RGD Reference Report - Pilot study on the effects of high cutoff hemofiltration on the need for norepinephrine in septic patients with acute renal failure. - Rat Genome Database

RGD Reference Report - Pilot study on the effects of high cutoff hemofiltration on the need for norepinephrine in septic patients with acute renal failure. - Rat Genome Database

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Pilot study on the effects of high cutoff hemofiltration on the need for norepinephrine in septic patients with acute renal failure.
Authors:	Morgera, S Haase, M Kuss, T Vargas-Hein, O Zuckermann-Becker, H Melzer, C Krieg, H Wegner, B Bellomo, R Neumayer, HH
Citation:	Morgera S, etal., Crit Care Med. 2006 Aug;34(8):2099-104.
RGD ID:	6907360
Pubmed:	PMID:16763508 (View Abstract at PubMed)
DOI:	DOI:10.1097/01.CCM.0000229147.50592.F9 (Journal Full-text)
OBJECTIVE: High cutoff hemofilters are characterized by an increased effective pore size designed to facilitate the elimination of inflammatory mediators in sepsis. Clinical data on this new renal replacement modality are lacking. DESIGN: Prospective, randomized clinical trial. SETTING: University hospital, intensive care units. PATIENTS: : Thirty patients with sepsis-induced acute renal failure. INTERVENTION: Patients were allocated to high cutoff (n = 20) or conventional (n = 10) hemofiltration in a 2:1 ratio. Median renal replacement dose was 31 mL/kg/hr. For high cutoff hemofiltration, a high-flux hemofilter with an in vivo cutoff point of approximately 60 kilodaltons was used. Conventional hemofiltration was performed with a standard high-flux hemofilter (PF11S). The impacts of high cutoff hemofiltration on the need for norepinephrine and on plasma levels and clearance rates for interleukin (IL)-6 and IL-1 receptor antagonist (IL-1ra) were analyzed. Absolute values, but also adjusted values (expressed as proportion of baseline), were analyzed. The observation period was restricted to 48 hrs. MAIN RESULTS: Apart from higher antithrombin III levels at entry into the study, main clinical and laboratory parameters were comparable between both groups. The median norepinephrine dose at entry into the study was 0.30 microg/kg/min in the high cutoff group and 0.21 microg/kg/min in the conventional hemofiltration group (p = .448). Only the high cutoff group showed a significant decline (p = .0002) in "adjusted" norepinephrine dose over time. Clearance rates for IL-6 and IL-1ra were significantly higher in the high cutoff hemofiltration group (p < .0001), which translated into a significant decline of the corresponding plasma levels (p = .0465 for IL-6; p = .0293 for IL-1ra). CONCLUSION: In this pilot study, high cutoff hemofiltration has been shown to exert a beneficial effect on the need for norepinephrine in septic patients with acute renal failure. In addition, we demonstrate that high cutoff hemofiltration is superior to conventional hemofiltration in the elimination of IL-6 and IL-1ra from the circulating blood of septic patients.

Only show annotations with direct experimental evidence (0 objects hidden)

Object Symbol	Species	Term	Qualifier	Evidence	With	Notes	Source	Original Reference(s)
IL1RN	Human	acute kidney failure		IDA		associated with Sepsis	RGD
Il1rn	Rat	acute kidney failure		ISO	IL1RN (Homo sapiens)	associated with Sepsis	RGD
Il1rn	Mouse	acute kidney failure		ISO	IL1RN (Homo sapiens)	associated with Sepsis	RGD

Genes (Rattus norvegicus)


Il1rn (interleukin 1 receptor antagonist)

Genes (Mus musculus)


Il1rn (interleukin 1 receptor antagonist)

Genes (Homo sapiens)


IL1RN (interleukin 1 receptor antagonist)