A retrospective study on application of continuous renal replacement therapy for severe hand foot and mouth disease

Background: The patients with severe hand foot and mouth disease (HFMD) grade 4 will be indicated continuous renal replacement therapy (CRRT), but the mortality rate is still high. The study was conducted to show the application of CRRT for severe HFMD patients in earlier stage improving the mortality. Method: A retrospective case series study was conducted about severe HFMD cases diagnosed clinically according to guidelines of the Ministry of Health and confirmed by Polymerase Chain Reaction (PCR) assay and having CRRT done. Variables would be recorded at admission, at starting CRRT and 16 hours later. The data were processed and analysed by software Stata version 14.0. Results: There were 38 eligible cases included in the study. The mean age was 25.3 months; the male: female ratio was 1.5. Most cases admitted within the first 3 day of illness (94.7%). The rate of HFMD grade 4 and grade 4 indicated CRRT was about 26.3% and 73.7% respectively. Vital signs, haematology parameters, biochemical parameters were improved significantly after 16 hours of CRRT. Average duration of CRRT was 2.4 ± 0.7 days. The survival rate of cases with HFMD grade 3 was 82.1% higher than that of cases with HFMD grade 4 at 40% significantly. Overall survival rate of HFMD patients indicated CRRT was about 71%. Conclusion: The CRRT could be considered as one of the measures that contributed to the improvement of mortality in patients with severe HFMD, and if the CRRT is indicated early it can produce much better results.