Comparison of effect of continuous renal replacement therapy in AKI 2 stage and AKI 3 stage on the prognosis of critical patients with acute kidney injury

Abstract

Objective To compare the effect of continuous renal replacement therapy(CRRT) in AKI 2 stage and AKI 3 stage on the prognosis of critical patients with acute kidney injury(AKI). Methods From February 2017 to October 2018, 56 cases of critical patients with AKI 2-3 stage who underwent CRRT in ICU of our hospital were selected as the research objects. According to the new AKI criteria formulated by the international organization for improving the prognosis of global kidney disease (KDIGO) in 2012, the patients were divided into AKI 2 stage group (n=26) and AKI3 stage group (n=30). The prognostic indexes (length of hospital stay, duration of CRRT, renal function recovery rate in 28 days, all-cause mortality in 28 days) were compared between two groups. The acute physiology and chronic healthⅡ(APACEⅡ)scores were compared between two groups before and after treatment. Survival analysis was performed by Kaplan-Meier in two groups. Results The duration of CRRT [(188.6±112.5)h vs. (96.3±44.7)h], all-cause mortality in 28 d[66.7%(20/30) vs.15.4%(4/26)] of AKI 3 stage group was significantly higher than that of AKI 2 stage group (P<0.05) and the renal function recovery rate in 28 days[36.7%(11/30) vs.92.3%(24/26)] of AKI 3 stage group was significantly lower than that of AKI 2 stage group (P<0.05). After treatment, the APACEⅡscores were significantly reduced in two groups (P<0.05) and the APACEⅡscores[(23.4±3.6) scores vs.(19.8±2.1) scores] of the AKI 3 stage group was significantly higher than that of AKI 2 stage group (P<0.05). The median survival time (34 days vs. 109 days) of AKI 3 stage group was significantly shorter than that of AKI 2 stage group (P<0.05). Conclusions CRRT initiation in AKI 2 stage could significantly reduce all-cause mortality in 28 days, prolong the median survival time and improve the health condition of patients. Key words: Acute Kidney Injury; Renal Replacement Therapy