BACKGROUND In recent years there have been attempts to treat
sepsis using various methods of extracorporeal blood purification in order to eliminate selected
mediators of inflammation. MATERIAL AND METHODS This retrospective study assessed 28 patients (17 males, 11 females, age 60.3 ± 14.5 years) in
septic shock, treated with
continuous venovenous hemodialysis (
CVVHD). Oligoanuric patients with
acute kidney injury were qualified for 24-hour
CVVHD using high cut-off (HCO) hemofilter. Before the start of dialysis and after 24 hours of treatment, the concentration levels of selected
cytokines (IFN-α, IFN-γ, TNF-α, IL-1β, IL-2, IL-6, IL-10, IL-12) in serum were assessed. After 12 hours and 24 hours of treatment, the concentration of the same
cytokines in the dialysis fluid was assessed. The aim of our study was to evaluate the effectiveness of HCO-
CVVHD in the removal of selected
cytokines. RESULTS After 24-hour HCO-
CVVHD treatment,
IL-10 and
IL-12 levels in serum were significantly lower. Concentrations of INF-α, IL-1β and
IL-2 in dialysis fluid significantly increased during HCO-
CVVHD, which corresponded with the parallel rise of related clearances. Clearance of
IL-6 was approximately four times higher than
IL-10. The rise of
IL-6 during HCO-
CVVHD significantly correlated with mortality due to
sepsis. CONCLUSIONS
Continuous venovenous hemodialysis using high cut-off hemofilter proved to be effective in the removal of IFN-α, IL-1β,
IL-2 and
IL-6,
IL-10 and
IL-12 from serum in patients during
septic shock. The rise of
IL-6 during HCO-
CVVHD seems to be a marker of bad prognosis in
septic shock patients.