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The optimal timing of continuous renal replacement therapy for patients with sepsis-induced acute kidney injury.
Int Urol Nephrol. 2014 Oct;46(10):2009-14
Authors: Tian H, Sun T, Hao D, Wang T, Li Z, Han S, Qi Z, Dong Z, Lv C, Wang X
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.
PMID: 24913907 [PubMed - indexed for MEDLINE]