Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients: impact on mortality and length of stay

Background: Almost 30-60% of patients treated in the intensive care unit (ICU) experience acute kidney injury (AKI) and approximately 5% of all ICU patients require renal replacement therapy. This study was conducted to determine the difference in length of stay (LOS) and mortality based on continuous renal replacement therapy (CRRT) compared to intermittent hemodialysis (IHD) in AKI patients in the ICU of a tertiary referral hospital in Indonesia. Methodology: A cross-sectional study was conducted on all patients diagnosed with AKI who were treated in the ICU. The study data included age, sex, comorbidities, The Sequential Organ Failure Assessment (SOFA) score, Acute Physiologic and Chronic Health Evaluation (APACHE) score, treatment modality, LOS, and mortality. Results: There were 18 patients in each of the IHD and CRRT groups. The number of study subjects with comorbidities was higher in the CRRT group (12 people (66.7%)), compared to the IHD group (11 people (61.1%)). The SOFA score in the IHD group was higher (6.06) than the CRRT group (5.44). APACHE score in the IHD group (18.50) differed greatly from the CRRT group (18.44). Discussion: Studies have shown no difference in mortality with CRRT compared to IHD. Studies showed higher APACHE scores were associated with shorter LOS, reflecting higher mortality rates. Conclusion: There is a significant difference in the LOS of AKI patients undergoing CRRT with IHD. However, no significant difference in the mortality rate between the CRRT and IHD groups was found. Abbreviations: APACHE - Acute Physiologic and Chronic Health Evaluation; CRRT - continuous renal replacement therapy; ICU - intensive care unit; IHD - intermittent hemodialysis; LOS - length of stay; Keywords: acute kidney injury, continuous renal replacement therapy, intermittent hemodialysis, length of stay, mortality rate Citation: Kestriani ND, Pradian E, Alifahna MR. Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients: impact on mortality and length of stay. Anaesth. pain intensive care 2024;28(6):1061-1066; DOI: 10.35975/apic.v28i6.2623 Received: August 30, 2024; Reviewed: September 15, 2024; Accepted: September 15, 2024