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| Therapeutic Effects and Prognostic Analysis of Different Replacement Fluid l Doses of CVVH in Patients with Sepsis Complicated by AKI |
| WENG Chuanyu, GUO Jinchun, HAO Xiaodan |
| General Hospital of Western Theater Command, Sichuan Chengdu 610000, China |
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Abstract Objective: To analyze the therapeutic effects and prognosis of different replacement fluid doses of continuous veno-venous hemofiltration (CVVH) in patients with sepsis complicated by acute kidney injury (AKI). Methods: A retrospective analysis was conducted on 122 patients with sepsis complicated by AKI who underwent CVVH treatment from March 2021 to December 2023.Patients were divided into three groups based on replacement fluid dose:low-dose group (n=20,20~35mL·kg-1·h-1),medium-dose group (n=61,35~45mL·kg-1·h-1),and high-dose group (n=41,45~70 mL·kg-1·h-1).The CVVH treatment duration,mechanical ventilation time,inflammatory factors [high-sensitivity C-reactive protein (hs-CRP),procalcitonin (PCT),tumor necrosis factor-α (TNF-α),and interleukin-6 (IL-6)],renal function [blood urea nitrogen (BUN) and serum creatinine (Scr)],and prognostic indicators [Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score] were compared among the three groups before and after treatment. Results: There were significant differences in hospital stay and mechanical ventilation time among the three groups (P<0.05),with the high-dose group showing significantly shorter durations than the medium- and low-dose groups (P<0.05).Before treatment,there were no significant differences in BUN,Scr,hs-CRP,PCT,TNF-α,and IL-6 levels among the three groups (P>0.05).After treatment,these indicators decreased in all groups (P<0.05),with greater reductions observed in the high-dose group compared to the medium- and low-dose groups (P<0.05).Before treatment,there were no significant differences in APACHE Ⅱ and SOFA scores among the three groups (P>0.05).After treatment,these scores decreased in all groups (P<0.05),with greater reductions in the high-dose group compared to the medium- and low-dose groups (P<0.05). Conclusion: High-dose replacement fluid CVVH is more effective in treating sepsis complicated by AKI,reducing inflammatory factor levels,and improving renal function and prognosis.
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2025, Vol. 31 
