| Continuous Renal Replacement Therapy (CRRT) in Intensive Care Unit (ICU) Patients with Acute Renal Failure |
| Eun Ah Hwang, M.D., Jeong Soo Yoon, M.D., Mi Hyun Jang, M.D., Jung Eun Kim, M.D., Seong Sik Kang, M.D., Go Choi, M.D., Seung Yeup Han, M.D., Sung Bae Park, M.D. and Hyun Chul Kim, M.D. |
| Department of Internal Medicine, Keimyung University School of Medicine, Kidney Institutue |
| 원저 : 중환자실에 입원한 급성 신부전 환자에서 지속적 신대체요법 |
| 황은아, 윤정수, 장미현, 김정은, 강성식, 최 고, 한승엽, 박성배, 김현철 |
| 계명대학교 의과대학 내과학교실, 계명대학교 신장연구소 |
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| Abstract |
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Purpose:The mortality rate in critically ill patients with acute renal failure (ARF) remains unacceptably high, despite numerous advances in dialysis techniques and intensive care medicine. We evaluated clinical characteristics and prognostic factors in ICU patients with ARF requiring continuous renal replacement therapy (CRRT).
Methods:We retrospectively reviewed the medical records of all ICU patients who received CRRT at the Keimyung University Dongsan Hospital from September 2002 to October 2007.
Results:Total number of patients who required CRRT in ICU was 58. The mean age was 58.3±14.8 years. The treatment duration of CRRT was 63.5±40.7 hours. The mechanical ventilation rate was 82.8%, vasoactive drug 79.3%, sepsis 39.7%. APACHE II score was 25.2±7.9, SAPS II score 48.1± 15.1, CCF score 9.3±3.6, the number of organ dysfunction 2.1±1.3. Overall mortality rate was 48%. When we compared sepsis group with non-sepsis group, the number of organ dysfunction and severity of illness were significantly higher in sepsis group than that of non-sepsis group. A mortality rate of sepsis group was significantly higher than non-sepsis group (82.6% vs 31.3%, p<0.001). In univariate analysis, significant risk factors for mortality were the number of organ dysfunction, severity of illness, MAP, platelet count, serum albumin level, and a type of hemofilter. Significances of all these factors were lost in multiple linear regression analysis.
Conclusion:A large scaled, prospective randomized multi-center trials are needed to confirm the beneficial effect of CRRT in patient with ARF in ICU. |
| Key Words:
Critical illness, Hypotension, Natriuresis, Polyuria, Adrenal insufficiency |
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