The study on application time of continuous renal replacement therapy in children with acute kidney injury
10.3760/cma.j.issn.1673-4912.2021.11.001
- VernacularTitle:连续性肾脏替代治疗在儿童急性肾损伤的应用时机探讨
- Author:
Jie HE
1
;
Xiayan KANG
;
Xiong ZHOU
;
Zili CAI
;
Wei DUAN
;
Wenjiao ZHAO
;
Xinping ZHANG
Author Information
1. 湖南省儿童医院急救中心，长沙 410007
- Keywords:
Acute kidney injury;
Continuous kidney replacement therapy;
Application timing;
Children
- From:
Chinese Pediatric Emergency Medicine
2021;28(11):941-945
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of the timing of continuous renal replacement therapy (CRRT) administration on the prognosis of acute kidney injury (AKI) in children.Methods:The medical records of children with AKI who were admitted to the Intensive Care Unit of Hunan Children′s Hospital from March 2015 to February 2020 and underwent CRRT were prospectively analyzed.The children who met the criteria were divided into early group (defined as AKI 1 and 2) and delayed group (defined as AKI 3) according to AKI stage.The general conditions, indicators when CRRT was initiated, and prognosis of the children in two groups were recorded.Results:(1) A total of 39 children were included in the study, including 23 in the early group and 16 in the delayed group.There were no significant differences in age, gender, body weight and proportion of mechanical ventilation between two groups ( P>0.05). The score of critical cases in the early group was higher than that in the delayed group ( P=0.008). (2) There were no significant differences in serum potassium and bicarbonate when CRRT was initiated between two groups ( P>0.05). The urine output in the early group was higher than that in the delayed group ( P>0.001). The serum creatinine and urea nitrogen in the early group were lower than those in the delayed group ( P>0.05). (3) The 28-day survival rate and proportion of renal function recovery at 28 days in the early group were significantly higher than those in the delayed group ( P>0.05). The duration of CRRT, ICU stay and duration of mechanical ventilation in the early group were shorter than those in the delayed group ( P>0.05). Conclusion:Early initiation of CRRT at AKI stage 1 and 2 can improve the 28-day survival rate and renal function recovery of survivors when critically ill children are complicated with AKI.
