Improved effect of continuous renal replacement therapy in metabolic status and body composition of early phase of acute pancreatitis.

Abstract

To observe the metabolic changes in the early phase of acute pancreatitis (AP) patients induced by continuous renal replacement therapy (CRRT), and to investigate the correlation between the metabolic changes and outcomes of the AP patients. We performed a retrospective analysis in the surgical intensive care unit (ICU) of a tertiary teaching hospital. A total of 169 patients diagnosed as AP were divided into 2 groups: CRRT group (n = 71) and non-CRRT group (n = 98), based on whether they received CRRT for more than 24 hours within 7 days from onset of AP. Measured energy expenditure was measured by indirect calorimetry and predicted energy expenditure was determined by specific equations on admission and day 7 (or the closest day to day 7), respectively. Meanwhile, the body composition was measured by multiple-frequency bioelectrical impedance analyzer. Blood test, body weight and vital signs were analyzed daily for both groups. In this study, we found a significant improvement in the hypermetabolism and fluid distribution of the CRRT group compared with the non-CRRT group. Complications, hospital and ICU length of stays were reduced in CRRT patients. CRRT is an effective treatment for AP patients. Patients with overhydration and hypermetabolism may get improved outcomes from CRRT.