Terapia renal en pacientes con fracaso renal agudo en Unidad de Cuidados Intensivos, terapia de reemplazo renal continua, intermitente prolongada e intermitente: estudio de supervivenci

Abstract

Background

Acute kidney injury (AKI) is a common complication in hospitalized patients, and is an independent predictor of mortality. Approximately 4-5% of patients in ICU will need renal replacement therapy (RRT), and more than two-thirds of these patients will develop AKI, with a mortality of 50 to 60%. Although continuous renal replacement therapy (CRRT) is the preferred treatment in patients with AKI in ICU, especially if there is hemodynamic instability, no differences in survival compared to intermittent hemodialysis (IHD) or hybrid therapies, such as prolonged intermittent renal replacement therapies (PIRRT), have been demonstrated.

Objective

To describe our experience with different renal replacement therapies and the survival of our patients.

Hypothesis

There is no difference in short-term survival between patients with AKI or acute chronic disease who required RRT, such as CRRT or hybrid therapy, than those who were treated using intermittent hemodialysis (IHD).

Methods

A retrospective study was conducted from March 2009 to June 2012 on all patients who were treated with RRT in ICU, with survival being assessed after 28 days follow-up.

Results and conclusions

The study included a total of 33 patients, of whom 20 were male and 13 females. They were divided into therapy groups, with 21 for CRRT, 6 for hybrid therapies, and 6 de IHD. The percentage survival was 28.6% for CRRT, 16.7% for hybrid, and 33.3% for IHD.

It could not be demonstrated that there was a greater survival in any of the therapies in this study.