The effect of continuous veno venous hemofiltration on neutrophil gelatinase-associated lipocalin plasma levels in critically ill patients with acute kidney injury
10.3760/cma.j.issn.0578-1426.2018.04.011
- VernacularTitle:连续静脉-静脉血液滤过对急性肾损伤重症患者血浆中性粒细胞明胶酶相关载脂蛋白水平的影响
- Author:
Hao WANG
1
;
Na CUI
;
Yuankai ZHOU
;
Wei CHENG
;
Ling LI
;
Yun LONG
;
Dawei LIU
Author Information
1. 100730,中国医学科学院北京协和医学院北京协和医院重症医学科
- Keywords:
Neutrophil gelatinase associated lipocalin;
Continuous veno venous hemofiltration;
Acute kidney injury
- From:
Chinese Journal of Internal Medicine
2018;57(4):285-289
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of continuous veno venous hemofiltration (CVVH) on neutrophil gelatinase associated lipocalin (NGAL) in critically ill patients with acute kidney injury (AKI).Methods Critically ill patients with AKI who needed CVVH and admitted to Department of Critical Care Medicine of Peking Union Medical College Hospital were enrolled prospectively from January 2015 to June 2015.AN69 membrane filters were used for CVVH.Prefilter,postfilter,and plasma NGAL measurements were taken at 10 mins,4 hours and 8 hours (T 10 min,T 4 h,T 8 h) after CVVH.The influence of membrane filter and volume management on NGAL level was analyzed.Results Forty patients were recruited.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 22.9±7.0.The sequential organ failure score (SOFA) was 12.1±2.9,and ICU mortality was 27.5％.During CVVH,there were no significant differences in NGAL levels between prefilter [T 10 min:39.3 (24.8,62.4)μg/min;T 4 h:(45.1±23.2)μg/min;and T 8 h:(45.5±22.4)μg/min] and postfilter [T 10 min:33.5 (25.1,60.7)μg/min;T 4 h:(44.2±24.3)μg/min,and T 8 h:(45.9±22.4)μg/min] (P＞ 0.05 for all).Compared with the survival group[310.0(162.0,588.0) μg/L],plasma NGAL level in T 10 min [684.0(270.0,944.0) μg/L] was significantly higher in death group (P=0.033).After fluid balance correction,T 4 h [603.4(484.8,620.2) μg/L] and T 8 h [590.2(475.9,749.4) μg/L] plasma NGAL levels in death group were significantly higher than those in the survival group [T4 h:419.5 (227.5,552.4)μg/L;T 8 h:400.7(196.1,517.4) μg/L] with statistical significance (P＜0.01 for both).Conclusions During CVVH,AN69 membrane filter does not have significant effect on plasma NGAL level in critically ill patients with AKI.After volume balance correction,plasma NGAL level could be used as an effective indicator in these patients.
