The Therapeutic Effct Of Continuous Renal Replacement Therapy With The Adsorbing Filter OXiris In Sepsis With Acute Kidney Injury Patients

Background:Sepsis is a response to an infection and could result in organ dysfunctions and death.Continuous renal replacement therapy（CRRT）with adsorbing membrane could improve sepsis patients’prognosis by removing endotoxin and cytokines,but the benefit is controversial.This study investigated whether oXiris membrane could control inflammation and improve the clinical organic function in sepsis patients with acute kidney injury（AKI）.Methods:Forty-five hospitalized patients diagnosed with sepsis/septic shock with AKI at the First Affiliated Hospital of Chongqing Medical University from February 19,2019,to December 30,2020,were included in this retrospective study.The inflammatory,hemodynamic,and respiratory parameters and outcomes of patients,who underwent CRRT with oXiris and M150 membrane treatment,were analyzed at the beginning of the first CRRT treatment（0h）and after receiving CRRT treatment for 24 hours（24h）.Results:Among the 45 patients,15 patients underwent CRRT with oXiris and30 with M150 hemofilter.In the oXiris-CRRT group,the levels of IL-6 and PCT decreased significantly（p<0.05）,and the reduction rate of IL-6 was significantly higher than the controls（80.2%vs.41.1%,p=0.005）after 24h treatment.There was no significant decrease of platelets in the oxiris-CRRT group,while the control group’s platelets significantly decreased within 24hours of treatment（p<0.05）.The MAP was significantly increased（p<0.05）,and the required dose of equivalent vasoactive agent decreased significantly in the oXiris-CRRT group（p=0.012）.The increase of MAP in the oXiris-CRRT group was notably better than that in the controls（13.6%vs.-2.4%,p=0.009）.Compared to 0h,the SOFA score at 24h significantly decreased by about 20%in the oXiris-CRRT group（p<0.05）,while the reduction of SOFA score by 24 hours was significantly better than the controls（20.0%vs.-2.4%,p=0.018）.The oxygenation index（Pa O₂/Fi O₂）and patients’heart rates got significantly better in both groups（p<0.05）.No difference in the 28-day survival rates between the two groups（p=0.757）.Conclusions:CRRT with oXiris membrane treatment could rapidly improve the hemodynamic status,oxygenation index（Pa O₂/Fi O₂）,and improve the SOFA score,accompanied by a significant reduction in inflammatory parameters（IL-6 and PCT）,and without effect on platelet.No improvement of the 28-day survival rates were observed in patients with sepsis/septic shock with AKI.