Watcharotone Narongsak, Sayumpoorujinant Wiwat, Udompon Udomsak, Leeaphorn Napat, Kanjanabuch Talerngsak
Saraburi Hospital, Saraburi, Thailand.
J Med Assoc Thai. 2011 Sep;94 Suppl 4:S126-30.
The mortality rate of acute kidney injury (AKI) patients is high despite of new advanced continuous renal replacement therapy (CRRT), which has widely become the treatment of choice in patients who are hemodynamically unstable. Nevertheless, the effectiveness of CRRT in improving the survival outcome is still unclear. Therefore, many centers still use intermittent peritoneal dialysis (IPD) or intermittent hemodialysis (IHD) in hospital where CRRT is unavailable. The present study was carried out to evaluate outcome of AKI patients who were treated with IHD and IPD in Saraburi Hospital.
A retrospective study of AKI patients requiring dialysis during 2004 to 2009 was conducted. Patients who were under 15 years old or underwent more than one modality of dialysis were excluded. Demographic data and mode of RRT were analyzed for survival.
Of all 145 patients, 101 were admitted into ICU. Mean age of patients was 61.6 +/- 17.8 years and 60.7% of all patients were male. Acute tubular necrosis was the most common cause of AKI, whereas volume overload was the leading indication for RRT. Overall mortality was 68.3%. There was no statistically significant difference in mortality rate between the two modes of dialysis.
The mortality rate of AKI patients is high despite having dialysis support. There is no statistically significant difference in mortality rate between IHD and IPD among these patients.
尽管新型先进的连续性肾脏替代疗法（CRRT）已广泛成为血流动力学不稳定患者的首选治疗方法，但急性肾损伤（AKI）患者的死亡率仍然很高。然而，CRRT在改善生存结局方面的有效性仍不明确。因此，在无法开展CRRT的医院，许多中心仍采用间歇性腹膜透析（IPD）或间歇性血液透析（IHD）。本研究旨在评估在沙拉武里医院接受IHD和IPD治疗的AKI患者的结局。
对2004年至2009年期间需要透析的AKI患者进行回顾性研究。排除15岁以下或接受过不止一种透析方式的患者。分析人口统计学数据和肾脏替代治疗方式以评估生存情况。
在所有145例患者中，101例入住重症监护病房。患者的平均年龄为61.6±17.8岁，所有患者中60.7%为男性。急性肾小管坏死是AKI最常见的病因，而容量超负荷是肾脏替代治疗的主要指征。总体死亡率为68.3%。两种透析方式的死亡率之间无统计学显著差异。
尽管有透析支持，AKI患者的死亡率仍然很高。在这些患者中，IHD和IPD的死亡率之间无统计学显著差异。
