The optimal timing of continuous renal replacement therapy for patients with sepsis-induced acute kidney injury
- 951 Downloads
High mortality in the intensive care unit (ICU) is probably associated with sepsis-induced acute kidney injury (AKI). The aim of this study is to explore which stage of AKI may be the optimal timing for continuous renal replacement therapy (CRRT).
A retrospective analysis of 160 critically ill patients with septic AKI, treated with or without CRRT was performed in Binzhou medical college affiliated hospital ICU. The parameters including 28-days mortality rate, renal recovery, ventilation time and ICU stay between CRRT group and control group were assessed.
Renal recovery, defined as independence from dialysis at discharge, was documented for 64/76 (84.2 %) of the surviving patients (48.1 % of total subjects included in the study). The mortality rate increased proportionally with acute kidney injury Network stages in CRRT subgroups (P = 0.001) and control groups (P = 0.029). CRRT initiation at stage 2 of AKI significantly reduced the 28-day mortality (P = 0.048) and increased the 28-day survival rate (P = 0.036) compared with those in control group. In addition, the ICU stay and ventilation time were shorter in CRRT group than that of control group in stage 2 of AKI.
The stage 2 AKI might be the optimal timing for performing CRRT.
KeywordsSepsis-induced acute kidney injury Continuous blood purification Acute kidney injury network Renal recovery
This study was supported by the Science and Technology Development Plan of Shandong Province (2011GSF11830), Natural Science Foundation of Shandong Province, China (Y2008C163), Department of Education Technology Plan of Shandong Province (J08LG03), Taishan Scholar project. At the same time, we also thank the Binzhou medical school of establishing affiliated hospital ICU medical staff to guide and help; Qilu Hospital of Shandong University professor: Dawei Wu, Shandong Qianfoshan Hospital: Jian Xie professor, Shandong Provincial Hospital Chunting Wang professor, Shandong Yuhuangding Hospital professor Luyi Liu professor.
Conflict of interest
All authors declare that they have no conflict of interest.
- 1.Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N (2007) Beginning and ending supportive therapy for the kidney (BEST Kidney) investigators: Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol 2(3):431–439PubMedCrossRefGoogle Scholar
- 15.Li W-X, Chen H-D, Wang X-W, Zhao S, Chen X-K, Zheng Y, Song Y (2009) Predictive value of RIFLE classification on prognosis of critically ill patients with acute kidney injury treated with continuous renal replacement therapy. Chin Med J (Engl) 122(9):1020–1025Google Scholar