连续性肾脏替代疗法联合持续性静脉输注钠疗法的临床效果

Clinical effects of combination therapy with continuous renal replacement therapy and continuous intravenous sodium infusion therapy.

作者信息

Yamaguchi Akinori, Mita Atsuyoshi, Sonoda Kosuke, Hashimoto Koji, Imamura Hiroshi, Kamijo Yuji

机构信息

Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

Intensive Care Unit, Shinshu University Hospital, Matsumoto, Nagano, Japan.

出版信息

Ther Apher Dial. 2025 Aug;29(4):543-556. doi: 10.1111/1744-9987.70021. Epub 2025 Apr 15.

DOI:10.1111/1744-9987.70021

PMID:40234097

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12213318/

Abstract

INTRODUCTION

This single-center retrospective study investigated the clinical effects of combination therapy involving continuous renal replacement therapy (CRRT) and continuous intravenous sodium infusion therapy (cIVNa) in critically ill patients with prerenal acute kidney injury (AKI) who were expected to experience insufficient plasma refilling.

METHOD

The clinical data of 92 patients were analyzed. Clinical data from the control (CRRT, n = 49) and intervention (CRRT + cIVNa, n = 43) groups were compared statistically.

RESULTS

Combination therapy increased blood pressure and urine volume, while reducing hypotension events, indicating hemodynamic stabilization. Furthermore, it significantly improved the 90-day survival rate (61.9% vs. 38.8%, p < 0.05), 60-day and 90-day survival rates without RRT (59.5% vs. 28.6%, p < 0.01; 54.8% vs. 26.5%, p < 0.01, respectively), survival discharge rate from intensive care unit, CRRT withdrawal rate, and renal replacement therapy withdrawal rate.

CONCLUSION

Combination therapy with continuous renal replacement therapy and continuous intravenous sodium infusion therapy may be a useful treatment option for critically ill patients with prerenal acute kidney injury who require continuous renal replacement therapy.

摘要

引言

本单中心回顾性研究探讨了连续性肾脏替代治疗（CRRT）联合持续性静脉输注钠治疗（cIVNa）对预计血浆补充不足的肾前性急性肾损伤（AKI）危重症患者的临床效果。

方法

分析92例患者的临床资料。对对照组（CRRT，n = 49）和干预组（CRRT + cIVNa，n = 43）的临床资料进行统计学比较。

结果

联合治疗可提高血压和尿量，同时减少低血压事件，表明血流动力学稳定。此外，它显著提高了90天生存率（61.9%对38.8%，p < 0.05）、无需肾脏替代治疗的60天和90天生存率（分别为59.5%对28.6%，p < 0.01；54.8%对26.5%，p < 0.01）、重症监护病房的生存出院率、CRRT撤机率和肾脏替代治疗撤机率。