Centro Universitário São Francisco de Barreiras, Departamento de Unidade de Terapia Intensiva, Barreiras, BA, Brazil.
Centro Universitário Faculdade de Medicina ABC, Departamento de Análises Clínicas, Santo André, SP, Brazil.
Rev Esc Enferm USP. 2022 Nov 7;56:e20220109. doi: 10.1590/1980-220X-REEUSP-2022-0109en. eCollection 2022.
to analyze the influence of early hemodialysis on the outcome of acute septic kidney injury.
this is an observational, analytical, prospective study with patients diagnosed with acute septic kidney injury on hemodialysis. A questionnaire for data collection was used as an instrument. We used the Shapiro-Wilk, nonparametric Kruskal-Wallis, Mann-Whitney U, Student t and chi-square tests for analysis.
of the 40 patients analyzed, 60% were male, with a mean age of 55 (±16.8) years, and length of hospital stay of 43 (±26.2) days. When separating patients undergoing early and late hemodialysis into two groups, an increase in serum creatinine (p = 0.001) was observed in those who underwent late hemodialysis, however, creatinine ≥ 4mg/dl is one of the characteristics of this group. In both groups, there was a high mortality: 62.5% (10) in the early hemodialysis group and 41.7% (10) in the late hemodialysis group, with vasopressor use (p = 0.001) being the main risk factor.
early onset of hemodialysis in acute septic kidney injury based on KDIGO definitions did not influence the outcome. However, vasopressor use associated with hemodialysis in septic patients was a predictor of death.
分析早期血液透析对急性感染性肾损伤结局的影响。
这是一项观察性、分析性、前瞻性研究，纳入了接受血液透析治疗的急性感染性肾损伤患者。使用问卷调查作为数据收集工具。我们使用 Shapiro-Wilk、非参数 Kruskal-Wallis、Mann-Whitney U、Student t 和卡方检验进行分析。
在分析的 40 名患者中，60%为男性，平均年龄为 55（±16.8）岁，住院时间为 43（±26.2）天。将早期和晚期血液透析的患者分为两组时，晚期血液透析组的血清肌酐升高（p = 0.001），但肌酐≥4mg/dl 是该组的特征之一。两组的死亡率都很高：早期血液透析组为 62.5%（10 例），晚期血液透析组为 41.7%（10 例），血管加压素的使用（p = 0.001）是主要的死亡风险因素。
根据 KDIGO 定义，急性感染性肾损伤的早期血液透析并未影响结局。然而，在感染性休克患者中，血液透析时使用血管加压素是死亡的预测因素。
