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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Continuous venovenous haemofiltration in cancer patients with renal failure: a single-centre experience.
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Continuous venovenous haemofiltration in cancer patients with renal failure: a single-centre experience.

机译：肾衰竭癌症患者的连续静脉血液滤过：单中心经验。

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OBJECTIVE: To assess the effect of continuous venovenous hemodiafiltration (CVVHDF) in cancer patients with acute renal failure. PATIENTS AND METHODS: Retrospective study of all patients with acute renal failure requiring dialysis and treated with CVVHDF in a medical intensive care unit (ICU) from a cancer hospital. RESULTS: From January 1997 until December 2002, 32 cancer patients were treated with CVVHDF for acute renal failure. Their characteristics were: male/female 23/9, median age 61 years, haematological/solid tumours 16/16, and median APACHE II and IGS II scores 31/67. The number of organ failures was 1/2/3/4 in respectively 10/6/13/2 patients. Complete, partial or absence of resolution of acute renal failure was noted in 13, 8 and 11 patients. Sixteen patients (50%) died in the ICU and 15 (47%) were discharged alive from the hospital. In univariate analysis, variables statistically significantly adversely associated with hospital mortality were renal failure of renal origin, bone marrow transplant, increasing number of organ failures, reduced lymphocyte count, elevated bilirubin and lower creatinine levels, increased thromboplastin time, younger age, increased APACHE II and IGS II, ARDS and mechanical ventilation. In multivariate analysis, two models were used including either APACHE II or IGS II. The number of organ failures was found as the only significant prognostic factor in both models ( p=0.01). Elevated phosphate level was a poor prognostic factor for hospital mortality ( p=0.04) in the model including APACHE II. CONCLUSIONS: In the experience of a single centre, CVVHDF is effective in the treatment of acute renal failure in cancer patients. The increasing number of organ failures was the single independent poor predictive factor for hospital mortality. Cancer characteristics and general gravity scores were not predictive factors.
机译：目的：评估连续性静脉血液透析滤过（CVVHDF）在患有急性肾衰竭的癌症患者中的作用。患者与方法：对所有需要透析并在癌症医院的医学重症监护病房（ICU）中接受CVVHDF治疗的急性肾衰竭患者的回顾性研究。结果：从1997年1月至2002年12月，有32例癌症患者接受了CVVHDF治疗急性肾功能衰竭。他们的特征是：男性/女性23/9，中位年龄61岁，血液学/实体瘤16/16，中位APACHE II和IGS II得分31/67。 10/6/13/2位患者的器官衰竭数量分别为1/2/3/4。在13、8和11位患者中发现了急性肾衰竭的完全，部分或无缓解。 16例患者（50％）在重症监护病房死亡，15例（47％）出院活着。在单因素分析中，与医院死亡率相关的统计学上显着负相关的变量是肾源性肾衰竭，骨髓移植，器官衰竭数目增加，淋巴细胞计数减少，胆红素升高和肌酐水平降低，凝血活酶时间增加，年龄更小，APACHE II增加以及IGS II，ARDS和机械通风。在多变量分析中，使用了两个模型，包括APACHE II或IGS II。在这两个模型中，发现器官衰竭的数量是唯一的重要预后因素（p = 0.01）。在包括APACHE II在内的模型中，磷酸盐水平升高是影响医院死亡率的不良预后因素（p = 0.04）。结论：根据一个中心的经验，CVVHDF可有效治疗癌症患者的急性肾衰竭。器官衰竭的增加是医院死亡率的唯一独立的不良预测因素。癌症特征和一般重力评分不是预测因素。

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