Effect of different timing of CRRT combined with CVVH on serum inflammatory factors in patients with sepsis-related acute kidney injury

Yuan Ruining; Qi Xiaoling; Li Yajuan

doi:10.3969/j.issn.1671-6450.2025.07.004

Abstract：Objective To investigate the effect of different timing of continuous renal replacement therapy(CRRT)combined with continuous venous haemofiltration(CVVH)on serum inflammatory factors in patients with sepsis-related acute kidney injury.Methods Patients with sepsis-related acute kidney injury(n=152)admitted to the Blood Purification Center of the Department of Nephrology,the First Affiliated Hospital of Air Force Military Medical University from February 2022 to August 2024 were selected.According to the Global Kidney Disease Prognostic Organization(KDIGO)grading criteria,pa-tients with acute kidney injury grade 1 and 2 who initiated CRRT and CVVH were divided into early group(n=95),and pa-tients with acute kidney injury grade 3 who initiated CRRT and CVVH were divided into late group(n=57).The general data and survival time of patients in the two groups were recorded,and the efficacy indexes,inflammatory factor indexes,renal function indexes and coagulation function indexes of the two groups were compared,and the 90-day survival rate of the two groups was analyzed by using the Kaplan-Meier survival curve.Results After treatment,the urine volume recovery time and mechanical ventilation time of the early group were significantly lower than those of patients in the late group(t/P=5.851/＜0.001,7.871/＜0.001);and the early group's levels of TNF-α,PCT,IL-6,CRP,IFN-γ and VCAM-1 were significantly lower than the late group's(t/P=12.301/＜0.001,8.974/＜0.001,7.295/＜0.001,5.065/＜0.001,5.821/＜0.001,7.830/＜0.001);the early group's levels of BUN,SCr,NGAL,and KIM-1 were significantly lower than the late group's(t/P=9.641/＜0.001,9.106/＜0.001,13.046/＜0.001,6.214/＜0.001);the early group's PT and APTT were significantly longer than the late group's(t/P=6.186/＜0.001,5.867/＜0.001);and the early group's levels of D-dimer and FIB were significantly lower than the late group's(t/P=12.407/＜0.001,12.950/＜0.001);the difference in the survival rate between the early group and the late group was not statistically significant according to the Log-rank test(x2=1.732,P=0.188).Conclusion Early CRRT combined with CVVH is effective in treating patients with sepsis-associated acute kidney injury,decreasing the level of inflammatory factors and im-proving renal and coagulation function,but it has no significant effect on ICU length of stay and survival time.