Application of continuous renal replacement therapy and intermittent hemodialysis in patients with severe hemorrhagic fever with renal syndrome

DU Hong; LI Jing; YU Hai-tao; ZHENG Rong; HAN Li-ping; JIANG Wei; WANG Ping-zhong; BAI Xue-fan

Abstract：Objective To observe the application of continuous renal replacement therapy (CRRT) and intermittent hemodia-lysis (IHD) in patients with severe hemorrhagic fever with renal syndrome (HFRS) retrospectively. Methods Totally 147 severe HFRS patients treated with blood purification in our center from Jan. 2008 to Aug. 2012 were enrolled in the study, and divided into a serious-type group and a critical-type group according to the clinical classification. The patients were treated with CRRT or IHD according to the Chinese Medical Association's guideline for blood purification in intensive care unit. The mortality, the occurrence of complications and biochemical parameters during the acute stage were compared between the patients receiving CRRT and IHD in the serious-type group and the critical-type group. Results All the patients in the serious-type group survived. The mortality rates were not significantly different between the patients receiving CRRT and IHD in the critical-type group (P=0.124). The number of the patients receiving CRRT in the critical-type group was more than that in the severe-type group (P<0.001). Among the patients in the overlapping phase, the number of the patients receiving CRRT was more than that of the patients receiving IHD, but the sur-vival rate of these patients receiving CRRT or IHD showed no significant difference (P=1.000). The clinical condition was worse, and extrarenal complications were more frequent in the CRRT group than those in the IHD group. Conclusions CRRT can be used ex-tensively in the treatment of critical-type HFRS patients. CRRT can relieve water load and improve hemodynamic stability effective-ly, which may contribute to a steady progression in the acute stage of the disease.