The influence of continuous renal replacement treatment on renal damage and inflammatory mediators of patients with severe acute pancreatitis

Objective To investigate the influence of continuous renal replacement treatment on the therapy of severe acute pancreatitis(SAP) associated with kidney injury(AKI) and inflammatory mediators.Methods Clinical data of 54 SAP patients complicated with AKI,who received conventional treatment (control group) or conventional therapy combined with CRRT(observation group) were retrospectively analyzed.The clinical efficacy between the two groups before and after treatment was compared.Results The mechanical ventilation proportion in control group was significantly higher than in the observation group (x2 =4.464,P ＜ 0.05).The mortality rate between the two groups had no statistical di.fference(P ＞ 0.05).In observation group,TNF-alpha and IL-6 levels were significantly lower than before treatment(P ＜0.01),APN was significantly increased (P ＜ 0.01).APN also increased in the control group,but the extent was less than the observation group.The levels of TNF-αand IL-6 in the control group were significantly higher than before treatment(P ＜ 0.01).The urine output of observation group increased significantly after 72h therapy (P ＜ 0.01).And blood urea nitrogen (BUN),creatinine (SCr),APACHE Ⅱ score were significantly decreased(P ＜ 0.01),in the control group,urine output also increased (P ＜ 0.01),but the extent was less than the observation group,APACHE Ⅱ score had no significant difference compared with before treatment(P ＞0.05).In control group,BUN and SCr levels significantly increased than before treatment (P ＜ 0.05).Conclusion CRRT for the treatment of SAP patients complicated with AKI can significantly improve renal function and reduce mortality,and its mechanism may be clear a large number of inflammatory mediators and metabolites in body,reduce the body inflammatory response. Key words: Pancreatitis; Continuous renal replacement therapy; Kidney injury; Inflammatory cytokines