Effect of sodium bicarbonate Ringer's solution combined with continuous renal replacement therapy on inflammation level and renal function in trauma patients with acute kidney injury

doi:10.3877/cma.j.issn.1674-6880.2023.05.005

Abstract

Abstract:

Objective

To investigate the effect of sodium bicarbonate Ringer's solution (BRS) combined with continuous renal replacement therapy (CRRT) on the inflammation level and renal function in trauma patients with acute kidney injury (AKI).

Methods

A total of 57 trauma patients with AKI admitted from April 2020 to April 2022 were collected and divided into an observation group (29 cases) and a control group (28 cases). The observation group was treated with BRS combined with CRRT, and the control group was treated with the sodium lactated Ringer's solution combined with CRRT. The white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), creatinine, urea nitrogen (BUN) and lactic acid before and after treatment were compared between the two groups, and the healing status of patients in the two groups was recorded.

Results

The WBC (Z = 1.269, P = 0.204), PCT (Z = 0.471, P = 0.638), CRP (Z = 1.493, P = 0.135), IL-6 (t = 1.870, P = 0.067), TNF-α (t = 0.961, P = 0.341), creatinine (t = 1.701, P = 0.095), BUN (t = 1.137, P = 0.260) and lactic acid (t = 0.239, P = 0.812) before treatment all showed no significant differences between the two groups. After treatment, the WBC (Z = 4.703, 3.196; both P < 0.001), PCT (Z = 4.320, 4.020; both P < 0.001), CRP (Z = 4.620, 4.540; both P < 0.001), creatinine (t = 6.560, 6.588; both P < 0.001), BUN (t = 4.877, 4.022; both P < 0.001) and lactic acid (t = 5.852, 6.073; both P < 0.001) in the observation group and control group were much lower than those before treatment, and the CRP level in the observation group was significantly lower than that in the control group (Z = 5.092, P < 0.001). The levels of IL-6 (t = 4.619, P < 0.001) and TNF-α (t = 3.099, P = 0.004) in the observation group after treatment were much lower than those before treatment, and the levels of IL-6 (t = 2.462, P = 0.017) and TNF-α (t = 2.404, P = 0.019) in the observation group also decreased markedly as compared with the control group. Meanwhile, the proportion of cure in the observation group was much higher than that in the control group (27/29 vs. 20/28, χ² = 4.884, P = 0.027).

Conclusion

BRS combined with CRRT can effectively improve the renal function, inhibit the inflammatory response and improve the cure status of trauma patients with AKI.

Key words: Trauma, Acute kidney injury, Sodium bicarbonate Ringer's solution, Continuous renal replacement therapy, Inflammation, Renal function

Shengjin Han, Zhengwu Zhou, Yunlong Weng, Xin Huang. Effect of sodium bicarbonate Ringer's solution combined with continuous renal replacement therapy on inflammation level and renal function in trauma patients with acute kidney injury[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2023, 16(05): 376-381.

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References 26

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组别	例数	年龄（岁）	男/女（例）	住院费用（万元）	ISS（分）	ICU住院天数（d）	致伤原因（例）
组别	例数	年龄（岁）	男/女（例）	住院费用（万元）	ISS（分）	ICU住院天数（d）	交通事故	高空坠落	其他
观察组	29	39 ± 13	19/10	5.2 ± 1.8	25 ± 7	8.8 ± 1.7	20	7	2
对照组	28	36 ± 11	16/12	5.4 ± 1.8	24 ± 6	11.2 ± 2.8	19	6	3
t/χ²值		1.299	0.422	0.506	0.519	3.875	0.286
P值		0.199	0.516	0.615	0.606	<0.001	0.867

组别	例数	年龄（岁）	男/女（例）	住院费用（万元）	ISS（分）	ICU住院天数（d）	致伤原因（例）
组别	例数	年龄（岁）	男/女（例）	住院费用（万元）	ISS（分）	ICU住院天数（d）	交通事故	高空坠落	其他
观察组	29	39 ± 13	19/10	5.2 ± 1.8	25 ± 7	8.8 ± 1.7	20	7	2
对照组	28	36 ± 11	16/12	5.4 ± 1.8	24 ± 6	11.2 ± 2.8	19	6	3
t/χ²值		1.299	0.422	0.506	0.519	3.875	0.286
P值		0.199	0.516	0.615	0.606	<0.001	0.867

组别	例数	WBC（× 10⁹/L）	PCT（μg/L）	CRP（mg/L）
观察组
治疗前	29	11（8，14）	16（7，29）	50（24，82）
治疗后	29	6（5，8）^a	10（4，16）^a	15（12，23）^a
对照组
治疗前	28	14（9，15）	15（10，29）	68（38，85）
治疗后	28	7（6，8）^a	10（5，21）^a	41（29，56）^ab

组别	例数	WBC（× 10⁹/L）	PCT（μg/L）	CRP（mg/L）
观察组
治疗前	29	11（8，14）	16（7，29）	50（24，82）
治疗后	29	6（5，8）^a	10（4，16）^a	15（12，23）^a
对照组
治疗前	28	14（9，15）	15（10，29）	68（38，85）
治疗后	28	7（6，8）^a	10（5，21）^a	41（29，56）^ab

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