title: Continuous Renal Replacement Therapy for Acute Renal Failure in Patients with Traumatic Brain Injury.
abstract: OBJECTIVE
  The purpose of this study was to investigate the impact of continuous renal replacement therapy (CRRT) on survival and relevant factors in patients who underwent CRRT after traumatic brain injury (TBI).
  
  
  METHODS
  We retrospectively reviewed the laboratory, clinical, and radiological data of 29 patients who underwent CRRT among 1,190 TBI patients treated at our institution between April 2011 and June 2015. There were 20 men and 9 women, and the mean age was 60.2 years. The mean initial Glasgow Coma Scale score was 9.2, and the mean injury severity score was 24. Kaplan-Meier method and Cox regression were used for analysis of survival and relevant factors.
  
  
  RESULTS
  The actuarial median survival time of the 29 patients was 163 days (range, 3-317). Among the above 29 patients, 22 died with a median survival time of 8 days (range, 3-55). The causes of death were TBI-related in 8, sepsis due to pneumonia or acute respiratory distress syndrome (ARDS) in 4, and multi-organ failure in 10. Among the various factors, urine quantity of more than 500 mL for 24-hours before receiving CRRT was a significant and favorable factor for survival in the multivariate analysis (p=0.026).
  
  
  CONCLUSIONS
  According to our results, we suggest that early intervention with CRRT may be beneficial in the treatment of TBI patients with impending acute renal failure (ARF). To define the therapeutic advantages of early CRRT in the TBI patients with ARF, a well-designed and controlled study with more cases is required.
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: Chang-Yong
authors.initials: CY
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Winjin Green Hospital, Seoul, Korea.
authors.forename: Hyun-Yong
authors.initials: HY
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: Nam-Kyu
authors.initials: NK
authors.lastname: You
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Roh
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: Sook Jin
authors.initials: SJ
authors.lastname: Seo
authors.affiliation: Department of Neurosurgery, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea.
authors.forename: Se-Hyuk
authors.initials: SH
authors.lastname: Kim
keywords: Acute kidney injury; Brain injuries; Intracranial pressure; Renal replacement therapy