Therapeutic effects of hybrid renal replacement therapy in patients with acute hyperlipidemic pancreatitis

Abstract

Objective To evaluate the therapeutic effects of hybrid renal replacement therapy (HRRT) in patients with acute hyperlipidemic pancreatitis. Methods Forty-two patients with HLP treated in Shanxi Dayi Hospital were enrolled into this study From June 2015 to Nov 2017. The patients were randomly divided into two groups to receive either plasma exchange (PE)/continuous veno-venous hemofiltration (CVVH; 22 patients) or CVVH alone (20 patients) for 8-12 hours. Clinical signs and symptoms, white blood cell count (WBC), C-reactive protein (CRP), serum amylase (AMY), alanine transaminase (ALT), serum creatinine (SCr), triglyceride (TG), APACHE II score, and clinical outcome were compared by paired t test or χ2test. Results Before treatment, WBC, CRP, AMY, ALT, SCr, and TG did not differ significantly between the two groups (P>0.05); after 7 days of treatment, WBC, CRP, AMY, ALT, SCr, and TG in the HP/CVVH group were significantly lower than those in the CVVH group [(12.6±3.7)×109/L vs (9.6±3.5)×109/L, t=-2.700, P=0.01; (34.7±2.2) mg/L vs (24.6±5.8) mg/L, t=-7.317, P<0.001; (819.6±89.8) IU/L vs (242.1±28.9) IU/L, t=-28.609, P<0.001; (78.9±18.) IU/L vs (56.6±5.4) IU/L, t=-5.521, P<0.001; (86.2±8.5) μmol/L vs (95.1±5.7) μmol/L, t=3.943, P<0.001; (4.1±1.6) mmol/L vs (8.9±2.1) mmol/L, t=-5.004, P<0.001]. Time to recovery of intestinal peristalsis, length of hospitalization duration, and time to disappearance of symptoms in the HP/CVVH group were significantly shorter than those in the CVVH group [(4.6±1.4) d vs (6.8±2.7) d, t=-3.36, P=0.002; (13.6±3.2) d vs (16.8±2.6) d, t=-3.535, P=0.001; (2.7±0.4) d vs (3.6±1.4) d, t=-2.891, P=0.006]. Conclusion HRRT can effectively reduce the levels of TG and inflammatory mediators and has a better therapeutic effect in patients with hyperlipidemic pancreatitis. Key words: Hybrid renal replacement therapy; Hyperlipidemic; Pancreatitis; Clinical research