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Continuous renal replacement therapy in patients with HIV/AIDS

BMC Nephrology Mar 18, 2020

Guo H, Liu J, Pu L, et al. - Given that HIV-infected patients frequently experience acute kidney injury (AKI) that results in increased morbidity and mortality and continuous renal replacement therapy (CRRT) represent a valuable method and instrument in critically ill patients with fluid overload and metabolic disarray, particularly in those who are unable to tolerate the intermittent hemodialysis, researchers here studied the HIV-infected patients admitted in intensive care unit (ICU) and sought the influence factors associated with CRRT and their prognosis. In the ICU of the Beijing Ditan Hospital Capital Medical University, they enrolled 225 cases for this retrospective case-control study from June 1, 2005 to May 31, 2017. AKI developed in 122 (54.2%) patients during their stay in ICU, the number and percentage of AKI stage 1, 2 and 3 were 38 (31.1%), 21(17.2%) and 63(51.7%), respectively. This indicates a high incidence of AKI in these HIV-infected patients. As per univariate logistics analysis, contributors to a higher mortality at ICU were higher likelihood of diagnosis for respiratory failure, higher likelihood of diagnosis for septic shock, and higher likelihood to use vasoactive agents, longer mechanical ventilation duration, higher likelihood for diagnosis for Pneumocystis Carinii Pneumonia, higher Sequential Organ Failure Assessment score at ICU admission, longer duration of CRRT. They observed higher tendency for admission for CRRT and a consequent poor prognosis among patients with severe AKI.

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