ABSTRACT
Objective To compare and explore the efficacy of regional citrate anticoagulation therapy and regional heparin anticoagulation therapy in continuous renal replacement therapy ( CRRT) of acute kidney injury ( AKI) patients with risk of bleeding by an retrospective study. Methods A total of 96 AKI patients with risk of bleeding were collected retrospectively and treated with CRRT. All the patients were divided into two groups:regional citrate group ( n=50) and regional heparin group ( n=46) . APTT, level of Ca2+, pH value, levels of HCO-3 and Na+, time of blood filter using and incidence of adverse events were compared between the two groups. Results Percentage of hypernatremia, metabolic alkalosis and elevation of transaminase in regional citrate group were 2.3%, 6.1%, 1.9%, respectively, those in the regional heparin group were 1.6%, 0.9%, 1.6%, respectively. The time of blood filter using in regional citrate group and regional heparin group were (70.0±5.3) h and (48.0±2.7) h, respectively (P<0.05). Incidence of bleeding event in regional citrate group and regional heparin group were 3.8% and 13.0%, respectively (P<0.05). Conclusion In patients with coagulation disorders or bleeding risk undergoing CRRT, regional citrate anticoagulation therapy is safer and more effective, and worthy of promotion.
ABSTRACT
Objective To compare and explore the efficacy of regional citrate anticoagulation therapy and regional heparin anticoagulation therapy in continuous renal replacement therapy ( CRRT) of acute kidney injury ( AKI) patients with risk of bleeding by an retrospective study. Methods A total of 96 AKI patients with risk of bleeding were collected retrospectively and treated with CRRT. All the patients were divided into two groups:regional citrate group ( n=50) and regional heparin group ( n=46) . APTT, level of Ca2+, pH value, levels of HCO-3 and Na+, time of blood filter using and incidence of adverse events were compared between the two groups. Results Percentage of hypernatremia, metabolic alkalosis and elevation of transaminase in regional citrate group were 2.3%, 6.1%, 1.9%, respectively, those in the regional heparin group were 1.6%, 0.9%, 1.6%, respectively. The time of blood filter using in regional citrate group and regional heparin group were (70.0±5.3) h and (48.0±2.7) h, respectively (P<0.05). Incidence of bleeding event in regional citrate group and regional heparin group were 3.8% and 13.0%, respectively (P<0.05). Conclusion In patients with coagulation disorders or bleeding risk undergoing CRRT, regional citrate anticoagulation therapy is safer and more effective, and worthy of promotion.
ABSTRACT
Objective To investigate the effects of ulinastatin on renal expression of endothelin￣1 and nitric oxide (NO) in rats with toxic acute kidney injury(AKI). Methods Twenty￣four male SD rats were randomly divided into the normal control group,model control group and treatment groups, with 8 rats in each group. Except normal control group, rats were subcutaneously injected with gentamicin (300 mg.kg-1 .d-1 ) for 3 days to establish a model of toxic AKI.Rats in the treatment group were intraperitoneally injected with a 7￣day course of ulinastatin (30 000 U.kg-1 .d-1 ) from the fourth day.While the other two groups were injected with 0.9% sodium chloride injection (3 mL.kg-1 .d-1 ). The serum level of creatinine and cystatin￣C,urinary concentration of kidney injury molecule￣1(Kim￣1) and neutrophil gelatinase￣associated lipocalin (NGAL), level of endothelin￣1 and NO,expression of endothelin￣1 mRNA,endothelial nitric oxide synthase (eNOS),induced nitric oxide synthase (iNOS),eNOS mRNA and iNOS mRNA in homogenate of renal tissues in each group were detected on the eleventh day. Results Compared with the normal control group,serum level of creatinine and Cystatin￣C,urinary concentration of Kim￣1 and NGAL,level of endothelin￣1 and NO,expression of endothelin￣1 mRNA,iNOS and iNOS mRNA in homogenate of renal tissues were higher in model control group (P<0.01, respectively), while which were lower in treatment group than those in model control group ( P < 0. 01, respectively). And no statistical significant difference of eNOS and eNOS mRNA expression in homogenate of renal tissues existed among the three groups. Conclusion Ulinastatin possesses curative role against rat with toxic AKI via down￣regulating renal expression of endothelin￣1,NO and iNOS.