Efficacy of CA330 hemoadsorption combined with CRRT in sepsis-associated acute kidney injury: A retrospective cohort study

Hemoadsorption regulates sepsis-related inflammatory mediators. The CA330 cartridge, a cross-linked divinylbenzene/polyvinylpyrrolidone (DVB/PVP) adsorbent, is approved in China but no prospective or retrospective clinical studies have validated the efficacy of the CA330 in the context of sepsis-associated acute kidney injury (SA-AKI). This single-center retrospective study (January 2022–December 2024) enrolled 60 SA-AKI patients (SEPSIS-3 criteria, AKI stage II): 30 received CA330 + continuous renal replacement therapy (CRRT), 30 CRRT alone. Key outcomes included hemodynamics, interleukin-6 (IL-6) levels, renal recovery, and mortality. The CA330 group had higher baseline severity (APACHE II score, norepinephrine (NE) requirements, IL-6). After 24h, it showed 60.2% lower NE ( P <.01), 21.2% higher mean arterial pressure ( P <.001), 66.0% lower IL-6 ( P <.01), and higher renal recovery (33.33% vs 16.67%, P = .0221) versus CRRT alone. Intensive care unit mortality was higher in CA330 group (43.33% vs 10%), but APACHE II score (not CA330) independently predicted mortality. Gram-negative bacilli subgroup had more pronounced hemodynamic benefits. No device-related adverse events occurred. CA330 + CRRT improves hemodynamics, cytokine clearance, and renal recovery in SA-AKI, especially in gram-negative infections. Baseline severity explains mortality differences, prospective RCTs are needed to confirm efficacy.