| アブストラクト | INTRODUCTION: Continuous renal replacement therapy (CRRT) is one of the adjunctive therapies for sepsis. In Japan, the polyethyleneimine-coated polyacrylonitrile membrane (AN69ST) with cytokine adsorption properties was approved in 2014. This study compared 30-day mortality between conventional hemofilter and AN69ST in patients who underwent CRRT in intensive care unit (ICU). METHODS: Using the Diagnosis Procedure Combination (DPC) database provided by Medical Data Vision Co., Ltd. (MDV), our analysis focused on patients who underwent CRRT in ICU from April 1, 2014. The primary outcome was defined as the 30-day mortality rate following the initiation of CRRT treatment. Patients were categorized into two groups: the AN69ST group, in whom CRRT was initiated with AN69ST, and the non-AN69ST group, in whom CRRT was initiated with membranes other than AN69ST. A subgroup analysis was performed to assess whether the effect of AN69ST differed based on the presence or absence of a sepsis diagnosis, and treatment interaction was also evaluated. Furthermore, analysis was conducted considering changes in hemofilters to align with actual clinical practice. RESULTS: A total of 9,147 patients underwent CRRT, including 7,728 in the non-AN69ST group and 1,419 in the AN69ST group. The median age was 72 years. The analysis demonstrated significantly lower 30-day mortality in the AN69ST group (hazard ratio [HR] 0.825, 95% confidence interval [CI] 0.744-0.916) compared with the non-AN69ST group. Subgroup analysis revealed a more pronounced reduction in mortality in the sepsis subgroup (HR 0.781, 95% CI: 0.690-0.884). CONCLUSION: The results of this study suggest that AN69ST membrane use was associated with lower 30-day mortality after the initiation of treatment. The results remained consistent even after considering changes in hemofilter. |
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