Sepsis-associated acute kidney injury (SAKI) is a common complication of patients in intensive care unit, and also an independent risk factor leading to high mortality of sepsis patients. SAKI leads to an extended hospital stay for patients, resulting in a huge medical burden. The pathogenesis of SAKI is complex, and systemic inflammatory response plays an important role in it. At present, blood adsorption is the main method for treating SAKI in intensive care units, but there is no consensus on the relevant treatment strategies. This article summarizes new perspectives and research conclusions on the application of blood adsorption technology in the treatment of SAKI, aiming to provide new references for the blood adsorption treatment strategies of SAKI.
Objective To explore the risk factors affecting the prognosis of patients with acute kidney injury (AKI) after extracorporeal circulation surgery who receive continuous renal replacement therapy (CRRT). Methods Patients who developed AKI and underwent CRRT treatment after extracorporeal circulation surgery at the First Affiliated Hospital of Chongqing Medical University between May 2019 and May 2024 were retrospectively selected. According to the prognosis, patients were divided into the good prognosis group and the poor prognosis group. Basic information, duration of extracorporeal circulation during surgery, aortic occlusion time, timing and duration of CRRT initiation therapy, relevant laboratory indicators before surgery, during CRRT intervention, and upon discharge or death were collected. The risk factors affecting the prognosis of such patients were analyzed. Results A total of 45 patients were included. Among them, there were 20 cases in the good prognosis group and 25 cases in the poor prognosis group. There was no statistically significant difference in the basic information between the two groups (P>0.05). Compared with the poor prognosis group, the good prognosis group had decreased preoperative urea nitrogen and increased hemoglobin levels, reduced levels of alanine aminotransferase and aspartate aminotransferase during the initiation of CRRT treatment, and reduced levels of white blood cell count, neutrophil percentage, alanine aminotransferase and aspartate aminotransferase and elevated platelet count before discharge or death (P<0.05). The results of multivariate logistic regression analysis showed that the total duration of CRRT treatment [odds ratio (OR)=1.007, 95% confidence interval (CI) (1.000, 1.015), P=0.046], white blood cell count before discharge or death [OR=1.541, 95%CI (1.011, 2.349), P=0.044], and platelet count before discharge or death [OR=0.964, 95%CI (0.937, 0.991), P=0.010] could affect patient prognosis. Conclusions In patients with AKI after extracorporeal circulation surgery, if combined with renal dysfuction and anemia before surgery, liver function damage and secondary infection during CRRT initiation therapy may be related to poor patient prognosis. The longer the duration of CRRT treatment, the higher the white blood cells before discharge or death, and the lower the platelet count are independent risk factors for poor prognosis in patients.
Severe bee stings can trigger a systemic inflammatory response and multi-organ dysfunction, potentially resulting in fatality. Acute kidney injury (AKI) is a frequent complication in patients with severe bee stings, and conventional comprehensive treatment combined with various blood purification therapies is commonly employed in clinical practice to promptly manage the condition and reduce the average hospital stay duration. This article primarily delves into the significance of enhanced clinical nursing care for patients with bee stings-induced AKI undergoing blood purification therapy. Specifically, it underscores the importance of patient education regarding treatment-related considerations, nursing techniques for vascular access during treatment, potential complications, and corresponding nursing interventions.