Continuous renal replacement therapy in patients with HIV/AIDS

Area of Science:

• Nephrology
• Infectious Diseases
• Critical Care Medicine

Background:

• Acute kidney injury (AKI) is a significant complication in human immunodeficiency virus (HIV)-infected patients, increasing morbidity and mortality.
• Continuous renal replacement therapy (CRRT) is vital for critically ill patients with fluid overload and metabolic disturbances, particularly those unable to undergo intermittent hemodialysis.
• The epidemiology, CRRT influencing factors, and mortality rates in HIV/AIDS patients in China remain understudied.

Purpose of the Study:

• To investigate the incidence of AKI in HIV-infected patients admitted to the Intensive Care Unit (ICU).
• To explore the factors influencing the need for CRRT in this patient population.
• To analyze the prognostic outcomes for HIV-infected patients requiring CRRT.

Main Methods:

• A retrospective case-control study was conducted at Beijing Ditan Hospital, Capital Medical University.
• Data were collected from 225 HIV-infected patients admitted to the ICU between June 1, 2005, and May 31, 2017.
• Univariate logistic analysis and Cox analysis were employed to identify influencing factors and survival outcomes.

Main Results:

• 54.2% of patients were diagnosed with AKI, with 51.7% having AKI stage 3.
• 26.2% of AKI patients received CRRT, and 56.25% of these patients died in the ICU.
• Factors associated with higher mortality included respiratory failure, septic shock, vasoactive agent use, longer mechanical ventilation duration, Pneumocystis pneumonia (PCP) diagnosis, higher SOFA score, and longer CRRT duration.

Conclusions:

• A high incidence of AKI was observed in HIV-infected ICU patients.
• Patients with severe AKI were more likely to require CRRT.
• CRRT initiation in severe AKI patients was associated with a poor prognosis.