Scientia et Cura: Illuminating the Dark Side of CRRT for Optimal Patient Benefits.

INTRODUCTION

Continuous Renal Replacement Therapy (CRRT) is commonly used in patients with hemodynamic instability but is associated with potential complications. Understanding these complications can improve CRRT efficiency and patient outcomes.

METHODS

This cross-sectional study investigated CRRT complications in patients > 18 years old who underwent CRRT at a tertiary medical center from 2017 to 2022. Data were collected from patient records and the hospital's laboratory system.

RESULTS

A total of 178 patients underwent CRRT for fluid overload (38%) and non-septic acute kidney injury (AKI) (35%). The most common CRRT modalities were hemofiltration (54%) and hemodiafiltration (31%). Among patients, 76% experienced a reduction in platelet count (mean decrease of 40% ± 24). Hemoglobin declined by ≥ 1 g/dL in 58% of patients. Phosphorus decreased in 64.6% of patients (mean reduction of 33%) and potassium decreased in 50% (mean reduction of 18%), but these reductions were not statistically significant (P-values: 0.73 and 0.88). Vasopressors were stopped in 27% of patients, and the dose was reduced in 50.4%. No significant hypothermia, allergic reactions, pneumothorax, hemothorax, or air embolism were reported. The survival rate at hospital discharge was 64% (123 out of 178).

CONCLUSION

CRRT is a safe and efficient treatment for AKI, with notable reductions in platelet count and vasopressor dependency. However, reductions in phosphorus and potassium were not significant, indicating manageable complications.