Clinical efficacy of hemoperfusion combined with continuous venous-venous hemofiltration in the treatment of sepsis-associated acute kidney injury
Objective This study aimed to investigate the clinical efficacy of hemoperfusion(HP)combined with continuous venous-venous hemofiltration(CVVH)in the treatment of sepsis-associated acute kidney injury(AKI),as well as its impact on inflammatory factors and hemodynamic parameters in patients.Methods A total of 98 patients with sepsis-associated AKI admitted to Beijing Shijitan Hospital,Capital Medical University from March 2020 to March 2023 were selected and al-located to a control group(n=48)and a study group(n=50)according to different treatment methods.The control group received CVVH treatment,while the study group received HP combined with CVVH treatment.The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scoring system was used to assess clinical efficacy.Serum levels of blood urea nitrogen(BUN),serum creatinine(Scr),procalcitonin(PCT),and high-sensitivity C-reactive protein(hs-CRP)were measured in both groups.Heart rate(HR),mean arterial pressure(MAP),and central venous pressure(CVP)were moni-tored,and adverse reactions in both groups were recorded.Results Before treatment,no significant difference was observed in APACHE Ⅱ scores between the two groups(P>0.05).After treatment,the APACHE Ⅱ score in the study group was significantly lower than that in the control group(P<0.05).Before treatment,no significant differences were found in ser-um BUN,Scr levels,and urine output between the two groups(P>0.05).After treatment,the serum BUN and Scr levels in the study group were lower than those in the control group,and the daily urine output was higher than that in the control group,with statistically significant differences(P<0.05).Before treatment,no significant differences were found in serum PCT and hs-CRP levels between the two groups(P>0.05).After treatment,the serum PCT and hs-CRP levels in the study group were significantly lower than those in the control group(P<0.05).Before treatment,no significant differences were noted in HR,MAP,and CVP levels between the two groups(P>0.05).After treatment,the HR in the study group was significantly lower than that in the control group,and the MAP and CVP levels were significantly higher than those in the control group(P<0.05).The difference in the incidence of adverse reactions between the study group and the control group was not statistically significant[4.00%(2/50)vs.10.42%(5/48);x2=0.707,P=0.401].Conclusion HP com-bined with CVVH treatment for sepsis-associated AKI can effectively reduce the levels of inflammatory factors,regulate he-modynamic parameters,and promote renal function,with a good safety profile.