Continuous renal replacement therapy in elderly with acute kidney injury

Medina-Liabres, Kristianne Rachel P.; Kim, Sejoong

doi:10.3904/kjim.2019.431

Cited by 13 publications

(13 citation statements)

References 51 publications

(68 reference statements)

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“…Another study by Conroy et al [22] reported that patients 75 years and older had higher hospital mortality (54.2% vs. 44%, p = 0.02) and 1-year mortality (63.6% vs. 50.6%, p = 0.005) than younger patients. Although poor outcomes have been observed in elderly AKI patients, this has not been consistent across all studies [23]. A retrospective study done in Germany of 424 patients found that the course and prognosis of AKI do not differ greatly in the elderly population [24].…”

Section: Discussionmentioning

confidence: 97%

Mortality predictors in critically ill patients with acute kidney injury requiring continuous renal replacement therapy

Medina-Liabres

Jeong

et al. 2021

Kidney Res Clin Pract

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Background: Because of high cost of continuous renal replacement therapy (CRRT) and the high mortality rate among severe acute kidney injury patients, careful identification of patients who will benefit from CRRT is warranted. This study determined factors associated with mortality among critically ill patients requiring CRRT. Methods: This was a retrospective observational study of 414 patients admitted to the intensive care unit of four hospitals in South Korea who received CRRT from June 2017 to September 2018. Patients were divided according to degree of fluid overload (FO) and disease severity. The Cox proportional hazards model was used to explore the effect of relevant variables on mortality. Results: In-hospital mortality rate was 57.2%. Ninety-day mortality rate was 58.5%. Lower creatinine and blood pH were significant predictors of mortality. A one-unit increase in the Sequential Organ Failure Assessment (SOFA) score was associated with increased risk of and 90-day mortality (hazard ratio [HR], 1.07; p < 0.001). The risk of 90-day mortality in FO patients was 57.2% (p < 0.001) higher than in those without FO. High SOFA score was associated with increased risk for 90-day mortality (HR, 1.79; p = 0.03 and HR, 3.05; p = 0.001) in patients without FO and with FO ≤ 10%, respectively. The highest mortality rates were in patients with FO > 10%, independent of disease severity. Conclusion: FO increases the risk of mortality independent of other factors, including severity of acute illness. Prevention of FO should be a priority, especially when managing the critically ill.

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Section: Discussionmentioning

confidence: 97%

Mortality predictors in critically ill patients with acute kidney injury requiring continuous renal replacement therapy

Medina-Liabres

Jeong

et al. 2021

Kidney Res Clin Pract

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“…Although renal failure can be managed with renal replacement therapy, unlike other organ failures, AKI-associated mortality remains high even when prompt dialysis is available [ 75 , 76 ]. Thus, increased mortality in patients with AKI cannot be solely explained by reduced renal clearance per se , and mechanisms beyond that are postulated [ 77 ].…”

Section: Role Of T Cells In Recovery or Aki To Ckd Transitionmentioning

confidence: 99%

Role of T cells in ischemic acute kidney injury and repair

Lee

Jang

2022

Korean J Intern Med

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Ischemic acute kidney injury (AKI) is a common medical problem with significant mortality and morbidity, affecting a large number of patients globally. Ischemic AKI is associated with intrarenal inflammation as well as systemic inflammation; thus, the innate and adaptive immune systems are implicated in the pathogenesis of ischemic AKI. Among various intrarenal immune cells, T cells play major roles in the injury process and in the repair mechanism affecting AKI to chronic kidney disease transition. Importantly, T cells also participate in distant organ crosstalk during AKI, which affects the overall outcomes. Therefore, targeting T cell-mediated pathways and T cell-based therapies have therapeutic promise for ischemic AKI. Here, we review the major populations of kidney T cells and their roles in ischemic AKI.

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“…Continuous renal replacement therapy (CRRT) is an essential treatment modality for patients with acute renal failure which helps remove toxins continuously from the body, effectively maintains homeostasis, and is more in line with the physiological characteristics of the body [1]. CRRT has become an important tool for the treatment of critically ill patients because of its low hemodynamic impact, safety and high e cacy [2].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the extracorporeal anticoagulation effect of modified citrate infusion during continuous haemodialysis in critically ill patients

Guo¹,

Liu²

2021

Preprint

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This study aimed to analyse the anticoagulation effect of different local infusion methods for citrate continuous haemodialysis in critically ill patients in order to identify a safe and effective citrate infusion method. Critically ill patients admitted to our hospital from April 2019 to December 2019 who underwent continuous renal replacement therapy (CRRT) using citrate for anticoagulation were divided into the conventional citrate infusion before the filter (conventional group) and citrate infusion group according to the different local citrate infusion methods (modified group). A total of 30 treatment sessions were performed for each group. the modified group patients were found to have longer mean treatment times(67.67 ± 18.69 vs 52.11 ± 24.26,p = 0.007), lower transmembrane pressures at the disconnection time from dialysis circuit(147.77 ± 66.85 vs 200.63 ± 118.66,p = 0.038), fewer citrate bag replacements(1.43 ± 0.50 vs 10.60 ± 3.19,p < 0.001), and steady ionised calcium at the venous end compared to the conventional group patients with statistically significant differences(0.35 ± 0.06 vs 0.40 ± 0.05,p = 0.006). The total calcium level was significantly higher in the conventional group patients than those of the other(2.29 ± 0.23 vs 2.19 ± 0.14,p = 0.038). Incidences of citrate accumulation and tubing coagulation were also marginally lower in the modified group. We infer that the modified local citrate infusion method can prolong the treatment time, reduce the nursing workload and the occurrence of citrate accumulation, resulting in safe and effective clinical outcome.

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Continuous renal replacement therapy in elderly with acute kidney injury

Cited by 13 publications

References 51 publications

Mortality predictors in critically ill patients with acute kidney injury requiring continuous renal replacement therapy

Mortality predictors in critically ill patients with acute kidney injury requiring continuous renal replacement therapy

Role of T cells in ischemic acute kidney injury and repair

Analysis of the extracorporeal anticoagulation effect of modified citrate infusion during continuous haemodialysis in critically ill patients

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