OBJECTIVE: To explore the efficacy of different doses of continuous renal replacement therapy (CRRT) in the treatment of severe pneumonia with acute kidney injury. METHODS:Twenty-eight patients with severe pneumonia and acute kidney injury were recruited from our hospital between February 2009 and March 2012. They divided into 3 groups: group A receiving a large dose of continuous veno-venous hemodiafiltration (CVVHDF) (70 ml×kg(-1)×h(-1), n = 9), group B a moderate dose of CVVHDF (45 ml×kg(-1)×h(-1), n = 8) and group C a low dose of CVVHDF (25 ml×kg(-1)×h(-1), n = 11). Before and after treatment, the changes of patient conditions, renal function and blood gas analysis were recorded. Such biomarkers as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), white blood cell (WBC) and neutrophil granulocyte (N) were determined. RESULTS: Compared with group C, the levels of leucocyte ((11.0 ± 3.2)×10(9)/L, (11.1 ± 5.3)×10(9)/L vs (8.5 ± 2.7)×10(9)/L), CRP ((89 ± 10), (90 ± 14) vs (107 ± 13) mg/L), TNF-α ((99 ± 39), (103 ± 28) vs (123 ± 35) pg/L), IL-6 ((54 ± 22), (69 ± 20) vs (81 ± 24) pg/L) and IL-8 ((104 ± 50), (138 ± 63) vs (167 ± 71) pg/L) decreased significantly in groups A and B after treatment (all P < 0.05). There were no differences in the levels of CRP, IL-6, IL-8 or TNF-α levels between groups B and C (all P > 0.05). The recovery of kidney function was much more rapid in group A than in groups B and C. CONCLUSION: The large dose of CRRT may be more effective in the clearance of inflammatory mediators and improved survival of severe pneumonia with acute kidney injury than moderate and low doses.
RCT Entities:
OBJECTIVE: To explore the efficacy of different doses of continuous renal replacement therapy (CRRT) in the treatment of severe pneumonia with acute kidney injury. METHODS: Twenty-eight patients with severe pneumonia and acute kidney injury were recruited from our hospital between February 2009 and March 2012. They divided into 3 groups: group A receiving a large dose of continuous veno-venous hemodiafiltration (CVVHDF) (70 ml×kg(-1)×h(-1), n = 9), group B a moderate dose of CVVHDF (45 ml×kg(-1)×h(-1), n = 8) and group C a low dose of CVVHDF (25 ml×kg(-1)×h(-1), n = 11). Before and after treatment, the changes of patient conditions, renal function and blood gas analysis were recorded. Such biomarkers as C-reactive protein (CRP), tumornecrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), white blood cell (WBC) and neutrophil granulocyte (N) were determined. RESULTS: Compared with group C, the levels of leucocyte ((11.0 ± 3.2)×10(9)/L, (11.1 ± 5.3)×10(9)/L vs (8.5 ± 2.7)×10(9)/L), CRP ((89 ± 10), (90 ± 14) vs (107 ± 13) mg/L), TNF-α ((99 ± 39), (103 ± 28) vs (123 ± 35) pg/L), IL-6 ((54 ± 22), (69 ± 20) vs (81 ± 24) pg/L) and IL-8 ((104 ± 50), (138 ± 63) vs (167 ± 71) pg/L) decreased significantly in groups A and B after treatment (all P < 0.05). There were no differences in the levels of CRP, IL-6, IL-8 or TNF-α levels between groups B and C (all P > 0.05). The recovery of kidney function was much more rapid in group A than in groups B and C. CONCLUSION: The large dose of CRRT may be more effective in the clearance of inflammatory mediators and improved survival of severe pneumonia with acute kidney injury than moderate and low doses.