Effect of anticoagulation regimens on handling of interleukin-6 and -8 during continuous venovenous hemofiltration in critically ill patients with acute kidney injury
► Type of anticoagulation may affect bioincompatibility of filters in CVVH. ► Fluxes of IL-6/IL-8 across filters did not differ among anticoagulation methods. ► Clearance, adsorption and removal were low and did not differ between the groups. ► IL-6 and IL-8 are high in critically ill non-survivors,...
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| Veröffentlicht in: | Cytokine (Philadelphia, Pa.) Pa.), 2012-12, Vol.60 (3), p.601-607 |
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| creator | Schilder, Louise Azam Nurmohamed, S. ter Wee, Pieter M. Girbes, Armand R.J. Beishuizen, Albertus Paauw, Nanne J. Beelen, Robert H.J. Johan Groeneveld, A.B. |
| description | ► Type of anticoagulation may affect bioincompatibility of filters in CVVH. ► Fluxes of IL-6/IL-8 across filters did not differ among anticoagulation methods. ► Clearance, adsorption and removal were low and did not differ between the groups. ► IL-6 and IL-8 are high in critically ill non-survivors, irrespective of CVVH.
During continuous venovenous hemofiltration (CVVH) to replace renal function in acute kidney injury (AKI), anticoagulation of the filter is routinely required. A survival benefit for citrate has been reported, possibly due to reduced proinflammatory effects of the filter (bioincompatibility). We hypothesized that the type of anticoagulation modulates the immune response to, and clearance by CVVH of interleukin-6 (IL-6) and -8 (IL-8).
Three anticoagulation regimens were compared: trisodium citrate (n=17), unfractionated heparin (n=8) and no anticoagulation in case of bleeding tendency (n=13). Immediately before initiation of CVVH (cellulose triacetate membrane) pre-filter blood was drawn. Thereafter, at 10, 60, 180 and 720min, samples were collected from the pre- and postfilter blood and from ultrafiltrate. IL-6 and IL-8 were determined by ELISA.
High inlet levels of IL-6 and IL-8, particularly in the no anticoagulation group, were associated with non-survival. The inlet concentrations and mass rates of IL-6 and IL-8 decreased during CVVH. The course of fluxes across the filter were similar for the groups, however. Although increasing in time for IL-6 in the no anticoagulation group, mass removal and adsorption of IL-6 and IL-8 were low and did not differ among the anticoagulation groups.
Blood to membrane contact, adsorption/clearance and anticoagulation do not increase nor attenuate high circulating levels of IL-6 and IL-8 during CVVH for AKI. This renders the hypothesis that the reported survival benefit for citrate anticoagulation is based on a reduction of bioincompatibility unlikely. |
| doi_str_mv | 10.1016/j.cyto.2012.08.015 |
| format | Article |
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During continuous venovenous hemofiltration (CVVH) to replace renal function in acute kidney injury (AKI), anticoagulation of the filter is routinely required. A survival benefit for citrate has been reported, possibly due to reduced proinflammatory effects of the filter (bioincompatibility). We hypothesized that the type of anticoagulation modulates the immune response to, and clearance by CVVH of interleukin-6 (IL-6) and -8 (IL-8).
Three anticoagulation regimens were compared: trisodium citrate (n=17), unfractionated heparin (n=8) and no anticoagulation in case of bleeding tendency (n=13). Immediately before initiation of CVVH (cellulose triacetate membrane) pre-filter blood was drawn. Thereafter, at 10, 60, 180 and 720min, samples were collected from the pre- and postfilter blood and from ultrafiltrate. IL-6 and IL-8 were determined by ELISA.
High inlet levels of IL-6 and IL-8, particularly in the no anticoagulation group, were associated with non-survival. The inlet concentrations and mass rates of IL-6 and IL-8 decreased during CVVH. The course of fluxes across the filter were similar for the groups, however. Although increasing in time for IL-6 in the no anticoagulation group, mass removal and adsorption of IL-6 and IL-8 were low and did not differ among the anticoagulation groups.
Blood to membrane contact, adsorption/clearance and anticoagulation do not increase nor attenuate high circulating levels of IL-6 and IL-8 during CVVH for AKI. This renders the hypothesis that the reported survival benefit for citrate anticoagulation is based on a reduction of bioincompatibility unlikely.</description><identifier>ISSN: 1043-4666</identifier><identifier>EISSN: 1096-0023</identifier><identifier>DOI: 10.1016/j.cyto.2012.08.015</identifier><identifier>PMID: 23006672</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acute kidney injury ; Acute Kidney Injury - metabolism ; Acute Kidney Injury - therapy ; Adsorption ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants - therapeutic use ; Biocompatibility ; Bleeding ; Blood ; Cellulose ; citrates ; Citrates - therapeutic use ; Citric acid ; Critically ill patients ; Enzyme-linked immunosorbent assay ; Female ; Filters ; Hemofiltration ; hemorrhage ; Heparin ; Heparin - therapeutic use ; Humans ; Immune response ; Inflammation ; Injuries ; Innate immunity ; Interleukin 6 ; Interleukin 8 ; Interleukin-6 - blood ; Interleukin-8 - blood ; kidneys ; Male ; Middle Aged ; patients ; Renal function ; Renal replacement therapy ; Survival ; Young Adult</subject><ispartof>Cytokine (Philadelphia, Pa.), 2012-12, Vol.60 (3), p.601-607</ispartof><rights>2012 Elsevier Ltd</rights><rights>Copyright © 2012 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c413t-53afcdef514b3c530187482a2167e53360a23a2d9a77e4ec7d5147e0b5803b703</citedby><cites>FETCH-LOGICAL-c413t-53afcdef514b3c530187482a2167e53360a23a2d9a77e4ec7d5147e0b5803b703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cyto.2012.08.015$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23006672$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schilder, Louise</creatorcontrib><creatorcontrib>Azam Nurmohamed, S.</creatorcontrib><creatorcontrib>ter Wee, Pieter M.</creatorcontrib><creatorcontrib>Girbes, Armand R.J.</creatorcontrib><creatorcontrib>Beishuizen, Albertus</creatorcontrib><creatorcontrib>Paauw, Nanne J.</creatorcontrib><creatorcontrib>Beelen, Robert H.J.</creatorcontrib><creatorcontrib>Johan Groeneveld, A.B.</creatorcontrib><title>Effect of anticoagulation regimens on handling of interleukin-6 and -8 during continuous venovenous hemofiltration in critically ill patients with acute kidney injury</title><title>Cytokine (Philadelphia, Pa.)</title><addtitle>Cytokine</addtitle><description>► Type of anticoagulation may affect bioincompatibility of filters in CVVH. ► Fluxes of IL-6/IL-8 across filters did not differ among anticoagulation methods. ► Clearance, adsorption and removal were low and did not differ between the groups. ► IL-6 and IL-8 are high in critically ill non-survivors, irrespective of CVVH.
During continuous venovenous hemofiltration (CVVH) to replace renal function in acute kidney injury (AKI), anticoagulation of the filter is routinely required. A survival benefit for citrate has been reported, possibly due to reduced proinflammatory effects of the filter (bioincompatibility). We hypothesized that the type of anticoagulation modulates the immune response to, and clearance by CVVH of interleukin-6 (IL-6) and -8 (IL-8).
Three anticoagulation regimens were compared: trisodium citrate (n=17), unfractionated heparin (n=8) and no anticoagulation in case of bleeding tendency (n=13). Immediately before initiation of CVVH (cellulose triacetate membrane) pre-filter blood was drawn. Thereafter, at 10, 60, 180 and 720min, samples were collected from the pre- and postfilter blood and from ultrafiltrate. IL-6 and IL-8 were determined by ELISA.
High inlet levels of IL-6 and IL-8, particularly in the no anticoagulation group, were associated with non-survival. The inlet concentrations and mass rates of IL-6 and IL-8 decreased during CVVH. The course of fluxes across the filter were similar for the groups, however. Although increasing in time for IL-6 in the no anticoagulation group, mass removal and adsorption of IL-6 and IL-8 were low and did not differ among the anticoagulation groups.
Blood to membrane contact, adsorption/clearance and anticoagulation do not increase nor attenuate high circulating levels of IL-6 and IL-8 during CVVH for AKI. This renders the hypothesis that the reported survival benefit for citrate anticoagulation is based on a reduction of bioincompatibility unlikely.</description><subject>Acute kidney injury</subject><subject>Acute Kidney Injury - metabolism</subject><subject>Acute Kidney Injury - therapy</subject><subject>Adsorption</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - therapeutic use</subject><subject>Biocompatibility</subject><subject>Bleeding</subject><subject>Blood</subject><subject>Cellulose</subject><subject>citrates</subject><subject>Citrates - therapeutic use</subject><subject>Citric acid</subject><subject>Critically ill patients</subject><subject>Enzyme-linked immunosorbent assay</subject><subject>Female</subject><subject>Filters</subject><subject>Hemofiltration</subject><subject>hemorrhage</subject><subject>Heparin</subject><subject>Heparin - therapeutic use</subject><subject>Humans</subject><subject>Immune response</subject><subject>Inflammation</subject><subject>Injuries</subject><subject>Innate immunity</subject><subject>Interleukin 6</subject><subject>Interleukin 8</subject><subject>Interleukin-6 - blood</subject><subject>Interleukin-8 - blood</subject><subject>kidneys</subject><subject>Male</subject><subject>Middle Aged</subject><subject>patients</subject><subject>Renal function</subject><subject>Renal replacement therapy</subject><subject>Survival</subject><subject>Young Adult</subject><issn>1043-4666</issn><issn>1096-0023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhSMEoqXwAizASzYJ_knsjMQGVYUiVWIBXVse52bGU8cebKfVvBDPyY1SukTIsnyk-91j-56qestowyiTHw-NPZXYcMp4Q_uGsu5Zdc7oRtaUcvF80a2oWynlWfUq5wOldCOUelmdcUGplIqfV7-vxhFsIXEkJhRno9nN3hQXA0mwcxOETFDvTRi8C7uFc6FA8jDfuVBL7BpI3ZNhTkvZRjQJc5wzuYcQl41yD1McnS9pNXaB2OTwMuP9iTjvyRELEEomD67sibFzAXLnhgBYDoc5nV5XL0bjM7x5PC-q2y9XPy-v65vvX79dfr6pbctEqTthRjvA2LF2K2wnKOtV23PDmVTQCSGp4cLwYWOUghasGpBUQLddT8VWUXFRfVh9jyn-miEXPblswXsTAH-iGVe4GOv-A2WcS45DXlC-ojbFnBOM-pjcZNJJM6qXKPVBL1HqJUpNe41RYtO7R_95O8Hw1PI3OwTer8Booja75LK-_YEOHebcd2zDkPi0EoAju3eQdLY4ZwuDSxi6HqL71wv-APq5u-w</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Schilder, Louise</creator><creator>Azam Nurmohamed, S.</creator><creator>ter Wee, Pieter M.</creator><creator>Girbes, Armand R.J.</creator><creator>Beishuizen, Albertus</creator><creator>Paauw, Nanne J.</creator><creator>Beelen, Robert H.J.</creator><creator>Johan Groeneveld, A.B.</creator><general>Elsevier Ltd</general><scope>FBQ</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20121201</creationdate><title>Effect of anticoagulation regimens on handling of interleukin-6 and -8 during continuous venovenous hemofiltration in critically ill patients with acute kidney injury</title><author>Schilder, Louise ; Azam Nurmohamed, S. ; ter Wee, Pieter M. ; Girbes, Armand R.J. ; Beishuizen, Albertus ; Paauw, Nanne J. ; Beelen, Robert H.J. ; Johan Groeneveld, A.B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c413t-53afcdef514b3c530187482a2167e53360a23a2d9a77e4ec7d5147e0b5803b703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acute kidney injury</topic><topic>Acute Kidney Injury - metabolism</topic><topic>Acute Kidney Injury - therapy</topic><topic>Adsorption</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - therapeutic use</topic><topic>Biocompatibility</topic><topic>Bleeding</topic><topic>Blood</topic><topic>Cellulose</topic><topic>citrates</topic><topic>Citrates - therapeutic use</topic><topic>Citric acid</topic><topic>Critically ill patients</topic><topic>Enzyme-linked immunosorbent assay</topic><topic>Female</topic><topic>Filters</topic><topic>Hemofiltration</topic><topic>hemorrhage</topic><topic>Heparin</topic><topic>Heparin - therapeutic use</topic><topic>Humans</topic><topic>Immune response</topic><topic>Inflammation</topic><topic>Injuries</topic><topic>Innate immunity</topic><topic>Interleukin 6</topic><topic>Interleukin 8</topic><topic>Interleukin-6 - blood</topic><topic>Interleukin-8 - blood</topic><topic>kidneys</topic><topic>Male</topic><topic>Middle Aged</topic><topic>patients</topic><topic>Renal function</topic><topic>Renal replacement therapy</topic><topic>Survival</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schilder, Louise</creatorcontrib><creatorcontrib>Azam Nurmohamed, S.</creatorcontrib><creatorcontrib>ter Wee, Pieter M.</creatorcontrib><creatorcontrib>Girbes, Armand R.J.</creatorcontrib><creatorcontrib>Beishuizen, Albertus</creatorcontrib><creatorcontrib>Paauw, Nanne J.</creatorcontrib><creatorcontrib>Beelen, Robert H.J.</creatorcontrib><creatorcontrib>Johan Groeneveld, A.B.</creatorcontrib><collection>AGRIS</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Cytokine (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schilder, Louise</au><au>Azam Nurmohamed, S.</au><au>ter Wee, Pieter M.</au><au>Girbes, Armand R.J.</au><au>Beishuizen, Albertus</au><au>Paauw, Nanne J.</au><au>Beelen, Robert H.J.</au><au>Johan Groeneveld, A.B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of anticoagulation regimens on handling of interleukin-6 and -8 during continuous venovenous hemofiltration in critically ill patients with acute kidney injury</atitle><jtitle>Cytokine (Philadelphia, Pa.)</jtitle><addtitle>Cytokine</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>60</volume><issue>3</issue><spage>601</spage><epage>607</epage><pages>601-607</pages><issn>1043-4666</issn><eissn>1096-0023</eissn><abstract>► Type of anticoagulation may affect bioincompatibility of filters in CVVH. ► Fluxes of IL-6/IL-8 across filters did not differ among anticoagulation methods. ► Clearance, adsorption and removal were low and did not differ between the groups. ► IL-6 and IL-8 are high in critically ill non-survivors, irrespective of CVVH.
During continuous venovenous hemofiltration (CVVH) to replace renal function in acute kidney injury (AKI), anticoagulation of the filter is routinely required. A survival benefit for citrate has been reported, possibly due to reduced proinflammatory effects of the filter (bioincompatibility). We hypothesized that the type of anticoagulation modulates the immune response to, and clearance by CVVH of interleukin-6 (IL-6) and -8 (IL-8).
Three anticoagulation regimens were compared: trisodium citrate (n=17), unfractionated heparin (n=8) and no anticoagulation in case of bleeding tendency (n=13). Immediately before initiation of CVVH (cellulose triacetate membrane) pre-filter blood was drawn. Thereafter, at 10, 60, 180 and 720min, samples were collected from the pre- and postfilter blood and from ultrafiltrate. IL-6 and IL-8 were determined by ELISA.
High inlet levels of IL-6 and IL-8, particularly in the no anticoagulation group, were associated with non-survival. The inlet concentrations and mass rates of IL-6 and IL-8 decreased during CVVH. The course of fluxes across the filter were similar for the groups, however. Although increasing in time for IL-6 in the no anticoagulation group, mass removal and adsorption of IL-6 and IL-8 were low and did not differ among the anticoagulation groups.
Blood to membrane contact, adsorption/clearance and anticoagulation do not increase nor attenuate high circulating levels of IL-6 and IL-8 during CVVH for AKI. This renders the hypothesis that the reported survival benefit for citrate anticoagulation is based on a reduction of bioincompatibility unlikely.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23006672</pmid><doi>10.1016/j.cyto.2012.08.015</doi><tpages>7</tpages></addata></record> |
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| source | Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE |
| subjects | Acute kidney injury Acute Kidney Injury - metabolism Acute Kidney Injury - therapy Adsorption Adult Aged Aged, 80 and over Anticoagulants - therapeutic use Biocompatibility Bleeding Blood Cellulose citrates Citrates - therapeutic use Citric acid Critically ill patients Enzyme-linked immunosorbent assay Female Filters Hemofiltration hemorrhage Heparin Heparin - therapeutic use Humans Immune response Inflammation Injuries Innate immunity Interleukin 6 Interleukin 8 Interleukin-6 - blood Interleukin-8 - blood kidneys Male Middle Aged patients Renal function Renal replacement therapy Survival Young Adult |
| title | Effect of anticoagulation regimens on handling of interleukin-6 and -8 during continuous venovenous hemofiltration in critically ill patients with acute kidney injury |
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