Continuous Renal Replacement Therapy Versus Intermittent Hemodialysis for Renal Prognosis in Elderly Patients With Acute Kidney Injury.

Abstract

Background: Continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) represent two common modes of renal replacement therapy (RRT) for elderly patients with acute kidney injury (AKI), but their clinical effectiveness is debated. This study aimed to compare the impact of CRRT and IHD on renal prognosis in elderly patients with AKI by analyzing their clinical data. Methods: The retrospective study population included elderly patients admitted to Xiangya Hospital between 2018 and 2022, who required RRT for AKI. Patients were separated into two cohorts based on the original RRT modes (CRRT or IHD). In our study, the primary outcome was recovery of renal function at discharge and the secondary outcome was RRT dependency rate at 90 days. A multivariate logistic regression model was constructed for the purpose of comparing the impact of CRRT and IHD on renal prognosis. Results: The mortality rate at the time of patient discharge was significantly elevated in the CRRT cohort relative to the IHD cohort (49.6% vs. 2.1%, p < 0.001). However, for the 155 patients who survived at discharge, the analysis revealed no statistically significant discrepancy in renal recovery across the two groups (40.3% vs. 59.7%, p = 0.694). Multivariate logistic regression analysis showed no statistically meaningful distinction among the CRRT and IHD groups concerning renal function recovery at discharge. Nevertheless, in comparison with IHD, CRRT reduced the risk of RRT dependence at 90 days. Conclusions: Our study indicated that CRRT and IHD have comparable effects on renal recovery at discharge in elderly patients with AKI who require RRT. However, in comparison with IHD, CRRT was linked to a diminished likelihood of requiring RRT at 90 days.