#6814 A NEW SORBENT DEVICE FOR MULTIPLE CLINICAL PURPOSES: CURRENT EVIDENCE AT A PRIVATE HOSPITAL IN MEXICO

Abstract

Background and Aims: Adsorption is an extracorporeal technique utilized for blood purification, it also complements convection and diffusion for solute removal. Since 1991 we had used blood purification techniques, over the years, new adsorption cartridges had been developed, the new ones involving treatment for inflammatory conditions, chronic uremic symptoms and autoimmune diseases. HA130, HA230, and HA330 (Jafron, Zhuhai City, China) are among the widely used adsorption cartridges in China. We report highlights of the use of hemoperfusion using HA130 cartridges in theMexican population cohorts in the context ofmultiple chronic inflammatory conditions in order to support evidence of effectiveness and safety. Method: We retrospectively analyzed the medical records of 14 critically ill patients in the context of chronic inflammatory conditions such as acute kidney injury in chronic kidney disease, acute lung injury due to SARS-COV- 2 infection and sepsis. Hemoperfusion in addition to standard therapy (fluid resuscitation, vasopressors, antimicrobial therapy and ventilatory support) resulted in the improvement of inflammatory substances levelswhen compared to standard therapy alone. Out of the 14 patients, 7 patients used HA130 cartridges and 7 patients with standard therapy alone. Results: There were no significant side effects associated withHA130 cartridge use.HA130 cartridgeswere found tobe effective in reducinguremic symptoms in chronic hemodialysis patients, improvement of pruritus score and decreased parathyroid hormone and phosphate product (p<0.5) when compared to HD alone, creatinine (MARS: -24 μmol/L, -19.5 to -10.46, p<0.001; SPAD: -2 μmol/L, -9.0 to +7.0/L, p=0.314) and urea (MARS: -0.9 mmol/L, -318 to -0.189, p=0.024; SPAD: -0.1 mmol/L, -1.0 to +0.68, p=0.523). 66.6% of cost-effectiveness when compared to standard therapy. Conclusion: In the group of patients that used HA130 cartridges we found statistically significant (p <0.05) reduction of pruritus score, PTH, phosphate product, creatine and urea when compared to the group of patients with standard therapy alone. The development in new cartridges technology allows more wide applications for renal patients. As we expand to involve other indications for this therapy there is cost-effectiveness improvement for the patients.More studies in different clinical settings are needed in order to achieve adsorption therapy national recommendations. We also found that the HA130 cartridges are effective in reducing uremic symptoms and microinflammatory status in acute kidney injury in chronic kidney disease patients due to the elimination of middle and small molecule uremic toxins and inflammatory mediators and endotoxins. This may translate as an improvement of quality of life and survive rates in patients with chronic hemodialysis, even though more studies are needed in order to prove this assumption.