Effect of continuous renal replacement therapy on acute renal failure complicated by multiple organ dysfunction syndrome

Objective To evaluate the effect of continuous renal replacement therapy (CRRT) on acute renal failure (ARF) complicated by multiple organ dysfunction syndrome (MODS) and its technique. Methods Sequential organ failure assessment scores (SOFA)were used to assess the data of the patients with ARF complicated by MODS and the effects of CRRT on the survival patients (8 cases) and death patients (12 cases).Results At the time of entering the ICU, the APACHE-Ⅱ score of the survival group is less than the death group (P=0.04). At the moment the CRRT started, the SOFA score of the survival group is lower than the death group (P=0.018). The circulatory SOFA score in the survival group decreased from (1.80±1.30) to (0.50±0.58)(P=0.028), significantly lower than that of the death group at the 72 hour of CRRT therapy (P=0.016). The total SOFA score in the death group had no significant alteration, but it decreased significantly in the survival group(P=0.021). The SOFA score in the death group was continuously at a high level. At the beginning of the therapy, the SOFA score (14.09±3.59) in the group is significantly higher than the survival group (9.40±3.65) (P=0.030). After the therapy, the SOFA score in the survival group decreased and that in the death group did not derease. Comparing the period from entering ICU to starting CRRT,that of the survival group (1.43±0.78) is significantly shorter than that of the death group (4.91±5.38)(P=0.030). Conclusion Severe damage of non-renal organs' function may be the major cause of death. If we initiate the CRRT therapy as earlier as possible, the prognosis of these patients may be improved.