早期启动CRRT对老年脓毒症急性肾损伤患者肾功能、全身炎症反应及短期预后的影响

doi:10.3969/j.issn.1001-8131.2025.03.012

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Abstract Objective To explore the effect of early initiation of continuous renal replacement therapy(CRRT)on renal function,systemic inflammatory response and short-term prognosis in elderly patients with acute kidney injury with sepsis. Methods Retrospectively selected 67 elderly patients with sepsis and acute kidney injury admitted to the Emergency intensive care department,early group(n=35)and late group(n=32)in the early group initiated CRRT within 12 hours after confirmed patients with AKI,and CRRT treatment was delayed to 48 hours in the late group.After propensity matching scores for all patient data,using propensity scoring to balance baseline characteristics between groups and adjusting for potential confounding factors,a total of 29 patients with no statistically significant difference in baseline.The treatment effect,renal function,systemic inflammatory response,short-term prognosis,and adverse reactions were compared between the two groups. Results After treatment,the sequential organ failure(SOFA)score,acute physiology and chronic health(APACHE Ⅱ)scores were lower than those in the advanced group(P<0.05).After treatment,the blood creatinine(SCr),urea nitrogen(BUN),hypersensitive C-responsive protein(hs-CRP)(TNF-α)were lower than in the advanced group(P<0.05),while the levels of urinary protein,interleukin-6(IL-6)were similar(P>0.05).The 28 d mortality and ICU stay in the early group were lower than the late group(P<0.05),while the 90 d mortality in the two groups was similar(P>0.05).The adverse reaction rate was similar in the two groups(χ²=0.744,P>0.05). Conclusion Compared with late CRRT,early initiation can improve the condition and renal function of elderly patients with acute kidney injury,relieve systemic inflammatory response,improve short-term prognosis,and have safety.

Key words： sepsis acute kidney injury persistent renal replacement therapy renal function systemic inflammation

Received: 18 February 2025

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R692.3

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	Liu Yanqun
	Sun Lidong
	Yu Jifen

Cite this article:

Liu Yanqun,Sun Lidong,Yu Jifen. Effect of Early Initiation of CRRT on Renal Function,Systemic Inflammatory Response and Short-term Prognosis in Elderly Patients with Septic Acute Kidney Injury[J]. journal1, 2025, 45(3): 43-46.

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http://www.hrbyybjb.org.cn/EN/10.3969/j.issn.1001-8131.2025.03.012 OR http://www.hrbyybjb.org.cn/EN/Y2025/V45/I3/43

[1] 江伟,杜斌.中国脓毒症流行病学现状[J].医学研究生学报,2019,32(1):5-8.
[2] 李青霖,胡新,毛智,等.连续性肾脏替代治疗时机对脓毒症相关急性肾损伤患者28天预后的影响[J].中华老年多器官疾病杂志,2019,18(9):651-655.
[3] Wang Z,Zhang L,Xu F,et al.The association between continuous renal replacement therapy as treatment for sepsis-associated acute kidney injury and trend of lactate trajectory as risk factor of 28-day mortality in intensive care units[J].BMC Emerg Med,2022,22(1):32.
[4] 盛冬来,郑敏,李琛.CRRT治疗老年重症急性肾损伤患者的效果及预后的影响因素分析[J].中华保健医学杂志,2023,25(1):105-107.
[5] Agapito Fonseca J,Gameiro J,Marques F,et al.Timing of Initiation of Renal Replacement Therapy in Sepsis-Associated Acute Kidney Injury[J].Clin Med.2020,9(5):1413.
[6] 吴相伟,叶继辉,孙敏,等.CRRT启动时机与脓毒症相关性AKI患者预后的关系[J].中华危重病急救医学,2020,32(11):1352-1355.
[7] 甘伟忠,卢彩宝,李芙蓉,等.介入时机对CRRT治疗脓毒症致AKI的疗效影响[J].重庆医学,2021,50(8):1385-1388.
[8] 中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].感染、炎症、修复,2019,20(1):3-22.
[9] Kellum JA Lameire N;KDIGO AKI Guideline Work Group.Diagnosis,evaluation,and management of acute kidney injury:a KDIGO summary(Part 1)[J].Crit Care,2013,17(1):204.
[10] 张辉,赵国敏,赵磊,等.全身免疫炎症指数联合序贯器官衰竭评估评分对脓毒症患者预后的评估价值[J].中国临床医生杂志,2023,51(8):983-987.
[11] 范昊,邵韩,臧宝赫.细胞因子联合急性生理学与慢性健康状况评分Ⅱ及多器官功能障碍综合征评分对脓毒症患者短期预后的评价[J].中国临床医生杂志,2023,51(4):496-499.
[12] 许剑云,戴晓勇,沈健,等.不同CRRT治疗时机对脓毒症合并急性肾功能不全患者疗效及预后的影响[J].现代生物医学进展,2018,18(15):2922-2925.
[13] 齐文旗,张斌,郑忠骏,等.拯救脓毒症运动:2021年国际脓毒症和脓毒性休克管理指南[J].中华急诊医学杂志,2021,30(11):1300-1304.
[14] 贺杰,康霞艳,周雄,等.连续性肾脏替代治疗在儿童急性肾损伤的应用时机探讨[J].中国小儿急救医学,2021,28(11):941-945.
[15] 郑金花,韦泽丰,顾申红.不同时机CRRT治疗脓毒症急性肾损伤疗效及对血清炎性因子和肾功能及凝血功能的影响[J].热带医学杂志,2023,23(9):1276-1280.
[16] 张晓媛. 早期连续性肾脏替代治疗对老年心脏手术后急性肾衰竭患者肾功能的影响[J].中国老年学杂志,2021,41(4):815-818.
[17] 孙立新,黄涛,高扬,等.连续性肾脏替代疗法对老年重症急性肾衰竭患者肾功能、血流动力学及炎症因子的影响[J].中国老年学杂志,2019,39(24):6036-6039.
[18] 黄巍. 脓毒症休克患者行连续肾脏替代疗法的治疗时机探讨[J].现代仪器与医疗,2018,24(2):28-30.