Abstract：【Objective】To investigate the influencing factors of maintenance hemodialysis (MHD) after continuous renal replacement therapy (CRRT) in patients with severe lupus nephritis (LN). 【Methods】A total of 140 patients with severe LN were treated with MHD after CRRT in our hospital. According to the clinical outcome of treatment with MHD for 6 months,patients were divided into the continuous dialysis group (n=57) and the dialysis free group (n=83). General data of patients at the time of enrollment were recorded. Serum creatinine (SCR),blood urea nitrogen (BUN),24-hour urine protein quantification (24hpro),serum complement C3 and C4 levels,and the positive rates of anti-double stranded DNA antibody (anti dsDNA) and anti-nuclear antibody (ANA) of patients in the two groups before MHD treatment were compared. The residual renal function (RRF) and urea clearance rate (Kt/V) of patients within 6 months after MHD treatment were calculated. The predictive indicators and influencing factors of patients who still need to continue dialysis after 6 months of MHD treatment were analyzed. 【Results】There were no significant differences in gender,diabetes mellitus,BUN,serum complement C3 and C4 levels,anti-dsDNA positivity and anti-ANA positive rate between the two groups (P>0.05). The age,Scr and 24hpro levels of the continued dialysis group were significantly higher than those of the free dialysis group,and the RRF and Kt/V were significantly lower than those of the free dialysis group (P<0.05). According to ROC analysis,the areas under the curve of age,Scr,24hpro,RRF and Kt/V in predicting the need for continuing dialysis in patients with severe LN were 0.751,0.651,0.944,0.919 and 0.834,respectively (all P<0.05). Multivariate logistic regression analysis confirmed that age > 57.09 years old,Scr > 461.13 μmol/L,24hpro > 3.405 g/24h,RRF <7.150 mL/min,Kt/V <1.225 were the influencing factors for patients to continue dialysis treatment (P<0.05). 【Conclusion】Age,Scr,24hpro,RRF,Kt/V are the influencing factors for severe LN patients to continue dialysis treatment after CRRT and MHD treatment for 6 months,which deserves clinical attention.
王震霓, 张强, 罗磊. 重症狼疮性肾炎CRRT后行维持性血液透析治疗的疗效影响因素[J]. 医学临床研究, 2022, 39(11): 1676-1679.
WANG Zhen-ni, ZHANG Qiang, LUO Lei. Factors of Influencing Efficacy of Maintenance Hemodialysis after CRRT in Severe Lupus Nephritis. JOURNAL OF CLINICAL RESEARCH, 2022, 39(11): 1676-1679.
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2022, Vol. 39 
