지속적 신대체 요법을 시행받은 급성 신부전증 환자들에서 사망률 예측인자에 대한 분석

Abstract

Purpose: Acute kidney injury (AKI) is a frequent condition with a high mortality rate that requires continuous renal replacement therapy (CRRT). We evaluated the Simplified Acute Physiology Score 3 (SAPS 3) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score, determined at the start of CRRT, for predicting mortality in AKI. Methods: We retrospectively analyzed the demographic, clinical, and laboratory data of 89 patients with AKI or acute-on-chronic kidney disease who received CRRT between September 2006 and September 2009. We calculated the SAPS 3 and APACHE II score at the start of CRRT. Results: The average age of the 89 patients was 64.4±13.9 (17-92) years. Fifty-nine (66.3%) were male. Eighteen (20.2%) patients had chronic kidney disease and 30 (33.7%) had diabetes. The overall mortality was 75.3%. The average SAPS 3 was 89.4±14.9 and the average APACHE II score was 28.4±5.2. The SAPS 3 was higher in non-survivors than survivors (p=0.038). Infection was more common in non-survivors (p=0.036). There were no significant differences between the two groups for other conditions. The variables influencing mortality on univariate analysis were SAPS 3 and presence of infection. The area under the receiver-operating characteristic curve for SAPS 3 was 0.69 (95% CI. 0.54-0.83). At a SAPS 3 of 84, the sensitivity for predicting mortality was 71.6% and the specificity was 69.2%. Conclusion: The SAPS 3 determined before starting CRRT could be a predictor of hospital mortality in patients with AKI.