The Clinical Study Of Blood Purification Therapy On Acute Kidney Injury Induced By Sepsis

Objection: The study was aimed at observing the patients with acute kidneyinjury as a result of sepsis and the relationship with prognosis by twopurification therapy models, and choosing a suitble opportunity according toAPACHEâ…¡score and the AKI'RIFLE standard for increasing restoration rateof renal function and decreasing death rate.Methods:We reviewed retrospectively ninety-six acute kidney injury (AKI)patients induced by sepsis in ICU of Tianhe hospital during March, 2004 toSeptember,2006; Ninety-six patients were allocated into two groups based onpurification models of continuous blood purification(CBP)group for 54 casesand intermittent hemodialysis(IHD) group for 42 cases. At the meanwhile, weclassified 54 CBP patiens into three groups through RIFLE criteria for acutekidney injury; All of these patients'clinnic status and laboratory data, variationof acute physiology and chronic health evaluation(APACHEâ…¡)were observed,and the relationship with prognosis of intergroups were respectively evaluatedon the day 0 hours in ICU,48 hours in ICU,24 hours after the end of the lastpurification in critical stage.Results:â‘ We realized that APACHEâ…¡score and blood Cr of two groupswere not markly difference on the day 0 hours and 48 hours in ICU (P＞0.05),however, APACHEâ…¡score of CBP group was shortly lower than that of IHDgroup after threatment.â‘¡Then, we observed that the individual death rate oftwo groups was samely not statistical diffrrence:CBP[51.9%]vs.IHD[52.4%](P＞0.05), but the restoration rate of renal function was existed statistical difference: CBP [92.3%] vs. IHD [65.0%] (P＜0.05).â‘¢Nextly, the observationexhibited that mean arterial pressure (MAP) and SpO₂ of CBP group werelower than IHD(P＜0.05);After CBP, MAP and SpO₂ were meaninglyincreased (P＜0.05):it existed statistical difference.â‘£Finally, we find out thatthe first group (CBP)'survival rate was 78.6%, APACHEâ…¡score before CBPwas 25.4±2.5, the restoration rate of renal function was 90.9%, APACHEâ…¡variation was -13.6±4.3, these of the third group(CBP) were38.1%, 36.1±5.7,62.5%, -7.1±4.2, it existed statistical difference(P＜0.05).Conclusions: Continuous blood purification may improve prognosis of AKIpatients induced by sepsis; The survival rate and the restoration rate of renalfunction at the first group(CBP) and the patients with APACHEâ…¡(22.9-27.9)score were better than those of the third group. Therefore, we should select asuitble purification opportunity according to APACHEâ…¡score and theincreace degree of renal function.