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Published on: July 19, 2018
Patterns and Mechanisms of Artificial Kidney Failure during Continuous Renal Replacement Therapy
Ling Zhang1, Aiko Tanaka, Guijun Zhu
1Department of Nephrology, West China Hospital of Sichuan University, Sichuan, Chengdu, China.
Background:
We aimed to describe the previously unstudied relationship between circuit pressures and circuit clotting, here labeled as 'artificial kidney failure' (AKF), in patients receiving continuous renal replacement therapy (CRRT).
Methods:
We performed an observational study of CRRT-treated critically ill patients to continuously record the multiple CRRT circuit pressures.
Results:
Three patterns of access outflow dysfunction (AOD) were also noted: severe, moderate and mild. Compared with circuits without AOD, circuits experiencing at least one AOD episode had shorter lifespans (14.2 ± 12.7 vs. 21.3 ± 16.5 h, p = 0.057). This effect was more obvious with moderate or severe AOD (8.7 ± 4.6 vs. 20.6 ± 15.7 h, p = 0.007). If any AOD events occurred within the first 4 h, the sensitivity and specificity in predicting early-immediate AKF were 53.4 and 94.4%, respectively.
Conclusions:
Early and intermediate AKF during CRRT is most likely dependent on AOD, which is a frequent event with variable severity.
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