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  • Title: [Effects of high-volume hemofiltration on serum levels of tumor necrosis factor and its receptors in patients with multiple organ dysfunction syndromes].
    Author: Zhang J, Tao LJ, Ning JP, Xu H, Ai YH, Zhao SP.
    Journal: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue; 2004 Feb; 16(2):81-4. PubMed ID: 14764220.
    Abstract:
    OBJECTIVE: To investigate whether serum tumor necrosis factor-alpha (TNF-alpha) and its receptors can be removed by high-volume hemofiltration (HVHF) or continuous veno-venous hemofiltration (CVVH). METHODS: The study was performed in 12 multiple organ dysfunstion syndrome (MODS) patients with acute renal failure (ARF). They were randomized to receive either CVVH (n=10) or HVHF (n=8). TNF-alpha and soluble tumor necrosis factor-receptor (sTNF-R1 and sTNF-R2) concentrations were measured in serum by enzyme-linked immunoadsorbent assay (ELISA). RESULTS: Compared with that before the therapy, the average concentrations of plasma creatinine and urea were decreased significantly 8 hours after HVHF or CVVH in MODS patients with ARF (P<0.001). In patients on HVHF, the serum TNF-alpha concentrations were significantly lower 8 hours after treatment (P<0.01) compared with that before treatment, 1 hour and 4 hours after treatment. There were not significant changes in the serum TNF-alpha concentrations in patients on CVVH and the serum sTNF-R1 and sTNF-R2 concentrations in patients on CVVH or HVHF. CONCLUSION: In MODS patients with ARF undergoing HVHF, the serum TNF-alpha concentrations dropped significantly, but the serum sTNF-R1 and sTNF-R2 concentrations do not change significantly. Our study suggests that HVHF may be the better option for the treatment of MODS patients.
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