|
|
|
| Efficacy of Continuous Renal Replacement Therapy in Patients with Severe Acute Kidney Injury |
| CHEN-Rui |
| Emergent Intensive Care Unit, People's Hospital of Zhongshan City, Zhongshan, 528400, Guangdong,China |
|
|
|
|
Abstract 【Objective】 To investigate the efficacy of continuous renal replacement therapy (CRRT) in patients with severe acute kidney injury (AKI).【Methods】 A total of 92 patients with severe AKI underwent CRRT in our hospital between March 2016 and August 2017 were retrospectively reviewed. Patients were divided into the survival group (n=42 cases) and the death group (n=50 cases) according to the outcomes. The mortality was the main endpoint at 28 days after ICU admission. The The efficacy and related index changes were observed and compared. 【Results】 The hospital stay and ICU stay in the survival group were significantly longer than those in the death group (P<0.05). The unrecovered rate in the survival group was significantly lower than that in the death group (26.19% vs. 76.00%), while the partial recovery rate in the survival group was 57.62% (20/42),which was significantly higher than that in the control group (12.00%, 6/50). The difference was statistically significant (P<0.05). Before the start of CRRT, the MAP and urine volume of the survival group were significantly higher than those of the death group, while the MPV and RDW were significantly lower than those of the death group (P<0.05). After the CRRT, the MPV, PCT and Cys-C of the survival group were significantly lower than those of the death group, and PLT and urine volume were significantly higher than those of death group (P<0.05). Before and after CRRT treatment, the MPV and urine volume in the survival group were significantly higher than those in the death group, while its Cys-C was significantly lower than that in the death group (P<0.05). The multivariate regression analysis showed that preoperative MAP, MPV and postoperative Cys-C were independent factors influencing the prognosis of patients with severe AKI.【Conclusion】 High MAP level is beneficial to the prognosis of severe AKI patients during CRRT.The elevated MPV and Cys-C can be used as independent risk factors for severe AKI mortality.
|
|
Received: 26 March 2019
|
|
|
|
|
|
[1] Kim IY, Kim JH , Lee DW,et al. Fluid overload and survival in critically ill patients with acute kidney injury receiving continuous renal replacement therapy[J].PLoS One,2017, 12(2):134-137.
[2] 陈敏华, 孙仁华, 李茜. 传统肾脏替代治疗开始指标在判断重症急性肾损伤患者预后的价值[J].中华急诊医学杂志, 2016, 25(2):182-189.
[3] Tseng J , Halbert RJ , Minissian N , et al. Association of Standardization of Continuous Renal Replacement Therapy and High-Value Care: An Evidence-Based Approach[J].JAMA Intern Med,2018, 178(4):1124-1126.
[4] 李世军. 改善全球肾脏病预后组织(KDIGO)临床实践指南:肾小球肾炎[J].肾脏病与透析肾移植杂志, 2012, 21(3):260-267.
[5] Kritmetapak K, Peerapornratana S, Srisawat N, et al. The Impact of Macro-and Micronutrients on Predicting Outcomes of Critically Ill Patients Requiring Continuous Renal Replacement Therapy[J].PLoS One,2016, 11(6):631-634.
[6] Pottecher T. High versus Low Blood-Pressure Target in Patients with Septic Shock-NEJM[J].N Engl J Med,2016, 370(17):1583-1593.
[7] 崔俊, 周峻峰, 万献尧. 脓毒症合并急性肾损伤患者连续性肾脏替代治疗剂量的选择[J].中华危重病急救医学, 2016, 28(10):957-960.
[8] Han JS, Park KS, Lee MJ,et al. Mean platelet volume is a prognostic factor in patients with acute kidney injury requiring continuous renal replacement therapy[J].J Criti Care,2016, 29(6):1016-1021.
[9] Oh HJ, Shin DH, Lee MJ, et al. Urine output is associated with prognosis in patients with acute kidney injury requiring continuous renal replacement therapy[J].J Criti Care,2016, 29(4):379-388. |
|
|
|
2020, Vol. 37 
