Timing of continuous renal replacement therapy in severe acute kidney injury patients with fluid overload: A retrospective cohort study
| Autor: | D C Guo, J Lin, P Liu, M Zhang, Z L Qi, J F Liu, X J Ji, Amanda Y. Wang, Ron Wald, Martin Gallagher, Sean M. Bagshaw, M L Duan, Rinaldo Bellomo |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Continuous Renal Replacement Therapy medicine.medical_treatment Water-Electrolyte Imbalance Critical Care and Intensive Care Medicine Early initiation 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient Renal replacement therapy Aged Retrospective Studies Aged 80 and over Proportional hazards model business.industry Mortality rate Acute kidney injury 030208 emergency & critical care medicine Retrospective cohort study Acute Kidney Injury Middle Aged medicine.disease Icu admission Renal Replacement Therapy Intensive Care Units 030228 respiratory system business |
| Zdroj: | Journal of critical care. 64 |
| ISSN: | 1557-8615 |
| Popis: | Purpose We aimed to evaluate the association of early versus late initiation of Continuous renal replacement therapy (CRRT) with mortality in patients with fluid overload. Methods This was a retrospective cohort study of patients with fluid overload (FO) treated with CRRT due to severe acute kidney injury (AKI) between January 2015 and December 2017 in a mixed medical intensive care unit of a teaching hospital in Beijing, China. Patients were divided into early (≤15 h) and late (>15 h) groups based on the median time from ICU admission to CRRT initiation. The primary outcome was all-cause mortality at day 60. Multivariable Cox model analysis was used for analysis. Results The study patients were male predominant (84/150) with a mean age of 64.8 ± 16.7 years. The median FO value before CRRT initiation was 10.1% [6.2–16.1%]. The 60-day mortality rates in the early vs the late CRRT groups were 53.9% and 73%, respectively. On multivariable Cox modelling, the late initiation of CRRT was independently associated with an increased risk of death at 60 days (HR 1.75, 95% CI 1.11–2.74, p = 0.015). Conclusions Early initiation of CRRT was independently associated with survival benefits in severe AKI patients with fluid overload. |
| Databáze: | OpenAIRE |
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