Acute Kidney Injury Clinical Trial
Official title:
The Effects of High-cutoff (HCO) Hemofiltration in the Immediate Postoperative Period on Systemic Inflammatory Response Syndrome (SIRS) and Renal Recovery in Cardiac Surgery Patients With a High Risk for Renal Failure. (HICOSIRS)
A high cut off dialyzer (septeX) is tested in patients after cardio-thoracic surgery with incidence of "systemic inflammatory response syndrome" (SIRS) and associated increased risk for acute kidney injury (AKI). Hypothesis: The high cut off dialyzer (septeX) can increase the postoperative IL-6/Il-10 ratio.
Cardiac surgery associated systemic inflammatory response syndrome (SIRS) plays an important
pathophysiological role in the development of AKI in patients after cardiothoracic surgery.
Previous studies have shown that the elimination of inflammatory mediators can be either
achieved by Continuous Venous Venous Hemodialysis(CVVHD) or Continuous Venous Venous
Hemofiltration (CVVH) by using a high-cutoff (HCO) membrane with a cut-off 45kD. Data from
patients treated with HCO-CVVHD during septic shock show a reduction in systemic cytokines
and improved hemodynamics.
No data about the effects of early HCO-CVVH in cardiac surgery patients with a high risk of
Cardiac Surgery associated AKI and consequently a high rate of postoperative renal
replacement therapy (RRT) are available.
It is of note that patients with Euroscore > 6 are on high risk to develop SIRS associated
AKI.
No pharmacological anti-inflammatory approach has convincingly shown to prevent renal
dysfunction in these patients.
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