Rationale for Early Renal Replacement Therapy for Multiple Organ Dysfunction

Abstract

Objective: to determine the impact of early initiation of renal replacement therapy on the manifestations of a systemic inflammatory response (SIR) and on the prevention of progression of organ dysfunction (OD). Subjects and methods. A prospective study was conducted in the intensive care units of the Kemerovo Regional Clinical Hospital and the Research Institute for Integrated Problems of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, in the identical period (2003—2009). Three hundred and fifty-four patients underwent a set of invasive hemodynamic studies, biochemical tests, and transpulmonary thermodilution. Conclusion. Renal replacement therapy prevents the progression of OD in patients with SIR irrespective of the etiology of the latter (infectious versus noninfectious SIR); the earlier initiation of continuous renal replacement therapy (within 24 hours after the determination of indications for its session) is most effective. Key words: renal replacement therapy, organ dysfunction.