López FJ, Vásquez AKE, Zamora GIS, Zavaleta HBF

Language: Spanish
References: 19
Page: 644-649
PDF size: 304.49 Kb.

ABSTRACT

Introduction: acute kidney injury in the setting of septic shock is associated with prolonged renal recovery and high mortality. Continuous renal replacement strategies are those techniques that include the continuous circulation of blood through extracorporeal circuits in order to purify it, and are part of the comprehensive treatment and care of patients with acute kidney injury. Therapy with an extracorporeal blood adsorbent filter establishes a causal model of endotoxin and cytokine elimination that could benefit patients with this entity. Objective: to compare the effectiveness of the adsorbent filter in the treatment of acute kidney injury in septic shock. Material and methods: we present a retrospective observational study carried out from September 2022 to January 2024 in the intensive care unit of a hospital center. All patients received CRRT for ≥ 24 hours. The primary outcome was mortality. Secondary outcomes like days of renal replacement therapy and SOFA score were included. Results: a total of 52 patients with septic shock and acute kidney injury were added. The intervention group (oXiris group; n = 26) received CRRT with cytokine adsorption and endotoxic function hemofilter (oXiris), meanwhile, the control group (group ST150; n = 26) was treated with the hemofilter ST150. A goodness-of-fit test was performed establishing a non-parametric distribution group where a correlation coefficient Kendall rank was used. The variables of interest were oXiris group, ST 150 group, renal replacement therapy duration (TDTRR) and survival, showed bilateral significance; oXiris group and TDTRR R = 0.53 (p ≤ 0.001), ST150 group and TDTRR R = −0.53 (p ≤ 0.001) ST150 group and survival R = 0.46 (p ≤ 0.001). A survival analysis was performed and a nominal level of significance was established using log rank. It was observed that early mortality in the oXiris group failed to increase life expectancy compared to the ST150 group, which increased 4.5 days the evaluation at 60 days in the oXiris group which didn't demonstrate from the established nominal level of significance. Conclusions: the use of hemofilters with adsorbent property did not demonstrate an increase in life expectancy in our study population through a correlation analysis compared to a ST150 hemofilter. The cost-benefit evaluation is our argument due to the rational use of the adsorbent filter at our environment. Further researches in randomized controlled trials or high-quality prospective studies are needed to validate the present findings.

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