dialysate plus high volume hemofiltration on plasma cytokines in patients with liver failure
- VernacularTitle:以血浆作透析液行血液透析联合高容量血液滤过治疗对肝衰竭患者血浆细胞因子的影响
- Author:
Wei CHEN
;
Hong-Bao LIU
;
Zhen-Jiang LI
;
Ke-Feng DOU
;
Zhen-Shun SONG
;
Yue-Qing XU
;
Han-Min WANG
;
- Publication Type:Journal Article
- Keywords:
Hyperbilirubinemia;
Liver failure;
Renal dialysis;
High volume hemofiltration
- From:
Chinese Journal of Nephrology
2005;0(12):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To propose a new blood purification modality-hemodialysis with plasma- based dialysate (HD-PBD) plus high volume hemofiltration (HVHF) for patients with liver failure, and to evaluate the effect of this treatment on plasma cytokines.Methods Twelve patients with liver failure were included in this study.All patients received HD-PBD therapy in the first 6 hours,and then were treated with HVHF for 24 hours with the same filter (AV600).The levels of TNF-?,IL-1?, IL-6 and IL-8 in plasma before and after HD-PBD plus HVHF for 6 and 24 hours were examined respectively by ELISA,and changes of clinical parameters were observed at the same time point. Serum bilirubin,total bile acids (TBA),serum ammonia,blood urea nitrogen (BUN) and serum creatinine (Scr) were detected before and after treatment.Arterial blood gas analysis and the concentration of electrolytes were monitored before and after treatment.Results (1)HD-PBD for 6 hours was more effective than HVHF for 24 hours in removal of serum bilirubin and TBA(P＜0.05). (2)Serum ammonia,BUN,Ser,arterial blood HCO_3~-,PCO_2,PO_2 and electrolytes did not show significant difference before and after HD-PBD (P＞0.05),but these parameters significantly changed before and after HVHF (P＜0.05).(3)The average level of serum bilirubin was sharply decreased after HVHF for 24 h following HD-PBD(P＜0.05).(4)After HD-PBD plus HVHF,there was a marked reduction of the plasma levels of TNF-?,IL-6 and IL-8.Conclusions HD-PBD plus HVHF,a newly proposed modality for patients with liver failure,can effectively decrease serum bilirubin,TBA,BUN,Scr,ammonia and cytokines,and adjust water-electrolyte as well as acid- alkali balance.It is a low-cost,safe,simple and convenient therapy.
