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The Role and Clinical Application of Novel Filters in Sepsis‐Associated Acute Kidney Injury Blood Purification

医学 败血症 肾脏替代疗法 急性肾损伤 促炎细胞因子 感染性休克 重症监护医学 血液滤过 血液灌流 血液透析 阿尔法德罗曲菌素 肾功能 背景(考古学) 炎症 免疫学 内科学 严重败血症 古生物学 生物
作者
Chunyu Deng,Wei Zhang,Yan Liu,Hao Zhang,Zhi Li
出处
期刊:Therapeutic Apheresis and Dialysis [Wiley]
标识
DOI:10.1111/1744-9987.70085
摘要

ABSTRACT Sepsis is a life‐threatening clinical syndrome, and renal impairment associated with sepsis significantly increases patient mortality. Blood purification techniques are crucial in managing sepsis by removing inflammatory mediators and toxic substances from the bloodstream, thereby improving outcomes. Traditional modalities, including continuous renal replacement therapy, hemodialysis, and hemoperfusion, have demonstrated clinical efficacy in this context. Recent advancements in blood purification filters have enhanced sepsis treatment strategies. This review assesses the mechanisms and clinical applications of novel filters such as the oXiris filter, AN69ST membrane, CytoSorb, Hemopurifier, and others, focusing on their effectiveness in eliminating toxins and inflammatory mediators. The oXiris filter has demonstrated superior capacity to remove small molecular toxins, pro‐inflammatory cytokines, and endotoxins while promoting renal protection and enhancing microcirculation. In contrast, the AN69ST membrane and CytoSorb filters have shown promising efficacy in cytokine clearance, though their ability to remove endotoxins is limited. The Hemopurifier specifically targets endotoxins like lipopolysaccharides, effectively suppressing inflammatory responses and mitigating renal damage. Furthermore, the integration of Extracorporeal Carbon Dioxide Removal (ECCO2R) with continuous renal replacement therapy (CRRT) offers benefits, including the regulation of carbon dioxide levels, maintenance of acid–base balance, and enhanced clearance of inflammatory factors from circulation. Additionally, selective removal of lipopolysaccharides (LPS) can alleviate leukopenia and immune dysregulation, preserving renal function. This review aims to provide clinical guidance for optimizing individualized treatment protocols to enhance survival rates and improve the quality of life for patients with sepsis‐related AKI. Incorporating these advanced filtration technologies into routine clinical practice can transform sepsis management and pave the way for innovative therapeutic strategies in critical care.
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