RESUMO
Acute renal failure is defined as rapid deterioration [hours to weeks] of kidney function. Introduction of continuous renal replacement therapy, with its advantages as regards hemodynamic stability, is expected to improve the outcome in patients with multi-organ failure MOF. It's also claimed to help in removal of IL-8, a pro-inflammatory chemokine that shares in leukocyte trafficking towards the kidney, where its removal could help in attenuating acute renal injury. The aim of our study was to test the effect of dialytic treatment opposed to non-dialytic treatment on the outcome of ARF. We also tested the difference between dialytic modalities on patients' outcome and on the ability to remove IL-8 from circulation. This study included 30 patients who suffered form acute renal failure [ARF] divided into two groups: Group A [15 patients] who received dialytic treatment and group B [15 patients] who did not receive dialysis. Group A was further subdivided into 3 groups according to the mode of dialysis used: Group A 1 [n=5]: Received continuous renal replacement therapies [CRRT], Group A 2 [n=5]: Received intermittent hemodialysis [IHD] and Group A 3 [n=5]: Received peritoneal dialysis [PD]. Plasma IL-8 level was determined pre and post dialysis. There is no significant difference in IL-8 pre in group A patients versus group B patients [p>0.05]. No significant difference was found between the outcome in group A versus group B [p>0.05]. There was no significant correlation between IL-8 pre and outcome in the whole population [p>0.05]. IL-8 is significantly higher in patients with septicemia [2233.5 +/- 1606.6] than that in patients without septicemia [202.4 +/- 256.7] [p<0.001]. Death was significantly higher in PD group compared with IHD [p<0.05], while there was no significant difference between IHD and CRRT, CRRT and IPD [p>0.05]. Death among patients with isolated ARF was significantly lower [16.6%] than death in patients with ARF as part of MOF [75%] [p<0.001]. Our results have shown that different dialytic modalities could remove the pro-inflammatory chemokine IL-8, from the plasma. Further studies aiming to evaluate the impact of variable dialytic modalities on ARF, need to be conducted using larger number of patients and more homogenous population as regard illness severity