Prognostic Factors of Acute Renal Failure Patients Treated with Continuous Renal Replacement Therapy

Korean Journal of Nephrology 2010;29(1):54-63.

Eui Sik Kim, M.D., Young Rok Ham, M.D., Won Ik Jang, M.D., Ji Yoon Jung, M.D. O-Kyoung Kwon, M.D., Sarah Chung, M.D., Dae Eun Choi, M.D., Ki-Ryang Na, M.D. Kang Wook Lee, M.D. and Young-Tai Shin, M.D.

Department of Internal Medicine, College of Medicine Chungnam National University, Daejeon, Korea

원저 : 지속적 신대치요법 (Continuous Renal Replacement Therapy)으로 치료받은 급성 신부전증 환자들의 예후 인자

김의식, 함영록, 장원익, 정지윤, 권오경, 정사라, 최대은, 나기량, 이강욱, 신영태

충남대학교 의과대학 내과학교실

Abstract

Purpose : Continuous renal replacement therapy (CRRT) has been used widely for treating critically ill patients with acute renal failure (ARF). We performed this study to identify predictors of mortality in critically ill ARF patients treated with CRRT. Methods : We analyzed the data of 128 patients who were treated with continuous veno-venous hemofiltration (CVVH) or continuous veno-venous hemodiafiltration (CVVHDF) from May, 2002 to March, 2008. We compared the clinical data of survivors with non-survivors. Results : On univariate analyses of prognostic factors of patients treated with CVVHDF, APACHE II scores (p=0.004), prothrombin time (INR) (p=0.033) and the number of inotropics used (p=0.005) were significantly lower in survivors than those of non-survivors. MAP (p=0.027), diastolic BP (p=0.015) and fibrinogen level (p=0.007) were significantly higher in survivors than those of non-survivors. Multivariate analysis revealed that APACHE II scores and fibrinogen level were the independent factors for the prediction of mortality. And on univariate analyses of prognostic factors of patients treated with CVVH, APACHE II scores (p=0.002) and the number of inotropics used (p=0.006) were significantly lower in survivors than in non-survivors. MAP (p=0.03), systolic BP (p=0.02) and diastolic BP (p=0.03) were significantly higher in survivors than in non-survivors. Multivariate analysis also revealed that APACHE II scores was the only independent factor for the prediction of mortality. Conclusion : This study showed that the independent prognostic factor for mortality in ARF patients treated with CRRT was the APACHE II score.

Key Words: Renal Replacement Therapy, Acute Renal Failure, APACHE II, Prognosis