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document
Enhanced vascular endothelial growth factor and inflammatory cytokine removal with online hemodiafiltration over high-flux hemodialysis in sepsis-related acute kidney injury patients . Hypercytokinemia plays a central role in pathogenesis and is related to the high mortality in sepsis-related acute kidney injury ( AKI ) . Besides the established cytokines , vascular endothelial growth factor ( VEGF ) is demonstrated as an important factor in enhancing vascular leakage in sepsis . This prospective randomized trial was conducted to compare the efficacy of cytokine removal between online hemodiafiltration ( HDF ) , which combines convective and diffusive solute removal , and high-flux hemodialysis ( HD ) . Twenty-eight sepsis-related AKI patients were included and randomized into online HDF and high-flux HD . The percentages of the reduction ratio in plasma cytokines were measured as primary outcomes . Other clinical parameters were determined as secondary outcomes . When compared with high-flux HD , online HDF provided significantly greater percentages of the reduction ratio in plasma cytokine levels , including VEGF ( P < 0.001 ) , IL-6 ( P = 0.001 ) , IL-8 ( P = 0.021 ) , IL-10 ( P = 0.011 ) , and tumor necrosis factor-α ( P = 0.029 ) . There were no significant differences in intradialytic blood pressures . Online HDF revealed better renal recovery and shorter length of hospitalization than high-flux HD . In conclusion , online HDF in sepsis-related AKI could provide significantly better removal of VEGF and other cytokines and these were associated with better renal outcome than high-flux HD . Thus , online HDF would offer a potential role in hypercytokinemic state in sepsis-related AKI .
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Intervention_Physical
cytokine removal between online hemodiafiltration ( HDF ) , which combines convective and diffusive solute removal , and high-flux hemodialysis ( HD )
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Intervention_Physical
online HDF
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Intervention_Physical
high-flux HD
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Outcome_Physical
reduction ratio in plasma cytokines
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Outcome_Physical
Other clinical parameters
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Outcome_Physical
reduction ratio in plasma cytokine levels
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Outcome_Physical
VEGF
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Outcome_Physical
intradialytic