PMID- 29273022 OWN - NLM STAT- MEDLINE DCOM- 20180827 LR - 20181113 IS - 1471-2369 (Electronic) IS - 1471-2369 (Linking) VI - 18 IP - 1 DP - 2017 Dec 22 TI - On-line hemodiafiltration did not induce an overproduction of oxidative stress and inflammatory cytokines in intensive care unit-acute kidney injury. PG - 371 LID - 10.1186/s12882-017-0785-1 [doi] LID - 371 AB - BACKGROUND: Though on-line intermittent hemodiafiltration (OL-IHDF) is a routine therapy for chronic dialysis patients, it is not yet widespread used in critically ill patients. This study was undergone to evaluate efficiency and tolerance of OL-IHDF and to appreciate inflammatory consequences of its use in intensive care unit (ICU)-acute kidney injury (AKI) patients. METHODS: In this prospective cohort study conducted in a medical academic ICU in France, 30 AKI patients who underwent OL-IHDF were included. OL-HDF used an ultrapure water production: AQ 1250 line with double reverse osmosis, a generator 5008 with a 1.8m(2) dialyzer with Polysulfone membrane (Fresenius Medical Care). Tolerance and efficiency of OL-IHDF were evaluated as well as its inflammatory risk by the measurement of plasma concentrations of proinflammatory (Interleukin 6, IL1beta, IL8, Interferon gamma) and anti-inflammatory (IL4, IL10) cytokines, Epidermal growth factor (EGF), Vascular Endothelial growth factor (VEGF) and Macrophage Chemoattractive Protein-1 (MCP-1) before and after sessions. RESULTS: Intradialytic hypotensive events were observed during 27/203 OL-IHDF sessions accounting for a mal-tolerated session's rate at 13.3%. Mean delivered urea Kt/V per session was 1.12 +/- 0.27 with a percentage of reduction for urea, creatinine, beta2-microglobulin and cystatine C at 61.6 +/- 8.8%, 55.3 +/- 6.7%, 51.5 +/- 8.7% and 44.5 +/- 9.8% respectively. Production of superoxide anion by leukocytes, mean levels of pro- and anti-inflammatory cytokines and plasmatic concentrations of EGF, VEGF and MCP-1 did not differ before and after OL-IHDF sessions. We observed however a significant decrease of mean TNFalpha plasmatic concentrations from 8.2 +/- 5.8 to 4.8 +/- 3.5 pg/ml at the end of OL-IHDF. CONCLUSIONS: OL-IHDF was not associated with an increase in pro and anti-inflammatory cytokines, oxidative stress or EGF, VEGF and MCP-1 in AKI patients and seems therefore a secure and feasible modality in ICUs. FAU - Klouche, Kada AU - Klouche K AUID- ORCID: 0000-0003-1633-7700 AD - Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France. k-klouche@chu-montpellier.fr. AD - Lapeyronie University Hospital. PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. k-klouche@chu-montpellier.fr. FAU - Amigues, Laurent AU - Amigues L AD - Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France. FAU - Morena, Marion AU - Morena M AD - Departments of Biochemistry, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. AD - Lapeyronie University Hospital. PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. FAU - Brunot, Vincent AU - Brunot V AD - Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France. FAU - Dupuy, Anne Marie AU - Dupuy AM AD - Departments of Biochemistry, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. FAU - Jaussent, Audrey AU - Jaussent A AD - Departments of Medical statistics, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. FAU - Picot, Marie Christine AU - Picot MC AD - Departments of Medical statistics, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. FAU - Besnard, Noemie AU - Besnard N AD - Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France. FAU - Daubin, Delphine AU - Daubin D AD - Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France. FAU - Cristol, Jean Paul AU - Cristol JP AD - Departments of Biochemistry, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. AD - Lapeyronie University Hospital. PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34295, Montpellier cedex 5, France. LA - eng PT - Journal Article PT - Observational Study DEP - 20171222 PL - England TA - BMC Nephrol JT - BMC nephrology JID - 100967793 RN - 0 (Cytokines) RN - 0 (Inflammation Mediators) SB - IM MH - Acute Kidney Injury/*blood/*therapy MH - Aged MH - Cohort Studies MH - Cytokines/*blood MH - Female MH - Hemodiafiltration/*trends MH - Humans MH - Inflammation Mediators/blood MH - Intensive Care Units/*trends MH - Male MH - Middle Aged MH - Oxidative Stress/*physiology MH - Prospective Studies PMC - PMC5741969 OTO - NOTNLM OT - Acute kidney injury OT - Anti-inflammatory cytokines OT - Egf OT - Inflammatory cytokines OT - Mcp-1 OT - On-line Hemodiafiltration OT - Oxidative stress OT - Vegf COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This observational prospective study was carried out at the Medical ICU of Lapeyronie University Hospital at Montpellier and was approved by the Ethics Research Committee of our hospital; PHRC regional: N degrees 2006-A00510-51. A written informed consent was obtained from the patients. If the patient has not the capability to give consent, a written informed consent was obtained from its closest relative. All the patients confirmed their consent by writing later on. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors' declare that they have no competing interest. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2017/12/24 06:00 MHDA- 2018/08/28 06:00 PMCR- 2017/12/22 CRDT- 2017/12/24 06:00 PHST- 2017/03/01 00:00 [received] PHST- 2017/12/08 00:00 [accepted] PHST- 2017/12/24 06:00 [entrez] PHST- 2017/12/24 06:00 [pubmed] PHST- 2018/08/28 06:00 [medline] PHST- 2017/12/22 00:00 [pmc-release] AID - 10.1186/s12882-017-0785-1 [pii] AID - 785 [pii] AID - 10.1186/s12882-017-0785-1 [doi] PST - epublish SO - BMC Nephrol. 2017 Dec 22;18(1):371. doi: 10.1186/s12882-017-0785-1.