The 28-day survival rates of two cytokine-adsorbing hemofilters for continuous renal replacement therapy: a single-center retrospective comparative study

Abstract

Aim: Continuous renal replacement therapy (CRRT) with a cytokine-adsorbing hemofilter (CAH) is effective in the treatment of sepsis. Two filter types, namely polymethyl methacrylate (PMMA) and surface-treated AN69 (AN69ST) hemofilters, have been successfully used for CRRT, but no direct comparisons have been published to date. This study compared the efficacy, as measured by 28-day survival rates, of PMMA and AN69ST hemofilters in patients receiving CAH-CRRT.

Methods: This retrospective observational study reviewed the medical records of 142 patients who received CAH-CRRT between November 2013 and February 2015.

Results: The 28-day survival rates were higher in the AN69ST group than in the PMMA group for patients with or without sepsis (all patients, 79.4% versus 54.1%; patients with sepsis, 77.3% versus 50.0%; patients without sepsis, 83.3% versus 57.5%; P < 0.05). No significant differences were observed regarding 28-day survival rates of patients with or without sepsis (AN69ST, 77.3% versus 83.3%; P = 0.51; PMMA, 50.0% versus 57.5%; P = 0.61) using the same hemofilter.

Conclusion: The AN69ST hemofilter could be more effective than PMMA hemofilters for improving the survival outcomes of patients with or without sepsis.

Keywords: Acute kidney injury; renal replacement therapy; retrospective study; sepsis.

Figure 1

Flowchart of patient recruitment to this study. AN69ST, surface‐treated AN69; CRRT, continuous renal replacement therapy; PMMA, polymethyl methacrylate; PMX, polymyxin B‐immobilized fiber column.

Figure 2

Kaplan–Meier curves comparing 28‐day survival rates among patients who underwent continuous renal replacement therapy (CRRT) with a surface‐treated AN69 (AN69ST) or polymethyl methacrylate (PMMA) filter. The AN69ST group showed higher 28‐day survival rates than the PMMA group for patients with and without sepsis. A, All patients, 79.4% versus 54.1%, respectively. B, Septic, 77.3% versus 50.0%, respectively. C, Non‐septic, 83.3% versus 57.5%, respectively. P < 0.05.

Figure 3

Kaplan–Meier curves comparing 28‐day survival rates of patients who underwent continuous renal replacement therapy, with or without sepsis, using a surface‐treated AN69 (AN69ST) or polymethyl methacrylate (PMMA) hemofilter. For patients using AN69ST, the 28‐day survival rate was 77.3% in patients with sepsis versus 83.3% in those without sepsis (P = 0.51). For patients using PMMA, the 28‐day survival rate was 50.0% in patients with sepsis versus 57.5% in patients without sepsis (P = 0.61).