Study On The Expression Of VEGF And Effect Of CVVH Intervention In Different Renal Failure With Cancer

Objective: At present VEGF is hot research topic. A lot of researchesfocuse on the relationship between VEGF and tumor. And it was taking astargeted therapy. We took different renal failures with cancer patients asresearch object, observed expression of serum VEGF in the case of suchpeople. As study showed dialysis was good for the cancer with renal failurepatients. It was helpful to prolong the survival period. The reports of whetherCVVH could improve renal function at the same time, and prevent the tumorgrowth, metastasis, invasion, and removed VEGF were rare.Through studyingon the expression of VEGF and effect of CVVH intervention in different renalfailures with caner, aimed to:(1)Comparison serum vascular endothelialgrowth factors between the acute kidney with cancer and the chronic renalfailure with cancer before CVVH treatment,(2) To determine the changes ofconcentration of vascular endothelial growth factor clear after CVVHtreatment.Methods: This study adopts the case-control and own before-and-afterstudy methods. Subjects were divided into two groups, including the cancerwith acute kidney injury group, the cancer with chronic renal failure group.The cancer with acute kidney injury group hospitalized in the Department ofNephrology in the4thHospital of Hebei Medical University from February2011to January2013.Inclusion criteria:①the primary disease of malignanttumor,②Corresponding KDIGO （Kidney Disease： Improving GlobalOutcomes）proposed the latest, global unified definition of AKI and AKIcriteria,③There are indications of continuous blood purification,④Noobvious pleural and peritoneal effusion,⑤No metal stents or pacemaker inbody,⑥Volunteered for the researchers. Exclusion criteria:①Having hadchest surgery (such as: coronary artery carotid stenting, aortic ballooncounterpulsation, coronary artery bypass surgery or heart pace makers surgery, etc.),②Sepsis shock,③Patients couldn’t coordinate test. Including a total of18cases (average age62.17+/-13.7years),11cases of males and females in7cases.5cases of digestive tract tumor,6cases of urinary system tumor,2cases of blood system tumor,3cases of gynecologic tumor,2cases with twoand above two kinds of tumors.. the cancer with chronic renal failure group:the inclusion criteria:①The primary disease of malignant tumor,②Corresponding the standard diagnosis of chronic renal failure,③No obviouspleural and peritoneal effusion in body,④No metal stents or pacemaker inbody.⑤Volunteered for the researchers.Exclusion criteria was equal to that ofthe cancer with acute kidney injury group. Including a total of9patients(mean age74.11+/-9.96years),7cases of males and females in2cases.3casesof digestive tract tumor,3cases of urinary system tumor,3cases with two andabove two kinds of tumors.Experimental methods:1Collecting general clinical datas after admissionin hospital, including age, sex, blood routine, renal function, blood albuminetc,2About general situation of continuity vein venous hemofiltration(CVVH), including dialysis machine, dialyser and the blood flow velocity,anticoagulant, the balance, time, urine volume, vascular access, etc,3Thepatients were informed consent clearly and collected39cases of venous bloodin each before and after CVVH.The two groups were measured bynoninvasive hemodynamic monitor(BioZ; Cardio Dynamics; U.S) at the sametime. The hemodynamic changing of patients was continuously monitored to astable condition, then recorded all hemodynamic parameters records beforeand after CVVH.Statistical methods: SPSS13.0software was adopted to conductstatistical analysis on the recorded datas. Describing measurement data using（x+/-S), comparing groups which conformed to normal distribution using ttest, which didn’t conform to the normal using nonparametric test(NPar).Comparing before-and-after of oneself, conform to the normal personwith paired t test, do not conform to the normal person with two relatedsamples nonparametric tests. All comparisons were considered statistically significant (P value <0.05).Results:1Serum VEGF concentration of the two groups before CVVHThe serum VEGF concentrations of the cancer with acute kidney injury group was lower than that of the cancer with chronic renal failuregroup（58.79±24.31vs118.92±28.850, P<0.05）.2The influence of CVVH treatment on serum VEGF concentrationThe serum VEGF concentration of the cancer patients with acute kidneyinjury after CVVH treatment was36.87+/-20.52pg/ml. Compared to thatbefore CVVH(58.79±24.31pg/ml), it decreased significantly. P <0.05, thereis statistical significance. The serum VEGF concentration of the cancerpatients with chronic renal failure after CVVH treatment was54.66+/-16.65pg/ml. Compared to that before CVVH(118.92±28.85pg/ml),it decreasedsignificantly. P <0.05, with statistical significance.Conclusion:1The serum VEGF concentration of the chronic renal failure elevatedmore significantly the acute kidney injury in cancer patients.2CVVH could remove part of serum VEGF.