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Differences in CVVH vs. CVVHDF in the management of sepsis-induced acute kidney injury in critically ill patients

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  • Artificial Kidney / Dialysis
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Abstract

We hypothesized that patients with sepsis and AKI, especially patients without preserved renal function, and treated with continuous veno-venous hemodiafiltration (CVVHDF), have lower risk for mortality than patients treated with continuous veno-venous hemofiltration (CVVH). Patients were included if they fulfilled the diagnosis of severe sepsis or septic shock, suffered AKI and received continuous renal replacement therapy (CRRT) in intensive care unit. There were 62 patients treated by CVVH and 75 treated by CVVHDF. Mean survival time was longer in CVVHDF group with oliguric/anuric patients than in CVVH group. CVVH, and not classic risk factors, was associated with higher overall mortality in oliguric/anuric patients. In the linear regression model, hourly urine output was the strongest and positive predictor of longer survival. CVVHDF is according to our results a CRRT modality of choice for the treatment and lower mortality of septic patients with AKI where renal function is no longer preserved. CRRT has been associated with improved renal recovery, but it should be started earlier in AKI evolution with still preserved hourly urine output which is the most sensitive and prognostic marker of survival in septic patients with AKI.

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Authors and Affiliations

  1. Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Kispaticeva 12, 10 000, Zagreb, Croatia

    Vedran Premuzic, Nikolina Basic-Jukic, Bojan Jelakovic & Petar Kes

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  1. Vedran Premuzic
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  2. Nikolina Basic-Jukic
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  3. Bojan Jelakovic
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  4. Petar Kes
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Correspondence to Vedran Premuzic.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Premuzic, V., Basic-Jukic, N., Jelakovic, B. et al. Differences in CVVH vs. CVVHDF in the management of sepsis-induced acute kidney injury in critically ill patients. J Artif Organs 20, 326–334 (2017). https://doi.org/10.1007/s10047-017-0970-9

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  • DOI: https://doi.org/10.1007/s10047-017-0970-9

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