ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2023, Vol. 32 ›› Issue (6): 508-514.DOI: 10.3969/j.issn.1006-298X.2023.06.002

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Characteristics and outcomes of patients with multiple organ dysfunction in renal intensive care unit

  

  • Online:2023-12-28 Published:2023-12-22

Abstract: Objective:To retrospectively investigate the clinical characteristics and prognosis of patients with multiple organ dysfunction syndrome(MODS).
Methodology:Patients with MODS admitted to the renal intensive care unit(RICU) of the National Clinical Research Center of Kidney Disease,from October 2011 to October 2021 were included in the study.The clinical characteristics and treatment of the two groups were compared.
Results:Among the 99 patients, the most common cause of admission was infection (72.7%), followed by hemorrhagic fever with renal syndrome(HFRS)(8.1%), heatstroke(6.1%),snake bite (3.0%) and bee stings (3.0%). The most commonly affected organs or systems were the kidneys (100%), followed by the liver (84.8%), the blood system (66.7%), the heart (49.5%), the lungs (48.5%), the gastrointestinal tract (25.3%), and the central nervous system (19.2%). There were 47 patients with pre-existing CKD, 72 with co-infection, and 47 with pulmonary infection. 84 patients received renal replacement therapy(RRT), 46 patients received mechanical ventilation, and 61 patients received vasoactive drugs to boost blood pressure. The mortality rate was 51.5% within 28-day after admission to RICU. Multivariate Logistic regression analysis showed that the number of organs or systems involvement,persistent lymphocytopenia and APACHE-Ⅱ score were independent risk factors for death in MODS patients.
Conclusion:Patients with MODS are not rare in our study and are critically ill with poor prognosis. Most patients had a previous history of chronic kidney disease, and severe infection was the main cause of MODS. In addition to the kidneys, the liver and the blood system are the most frequently involved organs systems. Patients who present with a large number of dysfunctional organs/systems and persistent immunosuppression are often at high risk of death and need to be taken seriously by clinicians.


Key words: multiple organ dysfunction syndrome, intensive care unit, clinical characteristic, prognosis