Clinical study of blood purification in the treatment of delayed graft function after renal transplantation

Objective: To compare the effects of the different blood purification methods on the treatment of delayed graft function (DGF) after renal transplantation. Methods: During the period from January 1998 to June 2003, a total of 54 patients received different methods of blood purification for DGF management. High volume hemofiltration (HVHF) was applied to 21 cases in HVHF group, hemodialysis (HD) to 25 cases in HD group, and peritoneal dialysis (PD) to 8 cases in PD group; and the effects of those methods were compared. Results: Altogether, 103 times of HVHF, 118 times of HD and 112 times of PD were performed. The incidence of hypotension in the HVHF group (4.85%) and the PD group (6. 25%) was lower than that in the HD group(17.8%) (P<0.01). Systolic blood pressure (SBP) of the cases in HVHF and PD groups showed slighter changes than that of the cases in HD group (SBP≥20 mmHg: 20.39%, 19.64% vs. 27.12%; SBP≥40 mmHg: 16.5%, 18.75% vs. 22.03%; SBP≥60 mmHg: 0%, 1.79% vs. 14.41%) (P<0.01). The graft function recovery period of HVHF group was shorter than that of the HD and PD groups (9.1±4.3d vs. 21.4±7.6d, 15.5±6.7d) (P<0.01). The incidence of postoperative infection in the HVHF group (9.52%) was lower than that in the HD group(20%) and PD group (37.5%) (P<0.01). After HVHF, the level of TNF-α, IL-1 β and IL-6 was decreased remarkably than before. Conclusion: Compared with HD and PD, HVHF is a better choice for the treatment of DGF.