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| Analysis of influencing factors of adverse prognosis of continuous renal replacement therapy in critically ill children with acute kidney injury |
| GUO Yanmei LI Jun’e SUN Hui HUO Ximin XU Meixian WANG Xiaodong |
| The First Department of Critical Care Medicine, Hebei Children’s Hospital, Hebei Province, Shijiazhuang 050031, China |
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Abstract Objective To analyze the influencing factors of adverse prognosis of continuous renal replacement therapy (CRRT) in critically ill children with acute kidney injury. Methods Clinical data of 158 cases with CRRT in critically ill children with acute kidney injury in Hebei Children’s Hospital from January 2017 to December 2019 were retrospectively analyzed. The subjects were followed up for 28 days after entering the pediatric intensive care unit. According to the prognosis, the subjects were divided into the survival group (105 cases) and the death group (53 cases), and the factors affecting the adverse prognosis of CRRT in critically ill children with acute kidney injury were analyzed. Results Septic shock, multiple organ dysfunction, acute kidney injury stage, Serum creatinine (Scr) level at 2 h after admission, urine volume, Scr level before CRRT, cystatin C, microalbuminuria (MAU), transferrin (TRU), α1-microglobulin (α1-MG), N-acetyl-β-D-glucosaminosidase (NAG), acute physiology and chronic health evaluation scoring system Ⅱ (APACHE Ⅱ) score, and estimated glomerular filtration rate (eGFR) between the two groups were compared and the differences were statistically significant (P < 0.05). Septic shock, multiple organ dysfunction, acute kidney injury stage three, Scr level before CRRT≥300.00 μmol/L, cystatin C≥1.00 mg/L, MAU≥7.00 mg/L, α1-MG≥12.00 mg/L, NAG≥24.00 U/L, APACHEⅡ score≥20 points, urine volume<800 mL, and eGFR<100 mL/(min·1.73m2) were risk factors for adverse prognosis of CRRT in critically ill children with acute kidney injury (OR >1, P < 0.05). Conclusion For septic shock, multiple organ dysfunction, acute kidney injury stage three, Scr level before CRRT≥300.00 μmol/L, cystatin C≥1.00 mg/L, MAU≥7.00 mg/L, α1-MG≥12.00 mg/L, NAG≥24.00 U/L, APACHEⅡ score≥20 points, urine volume<800 ml, and eGFR<100 ml/(min·1.73m2) of CRRT in critically ill children with acute kidney injury should be vigilant, active treatment, to reduce the fatality rate of critically ill children with acute kidney injury.
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