EFFECTS OF CRRT AND IHD ON IMMUNE FUNCTION, HEMODYNAMICS, AND PROGNOSIS IN PATIENTS WITH ACUTE RENAL FAILURE
Objective To investigate the effects of continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) on immune function,hemodynamics,and prognosis in patients with acute renal failure (ARF).Methods A prospective study was performed in 140 patients with ARF who were admitted to our hospital from January 2014 to January 2017.They were randomly divided into two groups using a random number table:CRRT group (n =68) and IHD group (n =72).The two groups were treated with CRRT and IHD,respectively.The following indices before and after treatment were compared be tween the two groups:electrolyte,pH,renal function parameters,immune function parameters,hemodynamic parameters,and clinical outcomes.Results At 6 hours after treatment,the CRRT group had significantly better heart rate,mean arterial pressure,systemic vascular resistance,and pulmonary vascular resistance than the IHD group (t =2.496-13.091,P＜0.05).On day 7 of treatment,compared with the IHD group,the CRRT group had significantly lower levels of serum creatinine,blood urea nitrogen,and K+ (t=9.957-14.534,P＜0.05) and significantly higher levels of Na+ and HCO3-and pH (t =4.488-11.791,P＜0.05),as well as significantly higher percentage of CD4+ T cells,CD4+/CD8+ ratio,and levels of IgA and IgG,and a significantly lower percentage of CD8+ T cells (t =8.589-19.425,P ＜0.05);in addition,the CRRT group had a significantly lower APACHE Ⅱ score and significantly shorter time to recovery of urine output,organ support time,and length of ICU stay than the IHD group (t =5.415-8.447,P ＜0.05).The CRRT group had a significantly lower overall incidence rate of cardiovascular events than the IHD group (13.24 ％ vs 33.33 ％,x2 =7.841,P＜0.05).There was no significant difference in survival rate on day 7 of treatment between the two groups (P＞0.05).However,the CRRT group had significantly higher survival rates on days 15 and 30 of treatment (x2=4.503,4.498;P＜0.05) and recovery rates of renal function on days 7,15,and 30 of treatment (x2=4.203-6.460,P＜0.05) compared with the IHD group.Conclusion CRRT and IHD have good efficacy in the treatment of ARF.However,compared with IHD,CRRT can more effectively maintain the stability of the internal environment and hemodynamics and enhance immune function and has fewer effects on the cardiovascular system,so as to improve the clinical outcome of ARF.
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NSTL
万方数据
维普
