Investigate the initiation time of continuous blood purification in the multiple organ dysfunction syndrome patients complicated with acute kidney injury

Objective: The objective was to discuss the initiation time of continuous blood purification (CBP) in the multiple organ dysfunction syndrome (MODS) patients complicated with acute kidney injury (AKI). Materials and Methods: We retrospectively analyzed 84 MODS patients combined AKI treated with CBP in intensive care unit during January 2006 to December 2009. The Acute Physiology and Chronic Health Evaluation II scores, Sequential Organ Failure Assessment scores, and other medical records were reviewed. Different indications for CBP (1 - azotemia, 2 - fluid overload, 3 - hyperklemia, 4 - oliguria, and 5 - metabolic acidosis) were recorded. Patients were characterized as early or late starters, based upon whether the blood urea nitrogen was less than or greater than 25 mmol/L, prior to CBP initiation. Compare the medical records and the mortality of the two groups. Results: The overall mortality in hospital rate was 60.7%. The most indications for CBP initiation were azotemia (95.2%) and oliguria (78.6%). The mortality of the early was 32%, the late was 72.9% ( P = 0.000). Conclusion: Earlier initiation of CBP may improve the prognosis of the MODS patients with AKI.