[Tumor necrosis factor-alpha kinetics during renal replacement therapy in patients with sepsis and multiple organ failure].

Peptide TNF-alpha (tumor necrosis factor alpha) secreted by monocytes and resident macrophages is a key proinflammatory mediator. It can generate response systemic inflammation leading to shock and polyorganic insufficiency. Elimination of circulating TNF-alpha is pathogenetically perspective in respect to therapy of septic shock. Plasma level of TNF-alpha and its elimination with the filter/dialysate was traced in 23 patients with sepsis and polyorganic insufficiency receiving substitute renal therapy (continuous hemodiafiltration, intermittent hemodialysis) for acute renal failure. Sepsis and polyorganic insufficiency was associated with elevated plasma levels of TNF-alpha correlating in many cases with the disease severity. TNF-alpha was for the most part eliminated with the filter/dialysate. The degree of this elimination was related to the technique of blood perfusion and characteristics of the procedure.