Document Detail


Effects of polymyxin B immobilized fiber on urinary N-acetyl-beta-glucosaminidase in patients with severe sepsis.
MedLine Citation:
PMID:  15672789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe sepsis is known to cause multiple organ failure, including renal dysfunction. During sepsis, endotoxin targets the renal proximal tubular cells, the function of which can be evaluated on the basis of urinary N-acetyl-beta-glucosaminidase (NAG). We investigated whether urinary NAG activity is altered in patients with severe sepsis and whether treatment with polymyxin B immobilized fibers (PMX-F) affects this activity. Subjects of this study were 120 patients with severe sepsis and 60 healthy volunteers matched for age and gender. Patients were randomly assigned to one of two treatments: PMX-F treatment (n = 70) or conventional treatment (n = 50). The plasma endotoxin level was significantly reduced, from 34.6 +/- 10.2 to 6.8 +/- 2.4 pg/ml (p < 0.01) in patients treated with PMX-F, and the urinary NAG/creatinine ratio was reduced from 46.5 +/- 26.8 U/gm to 18.6 +/- 13.6 U/gm (p < 0.01). The plasma endotoxin level and urinary NAG/creatinine ratio were unchanged in patients who received conventional treatment. The increased urinary NAG/creatinine ratio in patients with severe sepsis may reflect proximal tubular dysfunction. PMX-F is effective in reducing proximal tubular dysfunction, in part owing to reduced plasma endotoxin levels.
Authors:
Tsukasa Nakamura; Yasuhiro Kawagoe; Takaharu Matsuda; Yoshihiko Ueda; Hikaru Koide
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  50     ISSN:  1058-2916     ISO Abbreviation:  ASAIO J.     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2005-01-27     Completed Date:  2005-06-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  563-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acetylglucosaminidase / urine*
Aged
Creatinine / urine
Endotoxins / blood
Female
Humans
Male
Middle Aged
Polymyxin B / therapeutic use*
Regression Analysis
Sepsis / blood,  drug therapy*,  physiopathology*,  urine
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Endotoxins; 1404-26-8/Polymyxin B; 60-27-5/Creatinine; EC 3.2.1.52/Acetylglucosaminidase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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