连续性肾脏替代治疗中含钙置换液预防心血管并发症的有效性研究

LAI Kai-yuan; ZHU Wei-dong; JIANG Wen-yi; SU Wei-huan; HUANG Shu-ting

doi:10.3969/j.issn.1009-8933.2025.04.002

摘要：Background Continuous renal replacement therapy(CRRT)is frequently applied in critically ill patients with acute kidney injury who are vulnerable to cardiovascular complications.Differences in calcium management dur-ing CRRT may affect cardiac electrophysiology and hemodynamic stability,potentially influencing cardiovascular outcomes.Methods A total of 96 patients receiving CRRT were enrolled in this single-center study between Sep-tember 2020 and September 2023.Patients were divided into two groups:those receiving calcium-containing re-placement fluids(n=46)and those receiving calcium-free fluids(n=50).Clinical outcomes,including major adverse cardiovascular events(MACE),arrhythmias,hypotension,myocardial infarction,sudden cardiac arrest,intensive care units(ICU)stays,and hospital mortality,were compared between the two groups.Results The calcium-con-taining group had a significantly lower incidence of MACE(20%vs.32%,P<0.001)and arrhythmias(8%vs.17.3%,P=0.010)compared to the calcium-free group.ICU stays were also shorter in the calcium-containing group(11.6±8.8 days vs.16.6±7.6 days,P=0.004).Hospital mortality showed a trend toward being lower in the calcium-containing group,though this was not statistically significant(0.6%vs.10.1%,P=0.063).No significant differences were observed in the incidence of hypotension,myocardial infarction,or sudden cardiac arrest.Conclusions Calci-um-containing replacement fluids during CRRT were associated with improved clinical outcomes,including lower rates of MACE and arrhythmias,as well as shorter ICU stays.This simplified approach may be safer and more effi-cient,but larger studies are needed to confirm these findings and assess long-term outcomes.[S Chin J Cardiol 2025;26(4):219-227]