Effects of continuous renal replacement therapy on the treatment of cytomegalovirus pneumonia following kidney transplantation

Objective To observe the efficacy of continuous renal replacement therapy (CRRT) on cytomegalovirus (CMV) pneumonia following kidney transplantation. Methods Thirty recipients of kidney transplantation complicated with CMV pneumonia during the period of January 2003 to December 2007 were randomly divided into CRRT group (n=15) and control group (n=15). Patients in control group were treated with the routine conservative therapy, and those in CRRT group were treated with CRRT besides the routine conservative therapy. BM25 continuous blood purification system and AN69 hemofilter were used to perform the pre-dilution continuous venous-venous hemofiltration. Serum TNF-a and IL-8 were measured. Duration of mechanical ventilation, average hospitalized day and mortality rate were observed. Results Serum TNF-a and IL-8 were significantly increased on admission day (day 0) in the two groups compared with the values before the infection (P 0.01, for both groups). On the 7th day after treatment, serum TNF-a and IL-8 in control group remained increased, and then decreased after the 14th day as the patients recovered. In CRRT group, serum TNF-a and IL-8 levels were significantly lower than those in control group (P 0.05, for serum TNF-a and IL-8). The duration of mechanical ventilation was shorter in CRRT group (7.2 ± 2.5 days) than in control group (9.8 ± 3.0 days, P 0.01), and the average hospitalized day was also shorter in CRRT group (21.2 ± 5.3 days) than in control group (26.1 ± 5.5 days, P 0.01). There was no statistical difference in mortality rate between the two groups (P 0.05). Conclusion CRRT has a therapeutic effect on CMV pneumonia following kidney transplantation by clearance of systemic inflammatory factors.