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Tropical Journal of Pharmaceutical Research
Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
ISSN: 1596-5996 EISSN: 1596-5996
Vol. 16, No. 4, 2017, pp. 925-930
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Bioline Code: pr17119
Full paper language: English
Document type: Research Article
Document available free of charge
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Tropical Journal of Pharmaceutical Research, Vol. 16, No. 4, 2017, pp. 925-930
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Clinical effect of combined ulinastatin and continuous renal replacement therapy on management of severe sepsis with acute kidney injury
Fang, Qiying & Zhao, Xinghua
Abstract
Purpose: To explore the effect of a combination of ulinastatin and continuous renal replacement
therapy (CRRT) for the treatment of severe sepsis with acute kidney injury (SAKI).
Methods: Clinical data for 106 patients diagnosed with SAKI from April 2013 to May 2015 in the
intensive care unit (ICU) of Affiliated Hospital of Zhengzhou University, Zhengzhou, China, were
collected and randomly assigned into two groups: treatment and control groups. The general
information on the two groups were comparable. All the patients received a comprehensive treatment
program which included fluid resuscitation, antibiotics, nutritional support and CRRT. The patients in
treatment group also received intravenous injection of 300 thousand units/10 mL ulinastatin thrice daily
for 5 days. Serum levels of inflammatory cytokines, oxidative stress level, kidney and blood coagulation
functions were assayed before and after treatment, using standard methodologies. In addition, adverse
reactions and 28-day mortality were recorded.
Results: Levels of interleukin-6 (IL-6), tumor necrosis factor α (TNFα), serum C-reactive protein (CRP),
procalcitonin (PCT), malondialdehyde (MDA), cystatin, blood urea nitrogen (BUN), prothrombin time
(PT), activated partial thromboplastin time (APTT), serum creatinine (SCr) and urinary kidney injury
molecule-1 (Kim-1) in the treatment group were significantly lower than those in the control group after
ulinastatin treatment (p < 0.05). However, superoxide dismutase (SOD), fibrinogen (Fib) and total
antioxidant capacity (T-AOC) in the treatment group were significantly higher in the control group after
treatment (p < 0.05). No serious adverse drug reactions were seen in the two groups. In addition, there
were no significant differences in 28-day mortality between the two groups.
Conclusion: These results suggest that ulinastatin combined with CRRT effectively decreases serum
levels of inflammation in SAKI patients through a mechanism involving improvement of antioxidant
capacity, reduction of oxidative stress, and enhancement of renal and coagulation functions.
Keywords
Ulinastatin, Continuous renal replacement therapy, Sepsis, Acute kidney injury, Inflammatory cytokines
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