Clinical effects of different blood purification methods in the treatment of acute renal failure caused by wasp sting

Abstract:

Objective：To evaluate the effects of continuous venovenous hemofiltration（CVVH） combined with hemoperfusion（HP） in the treatment of acute renal failure（ARF） caused by wasp sting. Methods：Totally 72 patients with ARF caused by wasp sting were divided into haemodialysis（HD） group（n=30） and CVVH/HP group（n=42） based on the different treatments. Blood urea nitrogen（BUN），serum creatinine（Scr），K+，HCO3-，pH，β2-microglobulin（β2-MG） and myoglobin were measured at 24 h after the treatments. The total effective rate，average time of oliguria stage and average time in hospital were recorded and compared between two groups. Results：There were significant decreases in BUN，Scr and K ，and significant increases in HCO3- and pH in both two groups at 24 h after treatment（P<0.05）. There was no difference in β2-MG and myoglobin in HD group before and after the treatment（P >0.05）；however，significant decreases in β2-MG and myoglobin in CVVH/HP group were observed（P<0.05）. There was no significant differ－ence in K ，HCO3- and pH between two groups after the treatment（P >0.05）；but BUN，Scr，β2-MG and myoglobin were significantly lower in CVVH /HP group than in HD group（P<0.05）. The total effective rate in CVVH/HP group was significantly higher than that in HD group，and the average time of oliguria stage and the average time in hospital in CVVH/HP group were significantly shorter than those in HD group（P<0.05）. Conclusion：CVVH combined with HD can markedly correct turbulence of electrolyte and acid-alkali，effectively clear toxic substance in vivo，and significantly improve renal function and prognosis. It is of better clinical effect and may be a good therapeutic measure for ARF caused by wasp sting.