Continuous Renal Replacement Therapy (CRRT) in Intensive Care Unit (ICU) Patients with Acute Renal Failure

Hwang, Eun Ah; Yoon, Jeong Soo; Jang, Mi Hyun; Kim, Jung Eun; Kang, Seong Sik; Choi, Go; Han, Seung Yeup; Park, Sung Bae; Kim, Hyun Chul

Abstract

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.