[The influence of volume load on prognosis of patients with sepsis induced acute kidney injury].

OBJECTIVE: To investigate the influence of volume load on the prognosis of patients with sepsis induced acute kidney injury (AKI).

METHODS: A retrospective study was conducted. Patients with sepsis induced AKI from intensive care unit (ICU) of Binzhou Medical College Hospital from October, 2009 to September, 2011, were studied. 28-day mortality, 28-day renal-recovery rate, ICU stay days and mechanical ventilation rate were compared between negative fluid balance group and positive fluid balance group according to the fluid balance in first 72 hours. The influence of continuous renal replacement therapy (CRRT) on the volume load and the prognosis of patients with sepsis induced AKI were also studied.

RESULTS: One hundred and sixty patients were enrolled. Compared with positive fluid balance group (n=79), 28-day-mortality [37.0% (30/81) vs. 68.4% (54/79), P<0.01], ICU stay time (10.1±4.9 days vs. 12.4±8.0 days, P<0.05) and mechanical ventilation rate [50.6% (41/69) vs. 68.4% (54/819), P<0.01] were lower in negative fluid balance group (n=81). According to Acute Kidney Injury Net (AKIN) staging standard, in stage 1, 2, and 3 of AKI (n=49, n=52, n=59), the day volume of first 72 hours of patients undergoing CRRT were lower than that of patients not undergoing CRRT (-10 ml vs. 716 ml, 324 ml vs. 778 ml, 521 ml vs. 1177 ml, all P<0.05). The 28-day mortality of patients undergoing CRRT was lower than that of patients not undergoing CRRT in stage 2 of AKI [38.7% (12/31) vs. 66.7% (14/21), P<0.05].

CONCLUSIONS: There is a relationship between fluid balance and prognosis of sepsis induced AKI, and 28-day-mortality can be reduced by negative fluid balance. CRRT can regulate fluid balance and improve the prognosis of sepsis induced AKI.