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Prognosis of Long-Term Continuous Renal Replacement Therapy and the Impact of Combined Continuous Intravenous Sodium
Akinori Yamaguchi1,2, Atsuyoshi Mita2, Kosuke Sonoda1,2
1Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Introduction:
Patients requiring long-term continuous renal replacement therapy (CRRT) generally have poor prognoses. This study evaluated whether adding continuous intravenous sodium infusion (cIVNa) is associated with improved hemodynamics and outcomes in patients undergoing long-term CRRT for ≥ 7 days.
Methods:
This secondary analysis included 46 patients with acute kidney injury who required ≥ 7 days of CRRT from a previously published cohort. Patients received either conventional CRRT (n = 24) or CRRT plus cIVNa (n = 22). Hemodynamic parameters, fluid balance, laboratory findings, and clinical outcomes were compared.
Results:
cIVNa group exhibited more stable hemodynamics, higher urine output, and a more favorable fluid balance. Rates of 90-day survival without renal replacement therapy (RRT) (42.9% vs. 12.5%, p < 0.05), survival to ICU discharge (68.2% vs. 29.2%, p < 0.05), and CRRT/RRT withdrawal were significantly higher among patients receiving cIVNa than among those receiving conventional CRRT.
Conclusion:
cIVNa may support hemodynamic stability and improve RRT withdrawal and survival outcomes in patients requiring long-term CRRT.
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