2012, Number 2
Experience with the use continuos renal replacement therapy in patients with acute renal failure (ARF) in intensive care at a private hospital
PDF size: 224.47 Kb.
ABSTRACTBackground: Acute Kidney Injury is a common complication in hospitalized patients, is an independent risk factor of mortality in critical patients. Those who develop acute renal failure and have substitutive treatment could have a 50 to 60 percent of mortality even thought they have substitutive treatment. Continuous renal replacement is an option in patient with acute renal failure in shock state.
Objective: Describe the experience of the use of continuous renal replacement in patient with acute renal failure in the ICU from our hospital. Methods: It is a retrospective, observational and descriptive study. Includes 15 patients from marsh 2009 to October 2010.
Results: Average age is 66.33 years (ED 16.37). The Kind of shock was 60% (9) septic, 27% (4) Mix y 13% (2) cardiogenic. Admission APACHE II was 20.33 (ED 5.85), SOFA 10 (ED 4). The average days in continuous replacement therapy was 5.33 (± 3.75). It was possible to discharge from the therapy in 46.6% (7) of the patient who have an improvement in kidney function. Even though, 66.6% (10) of the patients died while they were in ICU.
Conclusions: Concurs with the literature, our sample, which is a small one, is compatible about the high mortality rate involved directly with the seriousness of the base etiology.
The RENAL Replacement Therapy Study Investigators. Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients. NEJM 2009;361(17):1627-38.
Rimmelé T, Kellum JA. Renal replacement therapy in the ICU. PCCU CHEST article 04. 01.2010.
Golper TA, Schwab SJ. Continuous renal replacement therapies: Overview, Up-to-date 15, April, 2009.
Hoste EA, Schurgers M. Epidemiology of acute kidney injury: How big is the Problem? Crit Care Med 2008:36(4).S146-S151.
Palevsky PM. Indications and timing of renal replacement therapy in acute kidney injury. Crit Care Med 2008;36(Suppl 4):S224-S228.
Brar H, Olivier J. Predictors of mortality in a cohort of intensive care unit patients with acute renal failure receiving continuous renal replacement therapy. The American Journal of the Medical Sciences 2008:335(5). 342-347.
Palevsky PM. Dialysis modality and dosing strategy in acute renal failure. Semin Dial 2006;19:105.
Rauf AA. Intermittent hemodialysis versus continuous renal replacement therapy for acute renal failure in the intensive care unit: an observational outcomes analysis. J Intensive Care Med 2008;23(3):195-203.
John S, Eckardt KU. Renal replacement strategies in the ICU. Chest 2007;132(4):1379-88.
Scherier RW. Fluid administration in critically ill patients with acute kidney injury. Clin J Am Soc Nephrol 2010;5(4):7333-9.
Bouchard J. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int 2009:76-422.
Dennen P. Acute kidney injury in the intensive care unit: an update and primer for the intensivist. Crit Care Med 2010;38(1):261-75.
Cho KC. Survival by dialysis modality in critically ill patients with acute kidney injury. J Am Soc Nephrol 2006;17(11):3131-8.
Li WX, Chen HD. Predictive value of RIFLE classification on prognosis of critically ill patients with acute kidney injury treated with continuous renal replacement therapy. Chen Med J (Engl) 2009;122(9):1020-5.
Ronco C. Continuos renal replacement in critical illness. Contrib Nephrol 2007;156:309-19.