Wu Buyun, Sun Jian, Liu Si, Yu Xiangbao, Zhu Yamei, Mao Huijuan, Xing Changying
Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Blood Purif. 2017;44(1):32-39. doi: 10.1159/000455063. Epub 2017 Feb 25.
BACKGROUND/AIMS: The study aimed to investigate the relationship among mortality of patients with cardiac surgery-associated acute kidney injury (CSA-AKI), fluid balance, and ultrafiltration of renal replacement therapy (RRT).
From January 2009 to October 2015, hospitalized patients with CSA-AKI receiving continuous or prolonged intermittent RRT were screened. The effects of fluid balance and ultrafiltration of RRT on clinical outcome were analyzed.
The 30-day mortality of all the 63 patients in the study was 58.6%. Compared with the death group, the survival group had a significantly lower fluid balance, larger ultrafiltration volume, and similar ultrafiltration rate during the first 3 days of RRT. Multivariate Cox regression analysis revealed that positive fluid balance during the first day of RRT, cardiac function of grade IV, and higher Sequential Organ Failure Assessment score were independent risk factors of 30-day mortality.
Fluid balance was more relevant to short-term prognosis of CSA-AKI-RRT patients than ultrafiltration volume or ultrafiltration rate.
背景/目的：本研究旨在探讨心脏手术相关急性肾损伤（CSA-AKI）患者的死亡率、液体平衡及肾脏替代治疗（RRT）超滤之间的关系。
筛选2009年1月至2015年10月期间住院并接受持续或延长间歇性RRT的CSA-AKI患者。分析RRT的液体平衡和超滤对临床结局的影响。
本研究中63例患者的30天死亡率为58.6%。与死亡组相比，存活组在RRT的前3天液体平衡显著更低，超滤量更大，超滤率相似。多因素Cox回归分析显示，RRT第一天的正液体平衡、IV级心功能以及更高的序贯器官衰竭评估评分是30天死亡率的独立危险因素。
对于CSA-AKI-RRT患者，液体平衡比超滤量或超滤率与短期预后的相关性更强。
