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Analysis of relevant factors for influencing renal recovery at discharge in critically ill patients with acute kidney injury requiring continuous renal replacement therapy / 中国医师进修杂志
Article in Zh | WPRIM | ID: wpr-790213
Responsible library: WPRO
ABSTRACT
Objective To investigate the potential risk factors for influencing renal recovery at discharge in critically ill patients with acute kidney injury (AKI) requiringcontinuous renal replacement therapy (CRRT). Methods This was a single-center, retrospective study. Critically ill patients with AKI requiring CRRT adimitted to the Department of Intensive Care Unit (ICU) in Taizhou Municipal Hospital, Zhejiang province, from June 2014 to December 2017 were included and divided into two groups according to the status of renal recovery at discharge as renal recovery group and renal non-recovery group. The data of acute physiology and chronic health evaluationⅡ(APACHEⅡ) score and sequential organ failure assessment (SOFA) score at adimission to ICU, initial serum creatinine (initial SCr) and lactate level and initial estimated glomerular filtration rate (initial eGFR) at time of AKI diagnosis, and total time of RRT and duration of anuria before CRRT were analyzed. Length of ICU stay and length of hospital stay in both groups were also analyzed. Multivariate logistic regression was taken to analyze the potential risk factors for influencing renal recovery at discharge in critically ill patients with AKI. Results A total of 115 critically ill patients with AKI requiring CRRT were included, of which whom 45 cases were in renal recovery group and 70 cases were in renal non-recovery group, and the renal recovery rate at discharge was 39.1% (45/115); 59 patients were dead during hospitalization and the hospital mortality was 51.3% (59/115). Compared with renal non-recovery group, renal recovery group have a lower value of APACHEⅡscore [(21.73 ± 2.66) scores vs. (23.19 ± 4.41) scores, Pi0.03), SOFA score [(11.02 ± 2.22) scores vs. (12.79 ± 2.82) scores, Pi0.001], lactate level [(3.82 ± 1.34) mmol/L vs. (4.47 ± 1.52) mmol/L, Pi0.021], initial SCr [(2.151 ± 0.677) mg/dl vs. (2.505 ± 0.792) mg/dl, Pi 0.015], duration of anuria before CRRT[(11.80 ± 4.71) h vs. (19.11 ± 5.98) h, Pi0.005] and total time of RRT [(8.64 ± 3.42) d vs. (15.81 ± 5.07) d, Pi0.001], and have a higher value of initial eGFR [(36.26 ± 14.74) ml/(min·1.73 m2) vs. (30.07 ± 10.38) ml/(min·1.73 m2), Pi0.009]. In addition, length of ICU stay [(12.58 ± 4.78) d vs. (15.30 ± 5.45) d, Pi0.007] and length of hospital stay [(19.58 ± 6.44) d vs. (22.11 ± 5.90) d, Pi0.032] in renal recovery group were also significantly lower than those in renal non-recovery group. Multivariate logistic regression analysis indicated that SOFA score ( OR i0.700, 95% CI 0.521-0.941, P i0.018), duration of anuria before CRRT ( OR i0.782, 95% CI 0.689-0.888, P<0.01) and total time of RRT ( OR i0.673, 95% CI 0.565-0.801; P<0.01) were independent risk factors influencing renal recovery at discharge in critically ill patients with AKI, and initial eGFR was a independent protective factor. Conclusions As to critically ill patients with AKI requiring CRRT, there are many factors that affect renal recovery at discharge,. SOFA score, duration of anuria before CRRT and total time of RRT are independent risk factors, and initial eGFR is an independent protective factor.
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Full text: 1 Index: WPRIM Type of study: Observational_studies / Risk_factors_studies Language: Zh Journal: Chinese Journal of Postgraduates of Medicine Year: 2019 Type: Article
Full text: 1 Index: WPRIM Type of study: Observational_studies / Risk_factors_studies Language: Zh Journal: Chinese Journal of Postgraduates of Medicine Year: 2019 Type: Article