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- 2019
Evaluation of preKeywords: P-selectin,pre-dilution,post-dilution,regulatory T cell,sepsis Abstract: We investigated the differences in biocompatibility pre- and post-dilution during continuous veno-venous hemofiltration in patients with sepsis, focusing on leukocyte and platelet function. Subjects were 12 patients with septic shock who underwent veno-venous hemofiltration for acute kidney injury between March 2016 and September 2017. The first six patients received pre-dilution veno-venous hemofiltration, and the next six patients received post-dilution veno-venous hemofiltration. The blood flow rate and filtration flow rate for veno-venous hemofiltration using a polysulfone hemofilter were set to 150 and 35?mL/min, respectively. Leukocyte and platelet counts were determined at 0 and 24?h after veno-venous hemofiltration commencement. Serum interleukin-6 and interleukin-10 levels, the induction rates of regulatory T cells, the expression rate of monocyte HLA-DR, neutrophil phagocytic and sterilizing ability, and platelet P-selectin expression rate were determined at 0, 6, and 24?h after veno-venous hemofiltration commencement. There were no significant differences in patient characteristics between the two groups. Serum interleukin-6 decreased over time during pre- and post-dilution veno-venous hemofiltration. Serum interleukin-10 levels decreased during pre-dilution veno-venous hemofiltration, but remained unchanged during post-dilution veno-venous hemofiltration. The Treg and platelet P-selectin expression rates significantly increased at 24?h compared to 0?h during post-dilution veno-venous hemofiltration. Neutrophil phagocytic ability at 24?h was significantly decreased compared to that at 0?h during post-dilution veno-venous hemofiltration. No significant changes in leukocyte and platelet function were observed during pre-dilution veno-venous hemofiltration. Pre-dilution veno-venous hemofiltration demonstrates superior biocompatibility in terms of decreased leukocyte function and platelet activation in septic shock patients with acute kidney injury
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