Clearance of NT-proBNP and Procalcitonin during Continuous Venovenous Hemodialysis with the Medium Cutoff Filter in Patients with Rhabdomyolysis-Associated Early Acute Kidney Injury

Critical Care Nephrology – Research Article

Mariano F.a,b· Mella A.a,b· Rumbolo F.c· Holló Z.a· Bergamo D.a· Congiu G.b· Mengozzi G.b,c· Berardino M.d· Stella M.e· Biancone L.a,b

Author affiliations

aNephrology, Dialysis and Transplantation U, University Hospital City of Science and Health, CTO Hospital, Torino, Italy
bDepartment of Medical Sciences, University of Torino, Torino, Italy
cClinical Biochemistry Laboratory, University Hospital City of Science and Health, Molinette Hospital, Torino, Italy
dAnesthesia and Intensive Care 3, University Hospital City of Science and Health, CTO Hospital, Torino, Italy
eBurn Center and Plastic Surgery, University Hospital City of Science and Health, CTO Hospital, Torino, Italy

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Article / Publication Details

First-Page Preview

Abstract of Critical Care Nephrology – Research Article

Received: May 21, 2022
Accepted: December 14, 2022
Published online: March 07, 2023

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 2

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Introduction: In polytrauma patients with AKI continuous venovenous hemodialysis (CVVHD) with medium cutoff membrane filters is commonly adopted to increase the removal of both myoglobin and inflammatory mediators, but its impact on increasing molecular weight markers of inflammation and cardiac damage is debated. Methods: Twelve critically ill patients with rhabdomyolysis (4 burns and 8 polytrauma patients) and early AKI requiring CVVHD with EMIc2 filter were tested for 72 h on serum and effluent levels for NT-proBNP, procalcitonin (PCT), myoglobin, C-reactive protein (CRP), alpha1-glycoprotein, albumin, and total protein. Results: The sieving coefficients (SCs) for proBNP and myoglobin were as higher as 0.5 at the start, decreased to 0.3 at the 2nd h, and then slowly declined to the final value of 0.25 and 0.20 at the 72nd h, respectively. PCT showed a negligible SC at the 1st h, a peak of 0.4 at the 12th h, and a final value of 0.3. SCs for albumin, alpha1-glycoprotein, and total protein were negligible. A similar trend was observed for the clearances (17–25 mL/min for proBNP and myoglobin; 12 mL/for PCT; <2 mL/min for albumin, alpha1-glycoprotein, and total protein). No correlation was found between systemic determinations and filter clearances of proBNP, PCT, and myoglobin. Net fluid loss/hour during CVVHD positively correlated with systemic myoglobin for all patients and NT-proBNP in the burn patients. Conclusion: CVVHD with EMiC2 filter showed low clearances for NT-proBNP and procalcitonin. CVVHD did not significantly affect the serum levels of these biomarkers, which could be adopted in the clinical management of early CVVHD patients.

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First-Page Preview

Abstract of Critical Care Nephrology – Research Article

Received: May 21, 2022
Accepted: December 14, 2022
Published online: March 07, 2023

Number of Print Pages: 9
Number of Figures: 4
Number of Tables: 2

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

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