Effect of fluid load on the prognosis of children with sepsis-associated acute kidney injury undergoing continuous renal replacement therapy
LAI Zhi-Jun, YANG Wen-Hai, MA Ke-Ze
Department of Pediatric Intensive Care Unit, Dongguan Children's Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong 523325, China
Abstract Objective To evaluate the effect of fluid load on the prognosis of children with sepsis-associated acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT). Methods A total of 121 children who underwent CRRT for sepsis-associated AKI from August 2018 to March 2021 were enrolled in the retrospective study. According to the fluid load from admission or disease progression to CRRT, they were divided into three groups: low fluid load (fluid load: <5%; n=35), high fluid load (fluid load: 5% - <10%; n=35), and fluid overload (fluid load: ≥10%; n=51). Baseline data and clinical biochemical data before CRRT were collected for comparison and analysis. The Kaplan-Meier survival curve analysis was used for comparison of 28-day survival between groups. The multivariate logistic regression model was used to identify the influencing factors for the prognosis of the children. Results The survival analysis showed that the fluid overload group had a significantly higher 28-day mortality rate than the low fluid load and high fluid load groups (P<0.05). The multivariate logistic regression analysis showed that an increase in fluid overload volume was a risk factor for increased 28-day mortality in the fluid overload group, while earlier initiation of CRRT was a protective factor (P<0.05). Conclusions Fluid overload before CRRT may increase the mortality in children with sepsis-associated AKI, and CRRT should be performed for these children as early as possible.
LAI Zhi-Jun,YANG Wen-Hai,MA Ke-Ze. Effect of fluid load on the prognosis of children with sepsis-associated acute kidney injury undergoing continuous renal replacement therapy[J]. CJCP, 2022, 24(3): 279-284.
LAI Zhi-Jun,YANG Wen-Hai,MA Ke-Ze. Effect of fluid load on the prognosis of children with sepsis-associated acute kidney injury undergoing continuous renal replacement therapy[J]. CJCP, 2022, 24(3): 279-284.
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Shaanxi Provincial Diagnosis and Treatment Center of Kawasaki Disease/Children's
Hospital of Shaanxi Provincial People's Hospital; Beijing Children's Hospital, Capital Medical University; Shanghai
Children's Medical Center; Children's Hospital of Shanghai Jiao Tong University; Xianyang Children's Hospital of
Shaanxi Province; Suzhou Children's Hospital, Suzhou University; Children's Hospital of Chongqing Medical University;
Expert Committee of Advanced Training for Pediatrician, China Maternal and Children's Health Association; Editorial Board of
Chinese Journal of Contemporary Pediatrics. Pediatric expert consensus on the application of glucocorticoids in Kawasaki disease[J]. CJCP, 2022, 24(3): 225-231.
