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Table 4 Cytokine clearance, albumin clearance and clinical effects of renal replacement therapy using high cutoff membranes

From: Acute kidney injury in the ICU: from injury to recovery: reports from the 5th Paris International Conference

First author, year

N

RRT modality

Qf or Qd (l/h)

Cutoffa (kDa)

Cytokine clearance

Albumin clearance

Clinical effects

Morgera et al. [103]

24

CVVH versus CVVHD

Qf 1 versus 2.5

Qd 1 versus 2.5

60

Greater IL-1ra clearance with CVVH. Increased Qf or Qd increased IL-6 and IL-1ra clearance

Highest with CVVH 2.5 l/h

Overall decrease in APACHE II and MODS scores. No difference between groups

Morgera [235]

30

CVVH

Qf 2.5

30 versus 60

Greater IL-6 and IL-1ra clearance with 60 kDa-filter

Plasma albumin levels not affected by filter cutoff

Reduced noradrenaline requirements with 60 kDa-filter

Haase et al. [104]

10

IHD

Qd 18

20 versus 60

Greater IL-6, IL-8 and IL-10 clearance with 60 kDa-filter

Plasma albumin levels not affected by filter cutoff

Trend toward increased mean arterial pressure and reduced vasopressor requirements with 60 kDa-filter

  1. RRT renal replacement therapy, Qf ultrafiltration rate, Qd dialysate flow rate, CVVH continuous venovenous hemofiltration, CVVHD continuous venovenous hemodialysis, IHD intermittent hemodialysis, APACHE acute physiology and chronic health evaluation, MODS multiorgan dysfunction syndrome
  2. aEstimated in vivo membrane cutoff