A Case-Control Study of Single-Pass Albumin Dialysis for Sub-Compensated Acute Liver Failure

Objective. The aim of the study was to evaluate the effectiveness of the improved method of hemodiafiltration (HDF), based on the Single pass albumin dialysis (SPAD), for extracorporeal liver support in patients with acute liver failure (ALF). Material and methods. The retrospective case-control study. We identified 69 ALF and acute-on-chronic liver failure (ACLF) patients (38 SPAD-treated, 31 controls) between January 2011 and March 2020. The average age was 34 years, 57% were male. To evaluate the therapy efficacy, laboratory tests (bilirubin, urea, creatinine, ammonia, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), prothrombin index (PTI) and INR) and the Model for End-Stage Liver Disease (MELD) score were used. Results. In patients with acute renal failure without concomitant hepatorenal syndrome, SPAD allowed stable stabilization and regression of the pathological process by the 5^th day of treatment in 81.6% of cases, while in the control group this indicator was 45.2% (p=0.003). Total bilirubin (p <0.05), ammonia (p <0.05) ALT and CRP (p <0.05) significantly decreased after treatment with SPAD. Conclusion. An improved HDF technique using 2% albumin in ALF and ACLF patients allows for a stable regression of the disease. At the same time, good results of applying the proposed method were noted in the absence of initial manifestations of hepatorenal syndrome with a creatinine < 100 μmol/l