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Sonography Guided Evaluation of Hemodynamic Indices in Critically Ill Patients Suffering from AKI during CRRT

Morteza Foroumandi1, Seyedpouzhia Shojaei2, Batoul Khoundabi3

  • 1Department of Intensive Care Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Tanaffos
|September 29, 2025
PubMed

Insights

Continuous renal replacement therapy (CRRT) improves hemodynamic stability in critically ill acute kidney injury (AKI) patients. This therapy helps balance cardiovascular parameters, potentially leading to better survival rates.

Area of Science:

  • Nephrology
  • Intensive Care Medicine
  • Critical Care

Background:

  • Continuous renal replacement therapy (CRRT) is increasingly recognized for its role in improving survival among critically ill patients.
  • CRRT is particularly effective in maintaining hemodynamic stability, a crucial factor in critical care settings.

Purpose of the Study:

  • To evaluate the impact of CRRT on hemodynamic parameters in critically ill patients with acute kidney injury (AKI).
  • To assess changes in hemodynamic status before and after CRRT using a point-of-care approach.

Main Methods:

  • An interventional before-after study was conducted on 20 critically ill patients with unstable hemodynamics and AKI.
  • Hemodynamic parameters including heart rate, mean arterial pressure (MAP), central venous pressure (CVP), and ultrasonographic measures (e.g., FTc, PSV, IVC size and distensibility) were assessed before and after CRRT.

Main Results:

  • CRRT significantly altered most ultrasonographic parameters, with notable decreases in IVC size, FTc, MAP, CVP, IJV area, and RI.
  • IVC distensibility index significantly increased post-CRRT.
  • While most patients showed significant changes, carotid PSV and heart rate did not change significantly in all subgroups.

Conclusions:

  • CRRT effectively balances cardiovascular and hemodynamic parameters in critically ill patients with AKI.
  • The application of CRRT in AKI patients can contribute to improved hemodynamic management and potentially enhance survival rates.
Abstract

Keywords:
Acute Renal FailureContinuous Renal Replacement TherapyMedical Intensive Care Unit

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