Efficacy and prognosis of continuous renal replacement therapy at different times in the treatment of patients with sepsis-induced acute kidney injury

Na An; Ruman Chen; Yafei Bai; Mingzhi Xu

Efficacy and prognosis of continuous renal replacement therapy at different times in the treatment of patients with sepsis-induced acute kidney injury

Am J Transl Res. 2021 Jun 15;13(6):7124-7131. eCollection 2021.

Authors

Na An¹, Ruman Chen¹, Yafei Bai¹, Mingzhi Xu¹

Affiliation

¹ Blood Purification Center, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University) Haikou, Hainan Province, China.

PMID: 34306472
PMCID: PMC8290701

Abstract

Objective: To investigate the efficacy and prognosis of CRRT at different times in the treatment of sepsis-induced acute kidney injury (SAKI).

Methods: A total of 156 patients with SAKI were grouped into two groups in accordance with a random number table, with 78 patients in each group. Patients in the observation group (OG) were treated with early CRRT, and in the control group (CG), patients were treated with delayed CRRT. According to whether the patients died, there were 51 cases in the death group and 105 in the survival group. Renal function and inflammatory factors were compared before and after treatment; univariate and multilateral comparison were conducted to analyze the survival status of the patients.

Results: After treatment, the blood urea nitrogen (BUN) and serum creatinine (Scr) in both groups fell below those prior to treatment, while the estimated glomerular filtration rate (eGFR) was elevated (P<0.01); the decrease of BUN and Scr in the OG was greater than that of the other group, while increase eGFR was more than that the other group (P<0.01). After treatment, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in both groups decreased compared to that prior to treatment (P<0.001); the decrease of the three factors in the OG was greater than that in the CG (P<0.05). The 60-day survival rate of patients in the OG was 76.92%, which was higher that of 57.69% in the CG (P<0.05). The age, acute physiology and chronic health enquiry (APACHE-II) score and proportion of chronic obstructive pulmonary disease (COPD) in the death group was elevated compared to those in the survival group, while the number of patients with early CRRT and eGFR level before treatment were lower than those in the survival group (P<0.05). Age was an independent risk factor for the prognosis of SAKI, and early CRRT was a protective factor for the prognosis (P<0.05).

Conclusion: Early CRRT for SAKI can improve the renal function and inflammatory state effectively, and reduce the mortality of patients. Age is an independent risk factor affecting the prognosis of patients with SAKI, and early CRRT is a protective factor for the prognosis.

Keywords: Continuous renal replacement therapy; efficacy; influencing factors; prognosis; sepsis-induced acute kidney injury.