The clearing effects and safety research of various blood purification modes on β2-microglulin in acute kidney injury children

Abstract

Objective To investigate the clearing effects and safety of various blood purification modes on β2-microglulin (β2-MG)in acute kidney injury(acute kidney injury, AKI)children. Methods We collected 38 acute kidney injury children including 98 cases by blood purification treatment in department of nephrology and immunology and PICU in Children's Hospital of Guiyang from March 2011 to March 2013, of which males 20 and females 18, aged from 5 months to 14.Sixty-six cases underwent continuous renal replacement therapy(CRRT)including continuous veno-venous hemofiltration(CVVH) and continuous veno-venous hemodiafiltration(CVVHDF), while 32 cases underwent intermittent hemodialysis(IHD). The primary disease of children: 7 cases of circulatory disturbance, 10 cases of nephrotoxic drugs and toxic poisoning, 9 cases of sepsis with multiple organ failure and 12 cases of renal parenchymal disease, such as nephrotic syndrome, poststreptococcal glomerulonephritis, lupus nephritis, rapidly progressive glomerulonephritis.The CRRT group were treated for 8 h to 16 h and the IHD group for 2.5 h to 3 h. Then we investigated blood urea nitrogen(BUN), serum creatinine(SCr), and disturbance of acid-base balance and β2-MG, etc. Results There were 98 cases treated by AKI of blood purification therapy(IHD, CVVH, CVVHDF). Sixty-six of them were CRRT group(CVVH or CVVHDF), others were IHD group.Two cases progressed to ESRD(accounted for 5%). They needed a long term dialysis in treatment.The mortality rates were 0.(1)Before and afert treastment of CRRT group, the difference of serum BUN[(22.34±2.08)mmol/L, (12.24±0.98)mmol/L] and Scr[(310.23±85.34)μmol/L, (178.15±34.12)μmol/L]had statistical significane(t=12.39, t=5.906, P all<0.05). Before and after trentment of IHD group, the difference of serum BUN[(23.80±2.14)mmol/L, (7.39±0.88)mmol/L] and Scr[(350.11±78.42)μmol/L, (108.20±28.20)μmol/L]had statistical significance(t=29.04, t=13.83, P all<0.05); (2)The clearing effects of β2-MG in CRRT group(40.50±7.20)% were better than IHD group(1.50±0.05)%.The difference had statistical significance(P<0.05). (3)The adverse reactions of CRRT group were mild.Its safety was higher than IHD group.In patients hemodynamics and vital signs were maintained stable after CRRT. Conclusion CRRT is good for the clearing effects of β2-MG and hemodynamics in acute kidney injury children.It is a quickly effective and safe method for treating acute kidney injury children. Key words: Acute kidney injury; Children; Continuous renal replacement therapy; Intermittent hemodialysis; β2-microglulin