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KMID : 0338420080230020058
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The Korean Journal of Internal Medicine
2008 Volume.23 No. 2 p.58 ~ p.63
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Continuous renal replacement therapy for the reatment of acute kidney injury
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Bae Woo-Kyun
Ma Seong-Kwon
Kim Nam-Ho
Choi Ki-Chul
Kim Soo-Wan
Lim Dae-Hun
Jeong Ji-Min
Jung Hae-Young
Kim Seong-Ku
Park Jeong-Woo
Bae Eun-Hui
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Abstract
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Background/Aims:Continuous renal replacement therapy (CRRT) has been widely used for treating critically ill
patients with acute kidney injury (AKI). Whether CRRT is better than intermittent hemodialysis for the treatment of AKI
remains controversial. We sought to identify the clinical features that can predict survival for the patients who are
treated with CRRT.
Methods:We analyzed the data of 125 patients who received CRRT between 2005 and 2007. We identified the
demographic variables, the underlying diagnoses, the duration of CRRT, the mean arterial blood pressure (ABP) and
the Simplified Acute Physiology Score (SAPS) II. The classification/staging system for acute kidney injury (AKI) was
applied to all the patients, who were then divided into stage 1-3 subgroups.
Results:The average age of the patients was 61.414.3 years and the mortality rate was 60% (75 of 125 patients).
The survivors had a significantly higher mean ABP and a higher mean serum bicarbonate level, which were measured
the day after CRRT, than the nonsurvivors (86.723.7 vs. 69.224.6 mm Hg, respectively, 21.43.5 vs. 16.45.4 mmol/L,
respectively,; p<0.05 for each). The stage 3 AKI patients showed the worst parameters for the SAPS II score and the
serum levels of creatinine and blood urea nitrogen. The mortality rate was higher for the stage 3 subgroup than the
other groups (70.5%, p<0.05).
Conclusions :The patients with AKI and who require CRRT continue to have a high mortality rate. A higher mean
ABP and a higher serum bicarbonate level measured the day after CRRT may predict a more favorable prognosis.
The staging system for AKI can improve the ability to predict the outcomes of CRRT patients.
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KEYWORD
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Hemodiafiltration, Acute kidney injury
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