Abstract
Cytokine-adsorbing hemofilter (CAH) -continuous renal replacement therapy (CRRT) is performed in both patients with sepsis and those with acute kidney injury (AKI). We previously reported significantly higher survival rates when CRRT was performed consistently with surface-treated AN69 (AN69ST), a type of CAH. Thus, AN69ST has the potential to improve the prognosis of patients with sepsis or AKI during CRRT. In this study, we retrospectively examined how survival rates changed over 7 years when it was possible to change the membrane material during CRRT. The results showed that using AN69ST, as the filtration membrane for CRRT, higher survival rates with and without sepsis were observed as compared with polymethyl methacrylate (PMMA). Multivariate analysis showed that the mortality rate was 0.682 times using AN69ST as compared to PMMA, implying that survival increased with AN69ST. Further, in the presence of sepsis, the mortality rate was 1.641 times higher, suggesting that the presence of sepsis increased mortality. These results suggest that CRRT with AN69ST followed by change to a non-CAH membrane is just as likely to result in higher survival as the constant application of AN69ST, suggesting that AN69ST may be a better initial blood filter in the first few days of CRRT.
