Risk Factors For Mortality In ICU Patients With Acute Kidney Injury Treated With Continuous Renal Replacement Therapy

Objective: Risk factors for mortality in ICU patients with acute kidney injury treated with continuous renal replacement therapy.Methods: A retrospectivel analysis was performed on the data of patients with AKI who no renal basic diseases and treated with CRRT from October,1,2017 to October,31,2019 in the Fourth Hospital of Hebei Medical University.According to the standard of Kidney Disdese:Improving Global Outcomes,the patients were diagnosed and staged.The name,age,bodymass index,comorbidities,fluid balance,central venous pressure and the worst APACHEII score and SOFA score within 24 hours after admission were recorded,and white blood cells,platelets,bilirubin andcreatinine were also recorded.The end point of the study was the 28 day prognosis.According to the 28 day prognosis,the patients were stratified into two groups :survival group and the death group,compared the influence factors of survival group and death group.Results: A total of 302 patients meeting the inclusion criteria were selected,and 133 patients were finally included.The results showed :(1)Compared with the survival group,CVP was significantly higher in the death group before CRRT stopped(P<0.05),and the CFB(Cumulative Fluid Balance,CFB)of the death group wassignificantly higher within7 days after the beginning of CRRT,and withthe increase of treatment days,the difference between the two groupswas more obvious,and APACHE II score,SOFA score and mechanicalventilation time were sig nificantly high in the death group.(2)The results of multivariate regressio n analysis showed that the old age[OR(95%CI):1.033(1.003,1.064),P=0.028 ],the high CVP before CRRT stopped [OR(95%CI):1.375(1.141,1.657),P=0.001],the high APACHE II score [OR(95%CI): 1.117(1.042,1.197),P=0.002 ] were independent risk factors of death.ROC curve analys is,the area under the curve is 0.678?0.808?0.753?Conclusions: 1.Negative fluid balance within 7 days after the beginning of CRRT can significantly improve the prognosis of patients;2.Old age,high APACHE II score,the high CVP before CRRT stopped were independent predictors of mortality in patients.