Department of Internal Medicine, Botucatu School of Medicine, UNESP, Botucatu, São Paulo, Brazil.
Ren Fail. 2012;34(8):964-9. doi: 10.3109/0886022X.2012.697444. Epub 2012 Jul 5.
Intensity of dialysis dose in acute kidney injury (AKI) might benefit critically ill patients. The aim of this study was to evaluate the effect of intermittent hemodialysis (IHD) dose on mortality in patients with AKI.
Prospective observational study was performed on AKI patients treated with IHD. The delivered dialysis dose per session was calculated based on single-pool Kt/V urea. Patients were allocated in two groups according to the weekly delivered median Kt/V: higher intensity dialysis dose (HID: Kt/V higher than median) and lower intensity dialysis dose (LID: Kt/V lower than median). Thereafter, AKI patients were divided according to the presence or absence of sepsis and urine output. Clinical and lab characteristics and survival of AKI patients were compared.
A total of 121 AKI patients were evaluated. Forty-two patients did not present with sepsis and 45 did not present with oliguria. Mortality rate after 30 days was lower in the HID group without sepsis (14.3% × 47.6%; p = 0.045) and without oliguria (31.8% × 69.5%; p = 0.025). Survival curves also showed that the HID group had higher survival rate when compared with the LID group in non-septic and non-oliguric patients (p = 0.007 and p = 0.003, respectively).
Higher dialysis doses can be associated with better survival of less seriously ill AKI patients.
急性肾损伤（AKI）中透析剂量的强度可能对危重症患者有益。本研究的目的是评估 AKI 患者间歇性血液透析（IHD）剂量对死亡率的影响。
对接受 IHD 治疗的 AKI 患者进行前瞻性观察研究。根据单池尿素 Kt/V 计算每次透析的输送透析剂量。根据每周输送的中位数 Kt/V 将患者分为两组：高透析剂量强度（HID：Kt/V 高于中位数）和低透析剂量强度（LID：Kt/V 低于中位数）。然后，根据是否存在脓毒症和尿量将 AKI 患者进行分组。比较 AKI 患者的临床和实验室特征及生存率。
共评估了 121 例 AKI 患者。42 例患者无脓毒症，45 例患者无少尿。无脓毒症（14.3%×47.6%；p=0.045）和无少尿（31.8%×69.5%；p=0.025）的 HID 组患者 30 天后死亡率较低。生存曲线还表明，与 LID 组相比，非脓毒症和非少尿患者的 HID 组生存率更高（p=0.007 和 p=0.003）。
较高的透析剂量可能与病情较轻的 AKI 患者的生存率提高相关。
