Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore the optimal dialysis treatment regimen and efficiency of continuous renal replacement therapy (CRRT) in maintenance hemodialysis (MHD) patients with “high risk of COVID19 infection”.
Ｍｅｔｈｏｄｏｌｏｇｙ：The high risk MHD patients with COVID19 who just turned negative from positive for nuclear acid test and received transitional dialysis in the Emergency Dialysis Center of Shanghai Changzheng Hospital from April 1 to June 30, 2022 were recruited. The 4hCRRT therapy was performed with Prismaflex dialysis machine and ST100 suite. We used the continuous venovenous hemodiafiltration (CVVHDF) mode with the total fluid exchange volume of 8 000 ml／h, including dialysate and total replacement fluid. We investigated the patients’ singlecompartment urea clearance index (spKt／V) and urea reduction rate (URR) and compared them to their routine dialysis evaluation by t test and Wilcoxon signed rank test, to evaluate the dialysis efficiency of 4hCVVHDF. The influential factors of dialysis efficiency were analyzed by Logistic regression. The tolerance to treatment was evaluated by the subjective feeling questionnaire.
Ｒｅｓｕｌｔｓ：During the treatment, the mean spKt／V was 086±019, and the mean URR was 5029%±760％. Although the spKt／V and URR of CVVHDF were significantly lower than those of IHD, the acidbase and electrolyte disturbances were well corrected, with potassium 362±061 mmol／L, phosphorus 137±034 mmol／L and carbon dioxide 289±29 mmol／L after dialysis. Multivariate analysis suggested that gender was an independent risk factor for spKt／V in CVVHDF patients. Correlation analysis showed that there was a significant inverse correlation between dry weight and spKt／V (R=-0563,P<0001). Subjective feelings questionnaire indicated that most patients had good tolerance, and some even had better experience than conventional IHD.
Ｃｏｎｃｌｕｓｉｏｎ：In the case of public health emergencies, the dialysis adequacy and safetyness of shortterm high doses CVVHDF are acceptable, and may be used as an optimal transitional replacement and support for the routine IHD.