Division of Nephrology, St. Michael's Hospital, Toronto, Ontario, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Semin Dial. 2021 Nov;34(6):495-500. doi: 10.1111/sdi.13016. Epub 2021 Sep 17.
Continuous renal replacement therapy (CRRT) is widely used in the care of critically ill patients with acute kidney injury (AKI). Despite hopeful trends suggested by recent studies, mortality among CRRT recipients with severe AKI remains extremely high. Moreover, CRRT does not confer a reduction in mortality in trials comparing CRRT to intermittent RRT modalities. Among AKI survivors, some preliminary studies suggest a higher likelihood of kidney recovery and dialysis independence in CRRT recipients. AKI survivors are at risk for a broad array of adverse outcomes; strategies that may mitigate these risks are discussed.
连续性肾脏替代治疗(CRRT)广泛应用于急性肾损伤(AKI)危重症患者的治疗。尽管最近的研究显示出一些有希望的趋势,但严重 AKI 的 CRRT 接受者的死亡率仍然极高。此外,在比较 CRRT 与间歇性 RRT 方式的试验中,CRRT 并未降低死亡率。在 AKI 幸存者中,一些初步研究表明 CRRT 接受者更有可能恢复肾脏功能并摆脱透析。AKI 幸存者面临广泛的不良后果风险;讨论了可能减轻这些风险的策略。