Abstract: Objective To investigate the effect of continuous renal replacement therapy (CRRT) on liver-type fatty acid binding proteins (L-FABP) levels in severe sepsis patients with acute kidney injury (AKI).Methods Sixty-eight severe sepsis associated with AKI patients admitted to the ICU were divided into conventional
drug treatment group (group A, n=33) and CRRT group (group B, n=35). Patients in group A were treat with standard anti-sepsis therapy (SSC protocol, 2012), and those in group B were treated with CRRT in addition to the standard anti-sepsis therapy. Serum creatinine (sCr), serum L-FABP (sL-FABP), and urinary LFABP (uL-FABP) were measured at 0, 12, 24, and 48 hours after the treatment. In group B, sL-FABP in the ultrafiltrate of CRRT was also measured. Results After 48 hours of the treatment, sL-FABP increased in group A (1328±101 μg/g of Cr vs. 700±88 μg/g of Cr, t=5.435, P＜0.02), but did not change obviously in group B (680±74 μg/g of Cr vs. 712±82 μg/g of Cr; t=1.682, P＞0.05); uL-FABP did not change obviously in group A (1428±124 μg/g of Cr vs. 1082±89 μg/g of Cr; t=4.854, P＞0.05), but decreased significantly in group B (1324±123 μg/g of Cr vs. 1978±88 μg/g of Cr; t=2.654, P＜0.02). At 12, 24 and 48 hours after the treatment, sL-FABP was significantly lower in group B than in group A (P＜0.05). No L-FABP cold be detected in ultrafiltrate in group B. Conclusion CRRT induces the decrease of sL-FABP expression, which may improve theprognosis of AKI. CRRT may not remove sL-FABP directly from plasma. sL-FABP level is a reliable indicator to evaluate the therapeutic effectiveness of CRRT.

Key words: Severe Sepsis, Acute kidney injury, Continuous renal replacement therapy, Liver-type fatty acid binding proteins