MO633: Survival Comparison Between CVVHDF and CVVH for Septic Acute Kidney Injury

Abstract

Abstract BACKGROUND AND AIMS The mortality rate of septic acute kidney injury (AKI) remains high despite improvements in renal replacement technology. Adding dialysis to continuous veno-venous hemofiltration (CVVH) can increase survival in these patients, although hemofiltration leads to better clearance of inflammatory mediators in sepsis than hemodialysis. We tested whether continuous veno-venous hemodiafiltration (CVVHDF) is more effective than CVVH with the same net effluent according to body weight in intensive care unit (ICU) patients with septic AKI. METHOD The mortality rate of septic acute kidney injury (AKI) remains high despite improvements in renal replacement technology. Adding dialysis to continuous veno-venous hemofiltration (CVVH) can increase survival in these patients, although hemofiltration leads to better clearance of inflammatory mediators in sepsis than hemodialysis. We tested whether continuous veno-venous hemodiafiltration (CVVHDF) is more effective than CVVH with the same net effluent according to body weight in intensive care unit (ICU) patients with septic AKI. RESULTS In this prospective randomized pilot study, 100 patients were assigned to CVVH (n = 47, M: F = 25:22, age 64 ± 15 years) or CVVHDF (n = 49, M: F = 30:19, age 65 ± 11 years). Baseline characteristics including age, sex, body weight, serum creatinine, blood urea nitrogen (BUN), beta-2 microglobulin, Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores did not vary between the two groups. There were no significant differences in the reduction ratios of serum creatinine, BUN, beta-2 microglobulin, APACHE II and SOFA scores between the two groups. Seven-, 28- and 60-day survival also did not vary. CONCLUSION In conclusion, CVVH and CVVHDF led to similar clearance of waste products and survival at the same net effluent in this study. Future large-scale randomized prospective studies will be needed to confirm these results in critically ill patients with septic AKI.