Abstract: 【Abstract】 Objective To evaluate the appropriate period and blood purification method for the treatment of sepsis-induced acute kidney injury by using Risk, Injury, Failure, Loss, and End-stage Kidney Classification for acute kidney injury (RIFLE criteria for AKI) and APACHE II score. Methods We retrospectively analyzed 96 sepsis-induced acute kidney injury patients treated in the ICU of Tianjin Tianhe Hospital during the period from March 2004 through September 2006. They were assigned in the continuous renal replacement therapy (CRRT) group (54 cases) or the intermittent hemodialysis (IHD) group (42 cases). In the CRRT group, patients were evaluated by RIFLE criteria for AKI, from which 14 cases were at stage I, 19 cases at stage II, and 21 cases at stage III. Their vital signs, laboratory parameters, dynamic change of APACHE II score and prognosis were observed. Results ①Before the treatment, there were no differences in APACHE II score and serum creatinine level between the two groups (P>0.05). After the treatment, APACHE II score, mean arterial pressure and oxygen saturation rate were lower in the CRRT group than in the IHD group (P<0.05). The lowered mean arterial pressure and oxygen saturation rate improved after the treatment (P<0.05). ②The mortality rate was 51.9% and 52.4% (P>0.05), and the recovery rate of renal function was 92.3% and 65.0% (P<0.05), in the CRRT group and the IHD group, respectively. ③ In the CRRT group, the survival rate was 78.6% and 38.1%, APACHE II score before the treatment was 25.4±2.5 and 36.1±5.7, recovery rate of renal function was 90.9% and 62.5%, the range of APACHE II score change was -13.6±4.3 and -7.1±4.2, in patients at stage I and stage III, respectively. These differences were statistically significant (P<0.05). Conclusion RIFLE criteria of AKI in association with APACHE II score are useful to estimate the appropriate time for blood purification. CRRT is an effective method to prevent and treat sepsis-induced acute kidney injury.

Key words: Intermittent hemodialysis, Sepsis, Acute kidney injury