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- Title
High permeability haemofiltration improves peripheral blood mononuclear cell proliferation in septic patients with acute renal failure.
- Authors
Stanislao Morgera; Michael Haase; Jens Rocktäschel; Torsten Böhler; Christian von Heymann; Ortrud Vargas-Hein; Dietmar Krausch; Heidrun Zuckermann-Becker; Joachim M. Müller; Wolfgang J. Kox; Hans H. Neumayer
- Abstract
Background. Continuous veno-venous haemofiltration (HF) with high permeability (HP) haemofilters is a novel approach in the adjuvant therapy of septic patients. HP haemofilters are characterized by an increased pore size which facilitates the filtration of inflammatory mediators. The present study examines whether HP-HF has an impact on peripheral blood mononuclear cell (PBMC) proliferation and whether ultrafiltrate can alter PBMC function in isolates from healthy volunteers. Methods. Twenty-eight septic patients with acute renal failure were randomly allocated to either HP-HF or conventional HF (C-HF). HP-HF was performed with a newly developed high-flux polyamide membrane (P2SH) with a nominal cut-off point of 60 kDa. For C-HF, a high-flux polyamide haemofilter (Polyflux 11S; cut-off, 30 kDa) was used. Results. Septic patients demonstrated a significantly reduced proliferation of anti-CD3-stimulated PBMCs compared to healthy controls (P = 0.016). Initiating HF led to a restoration of the PBMC proliferation in HP-HF but not in C-HF. Exposing PBMCs isolated from healthy donors to ultrafiltrates from patients with sepsis demonstrated a significant suppressive effect of HP ultrafiltrates on the anti-CD3-stimulated PBMC proliferation (P = 0.011). Ultrafiltrate from patients with sepsis who received C-HF had no impact on PBMC proliferation. Conclusion. HP-HF restores PBMC proliferation in septic patients probably by eliminating immunomodulatory mediators. HP-HF may represent a new renal replacement therapy able to modulate PBMC function in sepsis.
- Subjects
BLOOD filtration; CELL proliferation; ACUTE kidney failure; SEPSIS
- Publication
Nephrology Dialysis Transplantation, 2003, Vol 18, Issue 12, p2570
- ISSN
0931-0509
- Publication type
Article
- DOI
10.1093/ndt/gfg435