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Renal replacement therapy neutralizes elevated MIF levels in septic shock

Julia Pohl1, Maria Papathanasiou1, Martin Heisler1

  • 1West-German Heart and Vascular Center Essen, Department of Cardiology and Department ofVascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.

Journal of Intensive Care
|June 18, 2016
PubMed
Abstract

Insights

Continuous renal replacement therapy (CRRT) effectively reduced macrophage migration inhibitory factor (MIF) levels in septic shock patients. Lowering MIF through CRRT correlated with improved survival rates, suggesting a potential therapeutic strategy for severe sepsis.

Area of Science:

  • Critical Care Medicine
  • Immunology
  • Nephrology

Background:

  • Macrophage migration inhibitory factor (MIF) amplifies immune responses in sepsis, but clinical data on its role in septic patients are limited.
  • Renal replacement therapy (RRT) is explored for cytokine removal in sepsis.
  • MIF removal by RRT in chronic kidney disease suggests potential for septic shock patients.

Purpose of the Study:

  • To investigate if RRT can lower plasma levels of the pro-inflammatory cytokine MIF in septic shock patients.
  • To assess the impact of continuous RRT (CRRT) on MIF levels and mortality in septic shock with acute kidney injury (AKI).

Main Methods:

  • Observational, single-center study in an ICU involving 25 septic shock patients.
  • Assessed plasma MIF levels and mortality using a validated method.
  • Compared MIF levels and mortality between patients with and without CRRT for septic AKI.

Main Results:

  • CRRT significantly decreased plasma MIF levels in septic shock patients with AKI, indicating MIF removal by hemodialysis.
  • Patients undergoing CRRT showed lower MIF release (MIFAUC) and distinctly lower mortality.
  • Higher MIF levels and MIFAUC were associated with non-survival in septic shock.

Conclusions:

  • This study demonstrates efficient MIF removal from plasma in septic shock patients via CRRT.
  • Reduction of circulating MIF by CRRT correlated with improved survival.
  • Targeted MIF removal may be a promising therapeutic strategy to reduce mortality in severe sepsis.
Keywords:
HemodialysisICUMIFSeptic shock

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