重症患者伴急性肾损伤行连续肾脏替代疗法的预后因素分析

Outcome prediction of critically Ill patients with acute kidney injury requiring ontinuous renal replacement therapy

目的对重症监护病房(intensive care unit,ICU)中因急性肾损伤而行连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)的重症患者预后进行评估,并对其与死亡相关因素进行分析。方法 对2008年10月-2011年10月我院ICU收治的需要行CRRT治疗的急性肾损伤的重症患者进行回顾性分析研究。结果收治的2106例中伴急性肾损伤且需行CRRT治疗的有189例(9%),而其死亡率为64%。多元统计分析显示高血清肌酐值为预后较好的一个独立的因素,而机械通气(MV)的需求则成为一个预后较差的独立的因素。结论 ICU需行CRRT治疗的急性肾损伤的患者死亡率高。

Objective To determine the outcome and identify the predictors of mortality of critically ill patients treated with CRRT for AKI in the intensive care unit（ICU）.Methods This retrospective cohort study of critically ill patients with AKI requiring CRRT admitted to the ICU was carried out in the Jiangxi province hospital from October 2008 to October 2011.Results A total of 189 of 2106 patients with AKI required CRRT were studied.About 9% of the AKI patients required CRRT and comprised mainly those with medical cause,carrying a mortality of 64%.Multivariate analysis found high serum creatinine as an independent factor for better outcome and requirement of mechanical ventilation（MV） as an independent factor for worse outcome.Conclusion I AKI requiring CRRT in the ICU was associated with a high mortality.