Prognosis and its influencing factors in elderly AKI patients after continuous renal replacement therapy

doi:10.3877/cma.j.issn.2095-3216.2023.03.003

Abstract

Abstract:

Objective

To investigate the outcomes and influencing factors of elderly patients with acute kidney injury (AKI) after continuous renal replacement therapy (CRRT).

Methods

Data of elderly AKI patients aged≥80 were collected who received CRRT treatment for 90 days in the hospital from January 2016 to January 2023. Analysis was performed in their survival status, treatment dose, and scores of acute physiological and chronic health evaluation Ⅱ(APACHE Ⅱ) and sequential organ failure assessment (SOFA).

Results

After 90 days of CRRT in 43 AKI patients aged (91.3±6.6), 12 patients survived and 31 died, with a total mortality rate of 72.1%. The APACHE Ⅱ scores of the dead patients (27.2±4.2) were significantly higher than those of the surviving patients (24.0±5.0) (P<0.05). The cumulative survival rates of CRRT treatment for 15 days, 30 days, and 45 days were 71.8%, 56.8%, and 43.2%, respectively. Logistic regression analysis showed that APACHE Ⅱ score and SOFA score were independent influencing factors to affect the prognosis of the patients (P<0.05).

Conclusion

The mortality rate of the elderly AKI patients after the CRRT treatment increased with the increase of APACHE Ⅱ score. The APACHE Ⅱ score and SOFA score were the influencing factors in the initiation of CRRT treatment and prognosis for the elderly AKI patients.

Key words: Continuous renal replacement therapy, Acute kidney injury, Elderly, Prognosis

Tianyu Yu, Yue Yang, Haitao Lu, Zhiyong Tian, Wenge Li. Prognosis and its influencing factors in elderly AKI patients after continuous renal replacement therapy[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(03): 134-138.

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URL: https://zhsbyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3216.2023.03.003

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References 20

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项目	基线数值
年龄(岁)	91.3±6.6
男性[例(%)]	35(81.4)
血肌酐(μmol/L)	245.0(179.8, 333.7)
尿素氮(mmol/L)	28.1(20.3, 40.1)
碳酸氢根离子(mmol/L)	24.7±7.3
血白蛋白(g/L)	33.0(31.0, 36.0)
血钾(mmol/L)	4.5±0.8
血钙(mmol/L)	2.1(1.9, 2.3)
血磷(mmol/)L	1.5±0.7
血红蛋白(g/L)	85.6±16.3
总胆红素(mmol/L)	7.2(4.2, 13.7)
APACHE Ⅱ评分(分)	26.3±4.6
SOFA评分(分)	9.9±2.4
机械通气[例(%)]	30(69.8)
合并症[例(%)]
呼吸衰竭	25(55.8)
心力衰竭	18(41.9)
恶性肿瘤	10(23.3)

项目	基线数值
年龄(岁)	91.3±6.6
男性[例(%)]	35(81.4)
血肌酐(μmol/L)	245.0(179.8, 333.7)
尿素氮(mmol/L)	28.1(20.3, 40.1)
碳酸氢根离子(mmol/L)	24.7±7.3
血白蛋白(g/L)	33.0(31.0, 36.0)
血钾(mmol/L)	4.5±0.8
血钙(mmol/L)	2.1(1.9, 2.3)
血磷(mmol/)L	1.5±0.7
血红蛋白(g/L)	85.6±16.3
总胆红素(mmol/L)	7.2(4.2, 13.7)
APACHE Ⅱ评分(分)	26.3±4.6
SOFA评分(分)	9.9±2.4
机械通气[例(%)]	30(69.8)
合并症[例(%)]
呼吸衰竭	25(55.8)
心力衰竭	18(41.9)
恶性肿瘤	10(23.3)

APACHE Ⅱ评分(分)	生存患者(n＝12)	死亡患者(n＝31)	死亡风险系数	实际死亡率
≤23	6	7	0.22±0.08	53.84
24~30	5	15	0.37±0.06	75.00
≥30	1	9	0.57±0.09	90.00

APACHE Ⅱ评分(分)	生存患者(n＝12)	死亡患者(n＝31)	死亡风险系数	实际死亡率
≤23	6	7	0.22±0.08	53.84
24~30	5	15	0.37±0.06	75.00
≥30	1	9	0.57±0.09	90.00

不同预后结局	例数	治疗剂量[ml/(kg·h)]
不同预后结局	例数	<30	30~35	>35
生存	12	3例	4例	5例
死亡	31	11例	8例	12例
χ²值	0.578
P值	0.834

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