Prognostic Factors And Efficacy For Continuous Renal Replacement Therapy In Critically Ill Patients

Background There is controversy about the efficacy and prognostic factors for continuous renal replacement therapy（CRRT）in China due to practice variation.Our aim is to investigate these questions.Methods A total of 613 adult patients receiving CRRT in last 3 years（October,2013-October,2016）from one Chinese ICU were enrolled.The analysis of demographic data,vital signs,and laboratory tests prior to CRRT and outcomes were performed.The data between pre-and post-CRRT were compared for efficacy analysis.Results Prior to CRRT,partial pressure of carbon dioxide（PCO₂）,systolic blood pressure（SBP）,gender,age,bilirubin,cystatin C,and mechanical ventilation were correlated with in-hospital mortality.In a binary logistic regression,PCO₂（HR:2.80,95%CI:1.28–6.15,P=0.01）,SBP（HR:0.98,95%CI:0.97–1.00,P=0.04）,age（HR:1.03,95%CI:1.00–1.05,P=0.03）,and gender（HR:2.50,95%CI:1.15–5.44,P=0.02）were significant in predicting mortality.Cox regression analysis demonstrated PCO₂（HR:2.11,95%CI:1.16–3.84,P=0.01）independent association with mortality,and lower SBP（HR:,95%CI:1.49-13.91,P=0.01）worse mortality.CRRT could eliminate the fluid and metabolites.Conclusion CO₂ retention and low SBP prior to CRRT were associated with increased mortality.CRRT significantly improved hemeostasis.