Effects of sustained low-efficiency dialysis combined with hemoperfusion on routine blood indicators and inflammatory factors in patients with sepsis-induced acute kidney injury / 中国基层医药

ABSTRACT

Objective:To investigate the effects of sustained low-efficiency hemodialysis combined with hemoperfusion on routine blood indicators and inflammatory factors in patients with sepsis-induced acute kidney injury.Methods:Eighty-six patients with sepsis-induced acute kidney injury who received treatment in Yantai Laiyang Central Hospital from April 2018 to April 2021 were included in this study. They were randomly divided into an observation group and a control group, with 43 cases in each group. All patients received conventional supportive treatment. The control group received continuous renal replacement therapy and the observation group received sustained low-efficiency dialysis combined with hemoperfusion. Before and after treatment, routine blood indicators [hemoglobin (Hb), white blood cell (WBC) count, platelet (PLT) count, albumin (Alb)], inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), procalcitonin PCT)], renal function indicators [serum creatinine (Scr), blood urea nitrogen (BUN)], The Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of hospital stay, and 28-day mortality rate were compared between the two groups.Results:Before treatment, there were no significant differences in Hb, WBC count, PLT count, Alb, IL-6, CRP, TNF-α, PCT, Scr, BUN, and APACHE II score between the two groups ( t = 0.04, 0.95, 0.23, 0.67, 1.54, 0.75, 0.98, 0.23, 1.04, 0.44, 0.07, all P > 0.05). After treatment, serum levels of Hb and Alb in each group were significantly increased compared with those before treatment. After treatment, serum levels of Hb and Alb in the observation group were (105.29 ± 15.80) g/L, (39.25 ± 7.87) g/L, respectively, which were significantly higher than (98.55 ± 12.93) g/L and (33.38 ± 7.29) g/L in the control group ( t = 2.16, 3.58, both P < 0.05). After treatment, WBC count, PLT count, IL-6, CRP, TNF-α, PCT, Scr, and BUN levels, and APACHE II score in each group were significantly decreased compared with those before treatment. After treatment, WBC count, PLT count, IL-6, CRP, TNF-α, PCT, Scr, and BUN levels, and APACHE II score in the observation group were (10.28 ± 1.87) × 10 9/L, (129.32 ± 14.79) × 10 9/L, (59.00 ± 12.77) μg/L, (22.41 ± 5.01) mg/L, (28.41 ± 4.77) μg/L, (18.41 ± 2.78) μg/L, (162.01 ± 21.04) μmol/L, (7.38 ± 1.17) mmol/L, (11.28 ± 3.60) points, respectively, which were significantly lower than (12.32 ± 2.27) × 10 9/L, (137.39 ± 18.30) × 10 9/L, (79.35 ± 14.36) μg/L, (29.31 ± 6.37) mg/L, (34.33 ± 5.38) μg/L, (22.32 ± 3.35) μg/L, (184.06 ± 24.03) μmol/L, (9.87 ± 1.66) mmol/L, (14.65 ± 3.38) points in the control group ( t = 4.54, 2.24, 6.94, 5.58, 5.39, 5.89, 4.52, 8.03, 4.47, all P < 0.05). The length of intensive care unit stay in the observation group was significantly shorter than that in the control group [(11.63 ± 2.18) days vs. (14.07 ± 2.71) days, t = 4.60, P < 0.05]. There was no significant difference in 28-day mortality rate between the two groups ( χ2 = 1.36, P > 0.05). Conclusion:Sustained low-efficiency dialysis combined with hemoperfusion is effective on sepsis-induced acute kidney injury. The combined therapy can improve routine blood indicators, inhibit inflammatory reactions, promote renal function recovery, and decrease the mortality rate to a certain degree.