Xin Chen, Xiaoqing Lin, Fang Cheng, Shilin Zheng, Qiang Zhang, Te Wu, Jichan Shi

Department of Infectious Disease, Wenzhou Central Hospital, Dingli Clinical College of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China

Correspondence: Jichan Shi, Department of Infectious Disease, Wenzhou Central Hospital, Dingli Clinical College of Wenzhou Medical University, No. 252 Baili East Road, Lucheng District, Wenzhou City, Zhejiang Province, 325000, People’s Republic of China, Tel +86 0577 88882121, Email shijichan1822@163.com

Objective: To explore the clinical efficacy of continuous renal replacement therapy (CRRT) in patients with pulmonary tuberculosis (TB) complicated with sepsis, particularly focusing on 28-day mortality (primary objective), and to assess the impact of CRRT on inflammatory response, renal function, haemodynamics and overall prognosis (secondary objectives).
Methods: A total of 98 patients with pulmonary TB complicated by sepsis were included: 49 patients were enrolled in the control group and received routine treatment, whereas 49 patients were enrolled in the CRRT group and received CRRT based on the control group. Renal function indicators, inflammatory indicators, haemodynamic indicators and recovery status were analysed and compared.
Results: After 72 hours of treatment, C-reactive protein (CRP), serum creatinine (SCR), blood urea nitrogen (BUN) and plasma lactic in the CRRT group decreased (P < 0.001), procalcitonin (PCT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were reduced (P < 0.01) and urine volume and mean arterial pressure (MAP) increased (P < 0.001). After 72 hours of treatment, CRP and PCT in the control group increased (P < 0.05), SCR, BUN and NT-proBNP increased (P < 0.001), plasma lactic was not significantly changed and MAP decreased (P < 0.05). The 28-day mortality in the CRRT group was lower than in the control group (28.6% vs 49%, P = 0.038), intensive care unit hospitalisation time was shorter than in the control group (11.27 ± 9.34 vs 15.43 ± 9.19 d, P = 0.028) and Acute Physiological Function and Chronic Health Status Scoring System II and Sequential Organ Failure Score scores were lower after treatment (P < 0.001). The difference was statistically significant.
Conclusion: Continuous renal replacement therapy can significantly improve inflammatory response, enhance haemodynamics, promote renal function recovery and increase overall treatment efficacy in patients with pulmonary TB complicated with sepsis.

Keywords: continuous renal replacement therapy, pulmonary tuberculosis, sepsis, clinical efficacy