International Urology and Nephrology

, Volume 46, Issue 10, pp 2009–2014 | Cite as

The optimal timing of continuous renal replacement therapy for patients with sepsis-induced acute kidney injury

  • Huanhuan Tian
  • Ting Sun
  • Dong Hao
  • Tao Wang
  • Zhi Li
  • Shasha Han
  • Zhijiang Qi
  • Zhaoju Dong
  • Changjun Lv
  • Xiaozhi Wang
Nephrology - Original Paper

Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusion

The stage 2 AKI might be the optimal timing for performing CRRT.

Keywords

Sepsis-induced acute kidney injury Continuous blood purification Acute kidney injury network Renal recovery 

Notes

Acknowledgments

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.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Huanhuan Tian
    • 1
  • Ting Sun
    • 1
  • Dong Hao
    • 1
  • Tao Wang
    • 1
  • Zhi Li
    • 1
  • Shasha Han
    • 1
  • Zhijiang Qi
    • 1
  • Zhaoju Dong
    • 2
  • Changjun Lv
    • 1
  • Xiaozhi Wang
    • 1
  1. 1.Intensive Care UnitAffiliated Hospital of Binzhou Medical UniversityBinzhouPeople’s Republic of China
  2. 2.Healthy Administration CollegeBinzhou Medical UniversityBinzhouPeople’s Republic of China

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