engleski

CONTINUOUS RENAL REPLACEMENT THERAPY IN PATIENTS WITH ACUTE KIDNEY INJURY – AN EXPERIENCE FROM UHC RIJEKA

Background/Aim: Acute kidney injury (AKI) is a clinical syndrome characterized by sudden reduction in renal function, followed by oliguria or anuria. Despite the progress in modern medicine, the mortality from AKI is still high. Therefore, we were interested to analyze the effect of continuous renal replacement therapy (CRRT) on the survival of our patients with AKI. Patients and Methods: In this retrospective study we have analyzed 299 patients treated with CRRT in intensive care unit (ICU) in the period from 01 January 2010 to 30 June 2015. Patients’ demographic characteristic, as well as prescribed CRRT therapy and patients’ outcome were analyzed. Results: Out of 299 analyzed patients, there were 201 (67%) men and 98 (33%) women with an average age over 65 years of age (ranging from 1-89 years). The most common prescribed treatment was a continuous veno-venous hemodialysis (CVVHD) (85% of our patients), followed by veno-venous hemodiafiltration (CVVHDF) (12.7%) patients and continuous veno-venous hemofiltration (CVVH) in 7 (2.3%) of them. CVVHDF using AN69 membrane was applied in 11 (29%) patients. Average duration of treatment lasted for 72 (range 1-489) hours. The average prescribed dialysate flow was 1488 ml/h (500-3000ml / h) and the average flow of replacement of the solution was 1475 ml/h (600-3000 ml/h). Additionally, prescribed predilution (prescribed in 44 patients) and postdilution (prescribed in 45 patients) solutions were ranged from 0-2000ml/h. The average blood flow was adjusted to 200 ml/min (range 30-400 ml/min) with an average ultrafiltration rate of 135 ml/h (range of 0-400ml/h). The most common used anticoagulation were enoxaparin (90%) and fractionated heparin (4.3%). On the other hand, in 1.7% of patients we did not used anticoagulation during the CRRT treatment. Of 299 analyzed patients, 107 (35.8%) of them died, while, 23 (7.7%) of patients did not recovered their renal function and continued further renal replacement therapy. One hundred and thirty (56.5%) patients had recovered their renal function in the end of the CRRT treatment. Conclusion: The incidence of AKI in the ICU was 30% and the mortality rate is around 50%. Although, the mortality rate in patients with AKI treated with CRRT is still high, the percentage of patients with preserved renal function is increasing.

CONTINUOUS RENAL REPLACEMENT THERAPY

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