Comparison of intermittent and continuous renal replacement therapy for sepsis-associated AKI: a retrospective analysis of the Japanese ICU database.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-04-28 DOI:10.1186/s40981-025-00787-8

Hiromu Okano, Hiroshi Okamoto, Haruna Tanaka, Ryota Sakurai, Tsutomu Yamazaki

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引用次数: 0

Abstract

Introduction: While both intermittent renal replacement therapy (IRRT) and continuous renal replacement therapy (CRRT) are used to treat sepsis-associated acute kidney injury (S-AKI), their comparative effectiveness remains unclear. We compared the outcomes between these modalities in patients with S-AKI.

Methods: Data from the Japanese Intensive Care Patient Database (JIPAD) was used for this multi-center retrospective cohort study. Adult patients with S-AKI who received either IRRT or CRRT between 2015 and 2021 were included. The primary outcome was in-hospital mortality. We compared IRRT and CRRT using one-to-three propensity score matching analysis. A subgroup analysis was performed in patients with septic shock.

Results: Of the 756 patients analyzed, 79 received IRRT, and 677 received CRRT. After propensity score matching, baseline characteristics were well-balanced between groups. In-hospital mortality showed no significant difference between IRRT and CRRT (48.6% vs. 38.0%; risk difference - 10.6%; 95% CI - 23.0 to 2.9; P = 0.11). In patients with septic shock, in-hospital mortality was also not different between groups (52.6% vs. 40.4%; risk difference - 12.2%; 95% CI - 28.8 to 3.7; P = 0.10).

Conclusion: IRRT and CRRT may be similar in-hospital mortality in patients with S-AKI. Further studies are warranted to determine the most effective renal replacement modality for this patient population.

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间歇和连续肾替代治疗脓毒症相关AKI的比较：日本ICU数据库的回顾性分析

虽然间歇肾替代疗法（IRRT）和持续肾替代疗法（CRRT）都被用于治疗败血症相关急性肾损伤（S-AKI），但它们的比较效果尚不清楚。我们比较了这些治疗方式在S-AKI患者中的疗效。方法：采用日本重症监护患者数据库（JIPAD）的数据进行多中心回顾性队列研究。纳入了2015年至2021年间接受过IRRT或CRRT的S-AKI成年患者。主要终点是住院死亡率。我们使用1 - 3倾向评分匹配分析比较了IRRT和CRRT。对脓毒性休克患者进行亚组分析。结果：在分析的756例患者中，79例接受了IRRT， 677例接受了CRRT。倾向评分匹配后，各组之间的基线特征平衡良好。住院死亡率在IRRT和CRRT之间无显著差异(48.6% vs 38.0%；风险差- 10.6%；95% CI - 23.0 ~ 2.9；p = 0.11)。在感染性休克患者中，两组间住院死亡率也无差异(52.6% vs 40.4%；风险差- 12.2%；95% CI - 28.8 - 3.7；p = 0.10)。结论：rrt与CRRT在S-AKI患者的住院死亡率可能相似。需要进一步的研究来确定对这类患者最有效的肾脏替代方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.