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Annual Update in Intensive Care and Emergency Medicine 2020 pp 125–133Cite as

Biomarkers of Sepsis During Continuous Renal Replacement Therapy: Have We Found the Appropriate Biomarker to Use Under This Condition?

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Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

Abstract

Numerous biomarkers are now available to monitor the resolution of infection and the effectiveness of therapy against infection. Of the more than 180 biomarkers that have been identified, three are used most frequently in clinical practice—C-reactive protein, procalcitonin and N-terminal prohormone of brain natriuretic peptide. Unfortunately, each of these can be eliminated by continuous renal replacement therapy especially when using new adsorptive membranes. In addition to these three biomarkers of infection, we analyze seven other prominent biomarkers that are also unfortunately subject to removal with continuous renal replacement therapy. There is therefore currently no reliable marker of infection during continuous renal replacement therapy. Thus during continuous dialysis in intensive care unit patients, we are unable to know if infection is being treated effectively because we have no reliable biomarkers. We need to rely upon other methods like clinical evaluation, hemodynamic improvement, and organ failure improvement to cite a few. In the meantime, the odyssey for the search of the right biomarker during continuous dialysis continues.

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References

  1. Pierrakos C, Vincent JL. Sepsis biomarkers: a review. Crit Care. 2010;14:R15.

    Article  Google Scholar 

  2. Honore PM, Jacobs R, De Waele E, Van Gorp V, Spapen HD. Biomarkers of inflammation during continuous renal replacement therapy: sensors, players, or targets? Blood Purif. 2014;38:102–3.

    Article  Google Scholar 

  3. Tillett WS, Francis T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J Exp Med. 1930;52:561–71.

    Article  CAS  Google Scholar 

  4. McFadyen JD, Kiefer J, Braig D, et al. Dissociation of C-reactive protein localizes and amplifies inflammation: evidence for a direct biological role of C-reactive protein and its conformational changes. Front Immunol. 2018;9:1351.

    Google Scholar 

  5. Taylor KE, van den Berg CW. Structural and functional comparison of native pentameric, denatured monomeric and biotinylated C-reactive protein. Immunology. 2007;120:404–11.

    Article  CAS  Google Scholar 

  6. Dahaba AA, Elawady GA, Rehak PH, List WF. Procalcitonin and proinflammatory cytokine clearance during continuous venovenous haemofiltration in septic patients. Anaesth Intensive Care. 2002;30:269–74.

    Article  CAS  Google Scholar 

  7. Matsui T, Nakagawa T, Kikuchi H, Horio H, Hashimura K. The effect of continuous renal replacement therapy with the AN69ST membrane on inflammatory markers and the level of consciousness of hemodialysis patients with stroke: comparison with hemodialysis with low blood flow rate. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2018;39:29–35.

    Google Scholar 

  8. Taylor R, Jones A, Kelly S, et al. A review of the value of procalcitonin as a marker of infection. Cureus. 2017;9:e1148.

    PubMed  PubMed Central  Google Scholar 

  9. Vijayan AL, Ravindran S, Saikant R, Lakshmi S, Kartik R. Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy. J Intensive Care. 2017;5:51.

    Article  Google Scholar 

  10. Level C, Chauveau P, Guisset O, et al. Mass transfer, clearance and plasma concentration of procalcitonin during continuous veno-venous hemofiltration in patients with septic shock and acute oliguric renal failure. Crit Care. 2003;6:R160–6.

    Article  Google Scholar 

  11. Honore PM, Jacobs R, Joannes-Boyau O, et al. Newly designed CRRT membranes for sepsis and SIRS—a pragmatic approach for bedside intensivists summarizing the more recent advances: a systematic structured review. ASAIO J. 2013;59:99–106.

    Article  CAS  Google Scholar 

  12. N L, Zhang Y, Fan S, Xing J, Liu H. BNP and NT-proBNP levels in patients with sepsis. Front Biosci (Landmark Ed). 2013;18:1237–43.

    Article  Google Scholar 

  13. Pirracchio R, Salem R, Mebazaa A. Use of B natriuretic peptide in critically ill patients. Biomark Med. 2009;3:541–7.

    Article  CAS  Google Scholar 

  14. Wahl HG, Graf S, Renz H, Fassbinder W. Elimination of the cardiac natriuretic peptides B-type natriuretic peptide (BNP) and N-terminal proBNP by hemodialysis. Clin Chem. 2004;50:1071–4.

    Article  CAS  Google Scholar 

  15. Yumoto M, Nishida O, Moriyama K, et al. In vitro evaluation of high mobility group box 1 protein removal witvarious membranes for continuous hemofiltration. Ther Apher Dial. 2011;15:385–93.

    Article  CAS  Google Scholar 

  16. Honore PM, Jacobs R, Hendrickx I, De Waele E, Van Gorp V, Spapen HD. To counteract or to clear high-mobility group box-1 protein in influenza A (H1N1) infection? That may become the question. Crit Care. 2015;19:401.

    Article  Google Scholar 

  17. Honore PM, De Bels D, Attou R, Redant S, Gallerani A, Kashani K. Endocan removal during continuous renal replacement therapy: does it affect the reliability of this biomarker? Crit Care. 2019;23:184.

    Article  Google Scholar 

  18. Hureau M, Gaudet A, De Freitas Caires N, et al. Endocan is a reliable biomarker during continuous renal replacement therapy. Crit Care. 2019;23:296.

    Article  Google Scholar 

  19. De Freitas Caires N, Gaudet A, Portier L, Tsicopoulos A, Mathieu D, Lassalle P. Endocan, sepsis, pneumonia, and acute respiratory distress syndrome. Crit Care. 2018;22:280.

    Article  Google Scholar 

  20. Mueller T, Gegenhuber A, Kronabethleitner G, Leitner I, Haltmayer M, Dieplinger B. Plasma concentrations of novel cardiac biomarkers before and after hemodialysis session. Clin Biochem. 2015;48:1163–6.

    Article  CAS  Google Scholar 

  21. Elke G, Bloos F, Wilson DC, et al. The use of mid-regional proadrenomedullin to identify disease severity and treatment response to sepsis—a secondary analysis of a large randomised controlled trial. Crit Care. 2018;22:79.

    Article  Google Scholar 

  22. Honore PM, De Bels D, Attou R, Redant S, Kashani K. The challenge of removal of sepsis markers by continuous hemofiltration. Crit Care. 2019;23:173.

    Article  Google Scholar 

  23. Hansen MB, Rasmussen LS, Garred P, Bidstrup D, Madsen MB, Hyldegaard O. Pentraxin-3 as a marker of disease severity and risk of death in patients with necrotizing soft tissue infections: a nationwide, prospective, observational study. Crit Care. 2016;20:40.

    Article  Google Scholar 

  24. Schilder L, Nurmohamed SA, ter Wee PM, et al. Putative novel mediators of acute kidney injury in critically ill patients: handling by continuous venovenous hemofiltration and effect of anticoagulation modalities. BMC Nephrol. 2015;16:178.

    Article  CAS  Google Scholar 

  25. Honore PM, Spapen HD. Pentraxin-3 to better delineate necrotizing soft tissue infection: not really! Crit Care. 2016;20:173.

    Article  Google Scholar 

  26. Zhang X, Liu D, Liu YN, Wang R, Xie LX. The accuracy of presepsin (sCD14-ST) for the diagnosis of sepsis in adults: a meta-analysis. Crit Care. 2015;19:323.

    Article  Google Scholar 

  27. Honore PM, Jacobs R, Hendrickx I, De Waele E, Van Gorp V, Spapen HD. Presepsin and sepsis-induced acute kidney injury treated with continuous renal replacement therapy: will another promising biomarker bite the dust? Crit Care. 2015;19:428.

    Article  Google Scholar 

  28. Honore PM, De Bels D, Barreto Gutierrez L, Redant S, Spapen HD. Heparin-binding protein in sepsis: player! predictor! positioning? Ann Intensive Care. 2019;9:71.

    Article  CAS  Google Scholar 

  29. Tverring J, Vaara ST, Fisher J, Poukkanen M, Pettilä V, Linder A, FINNAKI Study Group. Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury. Ann Intensive Care. 2017;7:105.

    Article  CAS  Google Scholar 

  30. Honore PM, Jacobs R, Hendrickx I, De Waele E, Van Gorp V, Spapen HD. ‘Biomarking’ infection during continuous renal replacement therapy: still relevant? Crit Care. 2015;19:232.

    Article  Google Scholar 

  31. Schadler D, Pausch C, Heise D, et al. The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: a randomized controlled trial. PLoS One. 2017;12:e0187015.

    Article  CAS  Google Scholar 

  32. Honore PM, Hoste E, Molnár Z, et al. Cytokine removal in human septic shock: where are we and where are we going? Ann Intensive Care. 2019;9:56.

    Article  Google Scholar 

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Authors and Affiliations

  1. ICU Department, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium

    P. M. Honore, S. Redant & D. De Bels

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  1. P. M. Honore
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  2. S. Redant
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  3. D. De Bels
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Correspondence to P. M. Honore .

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Editors and Affiliations

  1. Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

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Honore, P.M., Redant, S., De Bels, D. (2020). Biomarkers of Sepsis During Continuous Renal Replacement Therapy: Have We Found the Appropriate Biomarker to Use Under This Condition?. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2020. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-37323-8_10

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  • DOI: https://doi.org/10.1007/978-3-030-37323-8_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-37322-1

  • Online ISBN: 978-3-030-37323-8

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