Department of Internal Medicine, Nephrology and Hypertension, University of Rome Tor Vergata, Rome, Italy.
Blood Purif. 2012;34(3-4):349-53. doi: 10.1159/000346288. Epub 2013 Jan 23.
Angioimmunoblastic T-cell lymphoma shows a high release of cytokines. Different blood purification techniques are employed to control hypercytokinemia. Here we investigated the effects of intermittent supra-hemodiafiltration with endogenous reinfusion on cytokine removal in a patient presenting with acute kidney injury. After the first day of chemotherapy for angioimmunoblastic T-cell lymphoma, a 78-year-old male patient developed acute kidney injury and systemic inflammatory response syndrome due to massive release of inflammatory cytokines. Three sessions of supra-hemodiafiltration were performed. Blood samples for evaluation of renal function and inflammatory mediators were collected at the beginning and the end of each dialytic session. A marked improvement of clinical state and renal function was associated to a significant reduction of inflammatory markers. Our results suggest that renal replacement therapy with supra-hemodiafiltration may remove a wide spectrum of inflammatory mediators and uremic toxins involved in acute kidney injury and systemic inflammatory response syndrome.
血管免疫母细胞性 T 细胞淋巴瘤会大量释放细胞因子。不同的血液净化技术被用于控制细胞因子血症。在此，我们研究了在一名因大量炎症细胞因子释放而发生急性肾损伤的患者中，采用内源性回输的间歇性超滤液置换对细胞因子清除的效果。在接受血管免疫母细胞性 T 细胞淋巴瘤化疗的第一天后，一名 78 岁男性患者因炎症细胞因子的大量释放而发生急性肾损伤和全身炎症反应综合征。进行了 3 次超滤液置换。在每次透析治疗开始和结束时采集血样，以评估肾功能和炎症介质。临床状态和肾功能的显著改善与炎症标志物的显著降低相关。我们的结果表明，超滤液置换的肾脏替代治疗可能会清除与急性肾损伤和全身炎症反应综合征相关的广泛的炎症介质和尿毒症毒素。
