[Continuous renal replacement therapy on patients of multiple organs dysfunction syndrome with acute renal failure]

To investigate the clinical effect of continuous renal replacement therapy (CRRT) on patients of multiple organ dysfunction syndrome (MODS) with acute renal failure (ARF).

Twenty-two MODS cases with ARF underwent CRRT. Blood urea nitrogen (BUN), serum creatinine (SCr), hydrocarbons, serum potassium, and artery blood pH were detected in all patients every morning after hemopurification, in all patients volumes of infused fluid were recorded. The experience in 17 MODS cases with ARF treated with intermittent hemodialysis (IHD) in our hospital before October 1999 was present.

The volumes of infused fluid were (5,237+/-106) ml and (2,319+/-87) ml in CRRT and IHD group respectively (P<0.05). In IHD group, 8 cases had cardiac failure between two hemodialysis sessions, and 13 cases had hypotension during hemodialysis; but in CRRT group there were only 1 and 3 cases respectively (both P<0.01). Mean levels of above BUN, SCr in IHD group were significantly higher than those in CRRT group (both P<0.05). The survival rates were 35.3% (6/17) and 45.5% (10/22) in IHD and CRRT group respectively, in the survival group, there were significantly less need of mechanical ventilation and vasoactive supporting.

CRRT has benefits in improving fluid balance, acid-base balance and azotemia beyond IHD. The patient's age, need of mechanical ventilation and vasoactive drugs are predictors of a worse prognosis in patients of MODS with ARF. The prognosis of MODS with ARF is improved with CRRT.