Bioartificial kidney alters cytokine response and hemodynamics in endotoxin-challenged uremic animals.

Abstract:

:The mortality from sepsis complicated by renal failure remains extremely high despite the application of modern renal replacement therapy. This study investigated whether treatment with a bioartificial kidney consisting of a hemofilter in a continuous venovenous hemofiltration circuit (CVVH) with a cartridge containing renal proximal tubule cells, also called the Renal Tubule Assist Device (RAD), would alter the course of sepsis in an animal model. The RAD has been previously characterized in vitro and ex vivo and provides transport, metabolic and endocrine activity. Mongrel dogs (n = 10) underwent surgical nephrectomy and 48 h later were treated with CVVH and either a RAD containing cells (n = 5) or an identically prepared sham cartridge (n = 5). After 4 h of therapy, intravenous endotoxin 2 mg/kg was infused over 1 h to simulate gram-negative septic shock. Data on blood pressure, cardiac output and systemic markers of inflammation were collected. Mean peak levels of an anti- inflammatory cytokine, IL-10, were significantly higher in cell-treated animals (15.25 vs. 6.29 ng/ml; p = 0.037), and mean arterial pressures were higher in cell-treated versus sham-treated animals (p < 0.04). We have demonstrated that treatment of an animal model of endotoxin shock and renal failure with a bioartificial kidney has measurable effects on circulating mediators of inflammation and on hemodynamic stability of the challenged animal.

journal_name

Blood Purif

journal_title

Blood purification

authors

Fissell WH,Dyke DB,Weitzel WF,Buffington DA,Westover AJ,MacKay SM,Gutierrez JM,Humes HD

doi

10.1159/000046986

subject

Has Abstract

pub_date

2002-01-01 00:00:00

pages

55-60

issue

1

eissn

0253-5068

issn

1421-9735

pii

bpu20055

journal_volume

20

pub_type

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