Abstract: Objective  To investigate the effects of continuous veno-venous hemofiltration (CVVH) combined with HA330 hemoperfusion (HP) on serum high mobility group protein 1 (HMGB1), high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT) and 28-day mortality in post-traumatic sepsis patients with acute kidney injury (AKI).   Methods  A total of 86 patients with post-traumatic sepsis and AKI treated during February 2020 to March 2021 in Guangzhou Red Cross Hospital Affiliated to Jinan University were retrospectively analyzed. They were divided into CVVH group (43 cases) and HP group (43 cases) according to whether the patient agreed to receive HA330 hemoperfusion treatment. CVVH group received CVVH treatment, and HP group was treated with the HA330 hemoperfusion device on the basis of CVVH. Blood creatinine (Scr), blood urea nitrogen (BUN), serum levels of HMGB1, hs-CRP and PCT, and scores of APACHE Ⅱ and sequential organ failure assessment (SOFA) were recruited from both groups before treatment and after the treatment for 3 and 5 days. 24-hour urine volume and 28-day mortality were recorded.  Results  After treatment for 3 days and 5 days, the urine volume increased more in HP group than in CVVH group (for 3 days:  t=-8.158, P＜0.001; for 5 days: t=-12.954, P＜0.001). Serum levels of Scr, BUN, PCT, hs-CRP and HMGB1, and scores of APACHE Ⅱ and SOFA were significantly lower in HP group than in CVVH group (for 3 days:  t=9.698, 3.313, 7.739, 7.266, 2.549, 7.340 and 3.556 respectively, P<0.001, =0.001, <0.001, <0.001, =0.006,  <0.001 and <0.001 respectively; for 5 days: t=7.189, 2.385, 14.583, 5.676, 2.797, 11.238 and 6.964 respectively, P<0.001, =0.010, <0.001, <0.001, =0.003, <0.001 and <0.001 respectively). The hospitalization days and mechanical ventilation days were lower in HP group than in CVVH group (for hospitalization days: 12.37±5.11 vs. 20.69±5.04 days, t=9.324, P＜0.001; for mechanical ventilation days: 9.36±2.47 vs. 14.09±2.85 days, t=8.224, P＜0.001). Patients with SOFA score <8 had a lower 28-day mortality rate (5.00% vs. 23.26%, χ2=8.444, P=0.004).  Conclusion  CVVH combined with HA for the treatment of post-traumatic sepsis patients with AKI can significantly reduce the inflammation responses, promote the recovery of renal function, and reduce the 28-day mortality with better therapeutic effects.

Key words: Hemofiltration, Hemoperfusion, Sepsis, Acute renal injury, Mortality