Indices predictive of circuit clotting in patients treated with continuous renal replacement therapy

Abstract

We investigated indices possibly predicting circuit clotting. This study included 43 patients with severe sepsis treated at Kurume University Hospital Advanced Emergency Medical Service Center between January 2011 and June 2012. They were divided into the clotting group with the occurrence of circuit clotting within 24 hours and the non-clotting group free of circuit clotting for at least 36 hours. The blood test results obtained immediately before the first session of continuous renal replacement therapy (CRRT) were compared between these two groups. Significant differences were observed in lactic acid levels, platelet counts, and thrombin-antithrombin Ⅲ complex (TAT) levels. Multivariate analysis of these three variables identified each as an independent risk factor for circuit clotting (lactic acid [odds ratio: 2.333, 95% confidence interval (CI): 1.122-4.854, P=0.023], platelet count [odds ratio：0.802, 95% CI: 0.674-0.954, P=0.013], and TAT [odds ratio：0.860, 95% CI: 0.761-0.971, P=0.0151]). It may be possible to predict the occurrence of circuit clotting within 24 hours after the start of CRRT based on initial lactic acid levels, platelet counts, and TAT levels.