NDLI: Kinetics of plasmatic cytokines and cystatin C during and after hemodialysis in septic shock-related acute renal failure

Content Provider	Springer Nature : BioMed Central
Author	Mayeur, Nicolas Rostaing, Lionel Nogier, Marie B Jaafar, Acil Cointault, Olivier Kamar, Nassim Conil, Jean M Fourcade, Olivier Lavayssiere, Laurence
Abstract	Introduction Cystatin C could be a relevant residual glomerular filtration rate marker during hemodialysis (HD), and a high cytokine plasma (p) rate is associated with an increase in mortality during sepsis. To the best of our knowledge, cytokines and cystatin C kinetics during and after HD during sepsis have never been studied. In this study, we described p cytokines and cystatin C variations during and after hemodialysis in septic-shock patients with acute kidney injury (AKI). Methods Ten patients, from two tertiary ICUs, with septic shock-related AKI, according to RIFLE class F, were studied. In this prospective observational study, blood samples were collected at the start, after 1 hour, 2 hours, and at the end of HD with a polymethymethacrylate (PMMA) hemodialyzer (D0, D1, D2, and endD), and 30, 60, 90, 120, and 180 min after HD (postD0.5, postD1, postD1.5, postD2, and postD3). We measured p interleukins (IL)-6, IL-8, IL-10, cystatin C, and albumin. Results are expressed as variations from D0 (mean ± SD). Results During HD, p[IL-6] did not vary significantly, whereas p[IL-8] and p[IL-10] reductions by D1 were 31.8 ± 21.2% and 36.3 ± 26%, respectively (P < 0.05 as compared with D0). At postD3, p[IL-8] and p[IL-10] returned to their initial values. p[Cystatin C] was significantly reduced from D1 to postD1, with a maximal reduction of 30 ± 6.7% on D2 (P < 0.05). Norepinephrine infusion rate decreased from D0 to postD3 (0.65 ± 0.39 to 0.49 ± 0.37 μg/kg/min; P < 0.05). Conclusions HD allows a transient and selective decrease in p cytokines, which are known as being correlated with mortality during septic shock. Because of a significant decrease in p cystatin C during HD, this should not be considered as an accurate marker for residual glomerular filtration rate during septic acute renal failure when receiving HD with a PMMA hemodialyzer.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc9064.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc9064
Journal	Critical Care
Issue Number	3
Volume Number	14
Language	English
Publisher	BioMed Central
Publisher Date	2010-06-14
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Septic Shock PMMA Mean Arterial Pressure Acute Kidney Injury Systemic Inflammatory Response Syndrome
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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