Overall efficacy of continuous renal replacement therapy in patients with multiple organ dysfunction syndrome without renal damage

Abstract

Objective To explore the efficacy of continuous renal replacement therapy (CRRT) in patients with multiple organ dysfunction syndrome (MODS) without renal damage. Methods A retrospective analysis was made of 190 MODS patients admitted to the emergency department of Sun Yat Sen Memorial Hospital of Sun Yat sen University from March 30, 2012 to February 1, 2018, including 113 males and 77 females, aged 14-97 years with an average age of (61.8) years. A total of 190 patients with MODS were divided into two groups: One group (87 patients, including 29 cases without renal injury) received conventional treatment including etiological treatment, anti-inflammatory treatment, organ function support and other measures; continuous renal replacement therapy was not selected as the conventional treatment group; another group in addition to routine therapy plus with continuous renal replacement therapy, as CRRT group, a total of 103 cases (including 20 patients without renal damage). Two groups of patients were compared before and after treatment for 24 h Marshall score, acute physiology and chronic health rating system Ⅱ (acute physiology and chronic health evaluation Ⅱ, APACHE Ⅱ) score, sequential organ failure (sequential outraged failure assessment, SOFA) score and 28d survival rate of the two groups. Comparison was also made between the two groups of patients without renal damage of 24 h before and after treatment of two subgroups Marshall score, APACHE Ⅱ score, SOFA score and survival rate to evaluate the effect of CRRT 28 days. Results Marshall score before and after the CRRT treatment group (7.2±2.6) and (6.7±2.8), APACHE Ⅱ score (24.0±7.8) and (19.7±7.5) and the SOFA score (11.8±2.6) and (10.7±3.1) were significantly decreased (P 0.05). Without renal damage of conventional Marshall score before and after treatment the treatment group (6.9±3.2) and (7.2±3.2), APACHE Ⅱ score (21.9±8.2) and (21.7±9.0) and SOFA score (10.1±3.2) and (10.3 ±3.2) had no obvious improvement (P> 0.05), and no significant improved survival 28 days P>0.05. Conclusions Early line of continuous renal replacement therapy in the treatment of multiple organ dysfunction syndrome can obviously improve the patients’ condition, raise survival rate of the patients with mid-term but without the renal damage in patients with multiple organ dysfunction syndrome APACHE Ⅱ score can significantly drop, but Marshall grade, SOFA and 28 days survival rate have no significant improvement, and therefore it is not recommended. Key words: Multiple organ dysfunction syndrome; Continuous renal replacement therapy; Mid-term survival rate