Prognostic factors in continuous hemofiltration therapy for patients with cardiorenal syndrome

The effect of continuous blood purification on the prognosis of cardiorenal syndrome patients

To discuss the effect of continuous blood purification (CBP) on the prognosis of cardiorenal syndrome (CRS) patients. Twenty-seven patients were selected for this study, who had previously been treated at the Blood Purification Center of the General Hospital of Jinan Military Region from May 2007 to October 2010. All patients suffered from chronic heart failure and acute kidney injury. Using a non-invasive hemodynamics monitoring system, we observed the dynamic changes in their cardiac output (CO), systemic vascular resistance (SVR), thoracic fluid capacity (TFC), central venous pressure (CVP), urinary volume, and Acute Physiology and Chronic Health Evaluation II system (APACHEII) score. Individual measurements were obtained at 24 h, 48 h, 72 h, 96 h, and 120 h after CBP treatment. At the same time, levels of serum creatinine (Scr), cysteine proteinase inhibitor Cystatin C (CysC), high sensitivity C-reactive protein (hs-CRP), and serum sodium were observed. The fatality rate at 28 days was also recorded. After 24 h of CBP treatment, acidosis, CO, and disturbances in water and electrolyte levels were all improved. As well, concentrations of Scr and CysC were significantly decreased, and the levels of SVR, TFC, and CVP were also decreased. After 72 h of CBP treatment, hs-CRP levels and APACHE II scores were significantly lower (P < 0.01). From 72 to 120 h of CBP treatment, oliguria was resolved in 24 patients, with improved sensitivity to diuretics. The fatality rate at 28 days was 11.12 %. CBP treatment could improve myocardial function, shorten the oliguria period, decrease the fatality rate, and improve the prognosis of CRS patients.