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논문분류	춘계학술대회 초록집
제목	Early Initiation of Continuous Renal Replacement Therapy May be a Significant Predictor of Mortality in Acute Kidney Injury
저자	Sangeon Gwoo, Ye Na Kim, Ho Sik Shin, Yeon Soon Jung, Hark Rim
출판정보	2013; 2013(1):
키워드	급성신손상, 지속적 신대체요법, 시기/AKI, CRRT, Timing
초록	Background: Approximately 5% of patients admitted to the intensive care units (ICUs) develop severe acute kidney injury (AKI), requiring renal replacement therapy (RRT). AKI is associated with increased mortality rates in ICUs. The effects of the timing of continuous RRT (CRRT) initiation and the characteristics of the infectious process on the clinical outcomes in patients with sepsis seem controversial. The purposes of this study were to compare survival rates between patients in whom CRRT was initiated at early and later stages (early CRRT group and late CRRT group, respectively) and to evaluate the predictors of mortality in both treatment groups. Methods: We evaluated patients with AKI who were treated in the ICU of the Kosin University Gospel Hospital from January 1, 2010 to December 31, 2011. A total of 200 consecutive patients were included over a 48-month period. Predictors of all-cause death were examined using Kaplan-Meier and Cox proportional hazards analyses in both treatment groups. Results: The main contributing factors of AKI were cardiac dysfunction (40%) and sepsis (38%). Overall 28-day mortality rates in the early CRRT group were significantly lower than those in the late CRRT group (p=0.001). Furthermore, early CRRT treatment was independently associated with a lower mortality rate even after adjustment for age, sex, chronic kidney disease, sepsis, and CRRT dose (p= 0.023). Conclusions: This study’s findings suggest that early initiation of CRRT may be a significant predictor of mortality.
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