Continuous renal replacement therapy: our experience in intensive care unit.

Area of Science:

• Nephrology
• Intensive Care Medicine
• Critical Care

Background:

• The optimal indication for Continuous Renal Replacement Therapy (CRRT) remains debated.
• Multiple Organ System Failure (MOSF) often involves renal dysfunction, necessitating renal replacement therapy.
• Acute or chronic renal failure in critically ill patients presents significant management challenges.

Purpose of the Study:

• To evaluate the impact of timely CRRT initiation on patient outcomes in MOSF with renal failure.
• To identify predictors of mortality and recovery in this patient cohort.
• To emphasize the importance of a comprehensive treatment strategy in the ICU.

Main Methods:

• Retrospective analysis of 98 patients with MOSF and renal failure treated with CRRT.
• Assessment of mortality rates at 5 days and discharge rates within 21 days.
• Evaluation of APACHE II score and Systemic Inflammatory Response Syndrome (SIRS) as prognostic indicators.

Main Results:

• Mortality after 5 days in the ICU was 60.2%.
• Of the survivors, 39 patients were discharged within 21 days, receiving CRRT for an average of 6.36 days.
• APACHE II score did not predict outcomes for acute renal failure (ARF) patients, while SIRS incidence was higher in non-survivors.

Conclusions:

• Immediate initiation of dialytic treatment, including CRRT, is vital for improving survival in MOSF patients with renal damage.
• A multidisciplinary approach is essential for managing metabolic, infectious, and nutritional complications in ICU patients.
• Early intervention and comprehensive care are key to enhancing patient survival in critical illness.