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논문분류	춘계학술대회 초록집
제목	Efficacy of Convection-Based Hemodiafiltration Compare With Diffusion-Based Hemodialysis in Sepsis-Associated Acute Kidney Injury: A Randomized Controlled Trial
저자	Chamanant Satjanon
출판정보	2025; 2025(1):
키워드	sepsis-associated acute kidney injury (SA-AKI), online hemodiafiltration (OL-HDF), intermittent hemodialysis (IHD)
초록	Sepsis-associated acute kidney injury (SA-AKI) is a frequent complication in critically ill patients which is associated with higher morbidity and mortality. There are many inflammatory cytokines released during sepsis eg.IL-6 and CRP which higher levels are believed to be a predictor and associated with poorer outcomes. SA-AKI patient were randomized into 2 groups for online hemodiafiltration (OL-HDF) and intermittent hemodialysis (IHD). Treatment time was 4 hours and prescription blood flow rate were 200 ml/min for both groups. In OL-HDF group 40L/session of substitution ultrapure fluid was added in predilution technique. Primary outcome are percent reduction of IL-6 and CRP at 4 hours and 48 hours after first dialysis session. Thirty-days mortality and kidney recovery are our secondary outcome. A total of 14 patients diagnosed with SA-AKI requiring dialysis, female 57.14%, mean age 67.86±16.21 years-old, hypertension 64.29%, diabetes 35.71%, mean eGFR 59.91±26.51 ml/min/1.73m2. Primary infectious organs are pneumonia 64.29% and urinary tract infection 21.43%. Severity of sepsis determined by mean SOFA score 11.14±3.44 and mean APACHE-II score 22.50±3.78. Percent reduction of IL-6 and CRP after dialysis 4 hours was -4.99 vs -3.19, P=0.94 and -7.45 vs -1.71, P=0.83 in convection group and diffusion group respectively. Over-all 30 days mortality was 42.86%, while in-hospital death was 71.43%. Patients discharge with dialysis independent were 28.57% in both groups. Patients diagnosed with SA-AKI who need dialysis has high mortality rate. In our study OL-HDF did not show significant efficacy for percent reduction of IL-6 or CRP compared with intermittent low-flux HD.
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