Objective: To investigate the effect of sustained low efficiency dialysis (SLED) on patients with multiple organ failure resulted from diabetic kidney disease (DKD).
Methods: Five DKD patients who developed MOF between Nov. 2011 and Jan. 2012 were recruited for SLED treatment (dose: 200 ml/min, for 8 to 12 hours every other day) in the West China Hospital. Meanwhile, other therapeutic measures, such as underlying disease management, infection control and nutritional support were applied. Biochemical changes and progress of disease were observed.
Results: One patient died unexpectedly 12h after admission to hospital. The main cause of death was multiple organ failure. The other four patients had sharp improvements in high potassium concentration and (or) metabolic acidosis after SLED therapy, with obvious amelioration of main organs functions and oxygenation index [PO2 (103.3 +/- 25.7) mm Hg]. Two ventilator dependent patients successfully weaned from mechanical ventilation 3 to 5 days after the treatment. BNP of the patients decreased from > 35,000 ng/mL before the treatment to (13,312 +/- 3,537) pg/mL after the treatment (P < 0.05). APACHE II decreased by 10.3%, 41.9% and 67.8% within 24 hours, three days and five days respectively.
Conclusion: SLED as early intervention can bring significant benefits to DKD patients with multiple organ failure (MOF). SLED has the same efficacy as continuous renal replacement therapy (CRRT) in the treatment of MOF for patients with DKD.