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Acute kidney injury. the need for renal replacement therapy and complications during the application

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Katerina Karpathiou, Dimitris Panagidis, Olga Kadda, Helen Dokoutsidou, Christine Routsi, Serafim Nanas
Katerina Karpathiou, Dimitris Panagidis, Olga Kadda, Helen Dokoutsidou, Christine Routsi, Serafim Nanas

Abstract


Introduction: Acute kidney  injury (AKI) is a  very common complication of critically ill patients in ICU. It  is  associated  with significantly increased morbidity and mortality. Renal replacement is a treatment with a lot of complications.

Aim: The  aim of  the present  study  was  to  observe the incidence of  AKI, the need for treatment with continuous renal replacement and the problems during the  therapy.

Material and Methods: This  is  an  observational  study. The study sample were patients admitted to the ICU of General  hospital ‘’Evagelismos’’. AKI, was defined according to the  RIFLE criteria. For quantitative variables analysis was used the test of independence through '' t-test (Independent Samples T-Test) '', while the quality was analyzed by X2 test of independence. The analysis was performed with SPSS 19.0 statistical package.

Results: Of the 192 study patients, 28% had AKI and the 17% received renal replacement therapy. AKI is associated with increased mortality which increases as increases the severity. The most commonly problems of treatment were:  hypothermia to 57.5%, hypotension and clotting filters in 54.5% and 51.5%, respectively. Factor that affect early clotting of the extracorporeal circulation, is  the use of heparin versus citrate as anticoagulation.

Conclusions: AKI  is  associated with severe  mortality which increases as increases the severe  of  AKI  stage , respectively. Factor that is associated with higher rates of unsuccessful completion of treatment, is the choice  of  anticoagulation  strategy.


Keywords


Acute Kidney Injury (AKI); renal replacement therapy; complications; acids events; filter span; anticoagulation.

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References


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