A Study Of The Start Timing And Prognosis Factors Of RRT Treatment On Acute Renal Injury Patients In Intensive Care Unit

Objective: To discuss the timing of begining renal replacement therapy in acute kidney injury patients in intensive care unit,summary and analysis of relevant prognosis factors.Methods: To choose 106 acute kidney injury patients with multiple organ dysfunction who accepted renal replacement therapy in intensive care unit.All patients in accord with the diagnosis of acute kidney injury standard from2012 KDIGO guidelines.According to the days of patients who diagnosed with AKI III stages,according to the time form they accept RRT treatment,divide into groups as follow: early-treated group(≤24hours),late-treated group(>24hours).Comparison general data: sex?age?protopathy?hypertension?diabetes?sepsis ? AKI pathogeny ? hypovolemia ? the APACHE II score before and after RRT treatment?mechanical ventilation time?Picco cases?the number of organ dysfunction?ICU stays?the recovery of kidney function rate?the recovery of illness rate?death rate in two groups.Comparison datas: mean arterial pressure(MAP)?heart(HR)?urine volume?serum?creatinine?urea nitrogen(BUN)?in inhibition C(CysC)?uric acid(UA)?potassium(K +)?serum sodium(Na +)?albumin(ALB)?PH?Lac?PaO2/FIO2?LMR before and the first day after RRTtreatment in two groups.Comparison the APACHE II score before and after RRT treatment?the ICU stays?RRT treatment time?mechanical ventilation time?Picco cases?the recovery of kidney function rate?the recovery of illness rate?the death rate in different renal replacement therapeutic agent and renal replacement therapeutic time in 106 patients.Univariate and multivariate were performed to identify risk factors associated with prognosis in patients.Results:1.The recovery of kidney function rate :early-treated group is higher than late-treated group.The mechanical ventilation time :late-treated group is higher than early-treated group.There were significant differences between them(P<0.05).For the APACHE II scores before RRT treatment,early-treated group is higher than late-treated group.For the APACHE II scores after RRT treatment,late-treated group is higher than early-treated group.There were significant differences between them(P<0.05).2.For the APACHE II scores after RRT treatment,the middle renal replacement therapeutic agent were less than the low renal replacement therapeutic agent,there were significant differences(P<0.05).There were no significant differences in ICU stays ? RRT treatment time?mechanical ventilation time?Picco cases?the recovery of kidney function rate ? the death rate ? the recovery of illness rate in different renal replacement therapeutic agent(P>0.05).3.There were no significant differences in ICU stays?mechanical ventilation time?Picco cases?the recovery of kidney function rate ? the death rate ? the recovery of illness rate in different renal replacement therapeutic time(P>0.05).4.The data analysis of the recovery of kidney function:age?the number of organ dysfunction?PaO2/FIO2?Lac?serum creatinine ? Cysc,there were significant differences among them(p<0.05).The number of organ dysfunction was independent risk factors of the renal function recovery.5.The data analysis of the prognosis:age ? HR ? the number of organdysfunction ? PaO2/FIO2 ? Lac ? serum creatinine ? Cysc,there were significant differences among them(p<0.05).The number of dysfunction,and Lac were independent dangerous of prognosis.The area of ROC curve of predicting poor prognosis :the number of dysfunction is 0.807,Lac is 0.79,there were significant differences between them(p<0.05).Conclusion:1.For acute kidney injury patients in intensive care unit,sepsis was main cause of acute kidney injury,patients who diagnosed with AKI III stages should begin RRT treatment within 24 hours,improving the renal function recovery.2.The number of organ dysfunction was independent risk factors of the renal function recovery.3.The number of organ dysfunction,Lac were independent risk factors of prognosis,they had high value in predicting poor prognosis for acute kidney injury patients in intensive care unit.