Effect of alprostadil on renal hemodynamic parameters in patients with severe lupus nephritis complicated with acute kidney injury
10.3760/cma.j.cn115455-20240507-00382
- VernacularTitle:前列地尔对重症狼疮肾炎合并急性肾损伤患者肾血流动力学参数的影响
- Author:
Mingming WEI
1
;
Jian LI
;
Xue MENG
Author Information
1. 济宁医学院附属医院肾内科，济宁 272000
- Publication Type:Journal Article
- Keywords:
Lupus nephritis;
Acute kidney injury;
Alprostadil;
Renal replacement therapy;
Hemodynamics
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(3):232-237
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effect of alprostadil on renal hemodynamic parameters in patients with severe lupus nephritis (LN) complicated with acute kidney injury (AKI).Methods:The clinical data of 130 patients with severe LN complicated with AKI from August 2020 to August 2023 in Affiliated Hospital of Jining Medical University were retrospectively analyzed. Among them, 66 patients were treated with continuous renal replacement therapy (CRRT) (CRRT group), and 64 patients were treated with CRRT combined with alprostadil (combination group). All patients of both groups were treated 10 d. The efficacy, renal function (serum creatinine, blood urea nitrogen and 24 h urinary protein quantitation), renal hemodynamic parameters and serum inflammatory factors were compared between two groups. The renal hemodynamic parameters included peak systolic velocity (PSV), resistance index (RI) and end diastolic velocity (EDV)), serum inflammatory factors (procalcitonin (PCT); and the inflammatory factor included procalcitonin (PCT), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).Results:The total effective rate in combination group was significantly higher than that in CRRT group: 96.88% (62/64) vs. 81.82% (54/66), and there was statistical difference ( χ2 = 7.67, P<0.01). There were no statistical difference in the indexes before treatment between two groups ( P>0.05). The serum creatinine, blood urea nitrogen, 24 h urinary protein quantitation, RI, PCT, TNF-α and IL-6 after treatment in combination group were significantly lower than those in CRRT group: (82.16 ± 16.66) μmol/L vs. (128.55 ± 21.06) μmol/L, (6.15 ± 1.66) nmol/L vs. (10.28 ± 2.45) nmol/L, (1.21 ± 0.42) g vs. (2.06 ± 0.52) g, (0.51 ± 0.12) cm/s vs. (0.61 ± 0.24) cm/s, (0.65 ± 0.12) μg/L vs. (0.89 ± 0.18) μg/L, (3.26 ± 0.34) μg/L vs. (6.82 ± 1.14) μg/L and (26.62 ± 3.62) μg/L vs. (40.55 ± 8.14) μg/L, the PSV and EDV were significantly higher than those in CRRT group: (25.66 ± 3.62) cm/s vs. (22.05 ± 1.84) cm/s and (10.92 ± 1.85) cm/s vs. (8.34 ± 1.26) cm/s, and there were statistical differences ( P<0.01). Conclusions:Alprostadil combined with CRRT can effectively improve renal function and renal hemodynamic in patients with severe LN complicated with AKI, enhance therapeutic efficacy, and inhibit the release of proinflammatory cytokines such as PCT.
