ROLE OF HEMADSORPTION THERAPY IN SEPSIS AKI, IN A TERITIARYCARE CENTRE IN INDIA

Sepsis AKI(S-AKI), is a commonly encountered problem, 6 -10 million people are falling prey of this critical illness every year, having short- and long-term complications, with mortality is around 25% without the initiation of Kidney Replacement Therapy (KRT) and 50% with initiation of KRT. Sepsis (Sepsis 3 definition) suspected infection with organ dysfunction characterized as a Sequential Organ Failure Assessment (SOFA) score ≥ 2. Acute Kidney Injury (AKI) is defined as sudden decrease in kidney function over hours to days, often reversible diagnosed by decrease in urine output or rise in serum creatinine, commonly staged according to the different definitions like (RIFLE, AKIN, KDIGO), and KDIGO definition is commonly used. S-AKI, is defined as simultaneous presence of sepsis and AKI, sepsis can precede AKI or vice versa or both can occur at a time. In view of lethal nature of S-AKI so many therapies were in pipeline depending on its pathophysiology. Recently the hemadsorption therapy has picked up its momentum, emerging as new frontier in treating S-AKI, by adsorption of cytokines in sepsis and acute kidney injury. We have used two cartridges for haemadsorption, we want to extrapolate the impact of hemadsorption therapy in treating the S-AKI, their utility in S-AKI.

It’s a retrospective observational study, a total of 29 cases, were analyzed from June 2021 to September 2025, who underwent Hemadsorption (OXIRIS, HEMOFEEL) for sepsis AKI in critical care unit of Santhiram medical college to improve the outcomes. OXIRIS is a special system used for nonselective hemadsorption of cytokines and hemodialysis in CRRT machines, Hemofeel is a cartridge used for nonselective hemadsorption of cytokines and hemodialysis in normal dialysis machines. 

Statistical Analysis: Excel was used to enter the data, and it was also used for descriptive and inferential statistics analysis, including assessments of the mean, standard deviation, and proportion. While categorical variables were displayed as percentages and numerical values, normally distributed values were expressed as mean ± standard deviation. Statistical tests, including paired t-test, were used to compare the variables before and after testing. A p-value of less than 0.005 was considered statistically significant. R programming was used to generate Forest plot comparing OXIRIS AND HEMOFEEL, and charts.

In this study of 29, male was majority, individuals between 50 -80 were the majority, all are having Sepsis AKI and 28/29 were having septic shock, majority were diabetic, majority underwent Oxiris, Individuals underwent Oxiris were have high SOFA score, before and after hemadsorption therapy significant improvement in SOFA score before a which is statistically significant, mortality in Oxiris 47.06 and hemofeel 15.38 as the people in oxiris were having high sofa scores, even with the hemadsorption the mortality is 31%.

Hemadsorption therapy, can be used in S AKI to reduce the mortality as effective adjunct to the usual conventional therapies like proper source reduction and use of appropriate antibiotics and antivirals in timely manner