title: The optimal timing of continuous renal replacement therapy for patients with sepsis-induced acute kidney injury.
abstract: OBJECTIVE
  High mortality in the intensive care unit (ICU) is probably associated with sepsis-induced acute kidney injury (AKI). The aim of this study is to explore which stage of AKI may be the optimal timing for continuous renal replacement therapy (CRRT).
  
  
  METHODS
  A retrospective analysis of 160 critically ill patients with septic AKI, treated with or without CRRT was performed in Binzhou medical college affiliated hospital ICU. The parameters including 28-days mortality rate, renal recovery, ventilation time and ICU stay between CRRT group and control group were assessed.
  
  
  RESULTS
  Renal recovery, defined as independence from dialysis at discharge, was documented for 64/76 (84.2 %) of the surviving patients (48.1 % of total subjects included in the study). The mortality rate increased proportionally with acute kidney injury Network stages in CRRT subgroups (P = 0.001) and control groups (P = 0.029). CRRT initiation at stage 2 of AKI significantly reduced the 28-day mortality (P = 0.048) and increased the 28-day survival rate (P = 0.036) compared with those in control group. In addition, the ICU stay and ventilation time were shorter in CRRT group than that of control group in stage 2 of AKI.
  
  
  CONCLUSIONS
  The stage 2 AKI might be the optimal timing for performing CRRT.
authors.affiliation: Intensive Care Unit, Affiliated Hospital of Binzhou Medical University, 661 Yellow River Road, Binzhou, 256603, Shandong, People's Republic of China.
authors.forename: Huanhuan
authors.initials: H
authors.lastname: Tian
authors.forename: Ting
authors.initials: T
authors.lastname: Sun
authors.forename: Dong
authors.initials: D
authors.lastname: Hao
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.forename: Shasha
authors.initials: S
authors.lastname: Han
authors.forename: Zhijiang
authors.initials: Z
authors.lastname: Qi
authors.forename: Zhaoju
authors.initials: Z
authors.lastname: Dong
authors.forename: Changjun
authors.initials: C
authors.lastname: Lv
authors.forename: Xiaozhi
authors.initials: X
authors.lastname: Wang
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007677:Kidney Function Tests; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications* / Q000401:mortality; D013997:Time Factors
chemical_list: D015415:Biomarkers