使用大体积高通量血液滤过清除少尿型急性肾损伤患者的肌红蛋白。
Myoglobin removal using high-volume high-flux hemofiltration in patients with oliguric acute kidney injury.
机构信息
Division of Renal Diseases and Hypertension, Division of Pediatric Nephrology, Departments of Internal Medicine and Pediatrics, UT Health Science Center at Houston, Medical School, Houston, Tex., USA.
出版信息
Blood Purif. 2013;36(2):107-11. doi: 10.1159/000354727. Epub 2013 Sep 25.
BACKGROUND
Rhabdomyolysis can cause acute kidney injury (AKI). It remains controversial whether or not myoglobin can be removed from the circulation with extracorporeal therapy and decrease the incidence of AKI. Therefore, we examined myoglobin removal in a series of 11 patients with oliguric AKI treated with high-volume hemofiltration.
METHODS
Patients received prefilter hemofiltration using a polysulphone filter with a molecular size cutoff of 65 kDa and a surface area of 1.7 m(2). Sieving coefficients and myoglobin clearances were calculated at 6, 12, and 24 h after the start of hemofiltration.
RESULTS
The mean sieving coefficient was 0.158, and the mean myoglobin clearance was 8.7 ml/min.
CONCLUSION
Despite the use of high-volume hemofiltration, the removal of myoglobin was negligible. In patients with normal renal function, the anticipated amount of extracorporeal removal would not significantly impact renal exposure to myoglobin.
背景
横纹肌溶解症可引起急性肾损伤（AKI）。用体外疗法清除肌红蛋白并降低 AKI 发生率是否有效仍存在争议。因此，我们观察了在接受高容量血液滤过治疗的 11 例少尿性 AKI 患者中肌红蛋白的清除情况。
方法
患者使用截留分子量为 65 kDa、表面积为 1.7 m(2)的聚砜膜进行预滤过血液滤过。在血液滤过开始后 6、12 和 24 小时计算筛系数和肌红蛋白清除率。
结果
平均筛系数为 0.158，平均肌红蛋白清除率为 8.7 ml/min。
结论
尽管使用了高容量血液滤过，但肌红蛋白的清除量可以忽略不计。在肾功能正常的患者中，预期的体外清除量不会对肌红蛋白在肾脏中的暴露量产生显著影响。
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