Prognostic factors in patients with acute kidney injury requiring continuous renal replacement therapy
10.3760/cma.j.issn.1671-0282.2019.09.004
- VernacularTitle: 急性肾损伤患者连续肾脏替代治疗预后因素分析
- Author:
Yang YU
1
;
Hao XU
;
Cuicui WANG
;
Liang CHEN
;
Aihua FEI
Author Information
1. Emergency Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
- Publication Type:Journal Article
- Keywords:
Acute kidney injury;
Continuous renal replacement therapy;
Prognosis;
ICU;
Risk factors
- From:
Chinese Journal of Emergency Medicine
2019;28(9):1078-1082
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify prognostic factors for mortality in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT).
Methods:A retrospective study was conducted in 138 patients with initiated CRRT due to AKI who were admitted to the Emergency Intensive Care Unit of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2012 to December 2016. According to whether these patients survived after 28 days, they were divided into the death group (58 cases) and survived group (80 cases). Demographic and clinical parameters were retrieved and compared between the two groups. Logistic multivariate regression analysis was performed to determine the risk factors related to mortality.
Results:Of the 138 patients included, 58 patients (42.0%) died after 28 days. Patients in the death group were older, more likely to be male, had a higher score on the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), higher serum lactate level and lower serum creatinine level on admission, higher prevalence of coronary artery disease, and were more likely to be mechanically ventilated or treated with vasopressors. Multivariate logistic regression analysis revealed that age (OR=1.064, 95%CI: 1.022-1.108, P=0.002), APACHEⅡ score (OR=1.127, 95%CI: 1.003-1.265, P=0.044), mechanical ventilation (OR=7.432, 95%CI: 2.183-25.308, P=0.001) and use of vasopressors (OR=24.558, 95%CI: 7.651-78.825, P<0.01) were independent risk factors for mortality.
Conclusions:Older age, higher APACHEⅡ score, mechanical ventilation and use of vasopressors are risk factors for mortality in EICU patients with acute kidney injury requiring CRRT.
