We hypothesized that patients with sepsis and AKI, especially patients without preserved renal function, and treated with continuous veno-venous hemodiafiltration (CVVHDF), have lower risk for mortality than patients treated with continuous veno-venous hemofiltration (CVVH). Patients were included if they fulfilled the diagnosis of severe sepsis or septic shock, suffered AKI and received continuous renal replacement therapy (CRRT) in intensive care unit. There were 62 patients treated by CVVH and 75 treated by CVVHDF. Mean survival time was longer in CVVHDF group with oliguric/anuric patients than in CVVH group. CVVH, and not classic risk factors, was associated with higher overall mortality in oliguric/anuric patients. In the linear regression model, hourly urine output was the strongest and positive predictor of longer survival. CVVHDF is according to our results a CRRT modality of choice for the treatment and lower mortality of septic patients with AKI where renal function is no longer preserved. CRRT has been associated with improved renal recovery, but it should be started earlier in AKI evolution with still preserved hourly urine output which is the most sensitive and prognostic marker of survival in septic patients with AKI.

中文翻译：

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CVVH与CVVHDF在重症患者败血症诱发的急性肾损伤的处理中的差异。

我们假设败血症和AKI的患者，特别是那些肾功能未得到保护并接受连续静脉血液透析滤过（CVVHDF）治疗的患者，其死亡风险要低于接受连续静脉血液透析滤过（CVVH）的患者。如果患者确诊为严重败血症或败血性休克，患有AKI并在重症监护病房接受连续肾脏替代治疗（CRRT），则将其包括在内。CVVH治疗62例，CVVHDF治疗75例。少尿/无尿患者的CVVHDF组的平均生存时间长于CVVH组。CVVH（不是经典的危险因素）与少尿/无尿患者的总体死亡率较高有关。在线性回归模型中，小时尿量是更长生存期的最强的积极指标。根据我们的研究结果，CVVHDF是一种选择CRRT方式来治疗败血症的AKI败血症患者，这些患者不再保留肾脏功能。CRRT与改善肾脏恢复有关，但应在AKI演变中更早开始，每小时仍需保留尿量，这是脓毒症AKI患者生存的最敏感和预后指标。