PMMA Hemofilter in Patients with Sepsis/Septic Shock Requiring Renal Replacement Therapy in Comparison with Conventional Dialysis

Background Acute kidney injury (AKI) due to sepsis is associated with a high mortality rate. Exaggerated inflammatory response plays a major role in sepsis and is also associated with poor prognosis. Efficient removal of cytokines can improve the outcomes of these patients. Continuous hemofiltration can modulate systemic and tissue immune activation. We define the impact of the polymethylmethacrylate (PMMA) hemofilter in comparison with conventional dialysis in patients with sepsis. Materials and Methods It is an observational retrospective study of 32 patients with sepsis/septic shock from January 2020 to August 2023. Subjects were divided into Group A (PMMA hemofilter–HEMOFEEL TM ) and Group B (regular dialysis filter), with 16 subjects in each group. The standard treatment guidelines were followed. The parameters such as vasopressor requirement, SOFA scores, and serial measurements of IL-6, CRP, and procalcitonin were assessed. Results Group A subjects showed statistically significant improvement in systolic (p <0.001) and diastolic blood pressure (p=0.002) and a reduction in the mean SOFA score (p<0.001) after treatment. Interleukin-6, procalcitonin, and CRP showed statistically significant reduction (p<0.001) post-treatment in Group A. The PMMA hemofilter led to an increase in SBP and DBP, reduction in CRP, procalcitonin and lactate, drop in inotropes use, as well as lower mortality. Conclusion The use of cytokine adsorption technique using the PMMA hemofilter decreased vasopressor requirements, SOFA score, and showed reduction in inflammatory markers. Large-scale randomized controlled studies are needed to assess the clinical efficacy of these filters.