Sapporo Medical Journal

Abstract : Despite the continuous renal replacement therapy (CRRT) indicated on patients with severe (Grade 4) hand, foot and mouth disease (HFMD), the mortality rate is high. The aim of the study was to assess the effectiveness of CRRT in earlier stages of severe HFMD pediatric patients on improving their mortality. A retrospective, case series study was conducted on severe HFMD cases diagnosed clinically, confirmed by polymerase chain reaction (PCR) assay and received CRRT. Variables were recorded at: Pediatric intensive care unit (PICU) admission, CRRT initiation and 16 hours after CRRT intervention. Data were processed and analyzed using STATA version 14.0. Thirty-eight eligible cases were included in the study. The mean age was 25.3 months; the male:female ratio was 1.5. Most cases were admitted within the first 3 day of illness (94.7%). The rate of HFMD grade 3 and grade 4 indicated CRRT was about 26.3% and 73.7% respectively. Vital signs, hematological and biochemical parameters improved significantly after 16 hours of CRRT. The average duration of CRRT was 2.4 ± 0.7 days. The survival rate of cases with HFMD grade 3 was 82.1% higher than that of cases with HFMD grade 4 at 40% significantly. The overall survival rate of HFMD patients indicated CRRT was about 71%. The CRRT could be considered as one of the measures contributing to the improvement of mortality rate in patients with severe HFMD. Early indication of CRRT can greatly improve clinical outcome in severe HFMD patients.