Continuous Renal Replacement Therapy And Changes In Trace Elements(Copper,Zinc,Iron)in Patients With Sepsis-Associated Acute Kidney Injury

Objective : To observe whether the concentration of trace elements(copper,zinc,iron)were different between patients with sepsis-associated acute kidney injury(SA-AKI)and healthy people.In addition,to preliminarily explore the changes of trace elements(copper,zinc,iron)during continuous renal replacement therapy(CRRT)in patients with SA-AKI.Methods: According to the inclusion and exclusion criteria,a total of 42 patients with SA-AKI who were admitted to the First Affiliated Hospital of Bengbu Medical College from January 2019 to October 2019 were collected,and a total of 19 healthy volunteers were recruited during the same period.All subjects received venous blood samples to determine the concentration of trace elements(copper,zinc,iron)in the body.Patients with SA-AKI were randomized immediately after enrollment and divided into CRRT and non-CRRT groups.Patients in the CRRT group were treated immediately with CRRT.Patients in the non-CRRT group were treated with CRRT as early as 24 hours after enrollment.The observation time window of each patient was 24 hours.After 12 hours and 24 hours of treatment in both groups,venous blood samples were taken again to determine the trace element(copper,zinc,iron)concentration in the body.The data were statistically analyzed using software SPSS 25.0.Results: Compared with the healthy group,patients with SA-AKI had significantly higher trace element copper,significantly reduced zinc and iron,and had significant statistical differences(P<0.01).After admission,patients with SA-AKI were randomly divided into CRRT and non-CRRT groups.There were no significant differences in age,gender,SOFA score,APACHEII score,KDIGO stage,GCS score,serum creatinine value,oxygenation index,platelet count,alanine aminotransferase,bilirubin,noradrenaline between the two groups(P>0.05).In the CRRT group,the three trace elements of copper,zinc and iron decreased 12 hours and 24 hours afteradmission.Among them,there was no statistically significant decrease in the three trace elements 12 hours after admission(P>0.05).The decrease of copper and zinc was statistically significant after 24 hours of admission(P<0.05),and the decrease of iron was not statistically significant(P>0.05).In the non-CRRT group,copper and iron decreased and zinc increased after 12 hours and 24 hours of admission.Among them,the changes of the three trace elements 12 hours after admission were not statistically significant(P>0.05).The decrease of copper was statistically significant(P<0.05),and the changes of zinc and iron were not statistically significant(P>0.05)after 24 hours of admission.Compared with the CRRT group and the non-CRRT group,the changes of the three trace elements were not statistically significant after 12 hours of admission(P>0.05);however,the changes of the three elements were statistically significant after24 hours of admission(P<0.05).Conclusions: 1.The concentration of trace element copper in patients with SA-AKI is higher than that of normal people,while the concentration of zinc and iron is lower than that of normal people.2.There were trace elements(copper,zinc,iron)lost during CRRT in patients with SA-AKI,and the changes were obvious after 24 hours.