Is Circulating Phospholipase A₂ Removed by Large‐Pore Continuous Venovenous Hemodiafiltration in Septic Acute Renal Failure?

Figures & data

Table 1. Patient Characteristics

Patient	Gender	Age (years)	BW (kg)	AP‐ II score	Pathology	Outcome
1	Male	74	63	18	CABG, aortic‐abdominal graft	Died
2	Female	58	34	16	Bronchoesophageal fistula	Died
3	Female	73	57	10	MNMS	Survived
4	Male	86	56	17	Burn	Died
5	Male	57	60	17	Crush syndrome	Died
6	Female	60	64	11	CABG	Survived
7	Male	80	42	14	CABG	Died
8	Male	73	39	15	Mitral valve replacement	Died
9	Male	76	45	20	Malignant lymphoma	Survived
10	Female	71	47	20	Pulmonary embolism	Survived

BW, body weight; AP‐ II, acute physiology and chronic health evaluation II; CABG, coronary artery bypass graft; MNMS, myonephropathic metabolic syndrome.

Table 2. Parameters of Phospholipase A₂ Clearance (mean ± SD) of LP‐CVVHDF

Parameters	Time after LP‐CVVHDF (hr)
	0	4	12	24
Plasma PLA2 activity	53.9 ± 40.1	46.5 ± 33.6	55.0 ± 40.7	61.2 ± 51.8
Sieving coefficient		0.03 ± 0.03	0.05 ± 0.05	0.08 ± 0.13
Plasma PLA2 CL		28.1 ± 7.6	23.2 ± 8.9a	17.5 ± 8.0a
Ultradiafiltrate PLA2 CL		0.4 ± 0.4	0.9 ± 0.9	1.4 ± 2.2
Adsorption PLA2 CL		27.7 ± 7.9	22.3 ± 8.8a	16.0 ± 8.3a

PLA₂, phospholipase A₂ (pmol/min/mL); CL, clearance (mL/min); LP‐CVVHDF, large‐pore continuous venovenous hemodiafiltration.

^ap < .05 compared with parameter at 4 hr.

Figure 1. Phospholipase A₂ (PLA₂) activity and protein concentration after heparin elution from large‐pore hemofilter. One hemofilter was washed with 1 L of acetate Ringer solution and ten 5‐mL fractions every 100 mL of washed solution (fraction number: F1 to F10) were collected. PLA₂ bound to hemofilter was eluted with 200 mL of saline including 1 mg/mL heparin and two 5 mL‐fractions every 100 mL of eluting solution (fraction number: H1, H2) were collected. Protein concentration (open circle) and PLA₂ activity (solid circle) of each fraction were assayed.

Figure 2. Western blot analysis of the eluted phospholipase A₂ (PLA₂) using anti‐human group IIA PLA₂ monoclonal antibody. The purified IIA PLA₂ (lane 1) and purified PLA₂ including 1 mg/mL heparin (lane 2) were identified as one approximately 14 kD band, and the PLA₂ in eluting solution (H‐1) (lane 3) was identified as an approximately 70 kD band. There was no band in washing solution (F‐10) (lane 4). The PLA₂ in the ultradiafiltrate was identified as an approximately 70 kD band (lane 5).