Early mortality risk factors at the beginning of continuous renal replacement therapy for acute kidney injury

González, Camilo; Pinto, Jessica; Orozco, Viviana; Contreras, Kateir; Garcia, Paola; Rodríguez, Patricia; Patiño, Juan; Echeverri, Jorge

doi:10.1080/2331205x.2017.1407485

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…This study showed that the mortality rate was high among critically ill patients who received CRRT (in-hospital, 57.2% and 90-day, 58.5%). Our result is comparable to mortality rates in previously published data [ 3 , 13 – 15 ] but better than those reported by Prasad et al [ 16 ] (64%), Kao et al [ 17 ] (66.5%), and Gonzalez et al [ 18 ] (68.4%). Some studies have even reported in-hospital mortality as high as 70%–80% [ 19 , 20 ].…”

Section: Discussionsupporting

confidence: 87%

“…The association between advanced age and mortality among AKI patients has been extensively studied [17][18][19]. In a study by Allegretti et al [14] of 725 AKI patients who received CRRT, age over 60 years was an independent risk factor of in-hospital mortality (odds ratio [OR], 1.9; 95% CI, 1.3-2.7; p = 0.001) and mortality following hospital discharge (HR, 1.9; 95% CI, 1.2-3.0).…”

Section: Discussionmentioning

confidence: 99%

“…The mean age was 66.4 ± 14.8 years, and most of the patients were ≥65 years (250, 60.4%). The most common etiology of AKI was sepsis, as was the case in the studies conducted by Kao et al [ 17 ], Gonzalez et al [ 18 ], and Soni et al [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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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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“…However, most of these studies assessed mortality beyond 28 days post-initiation of CRRT. Only a few studies have been conducted to investigate early mortality among critically ill patients undergoing CRRT [ 27 , 28 ]. In contrast, clinicians are often challenged to determine the benefit of CRRT, and it is difficult to identify patients that are more likely to demonstrate poor clinical outcomes, despite active treatment with CRRT to make the best decision for patients requiring RRT.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Early Mortality in Critically Ill Patients Following the Initiation of Continuous Renal Replacement Therapy

Kee

Kim

et al. 2018

JCM

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Continuous renal replacement therapy (CRRT) is an important modality to support critically ill patients, and the need for CRRT treatment has been increasing. However, CRRT management is costly, and the associated resources are limited. Thus, it remains challenging to identify patients that are likely to have a poor outcome, despite active treatment with CRRT. We sought to elucidate the factors associated with early mortality after CRRT initiation. We analyzed 240 patients who initiated CRRT at an academic medical center between September 2016 and January 2018. We compared baseline characteristics between patients who died within seven days of initiating CRRT (early mortality), and those that survived more than seven days beyond the initiation of CRRT. Of the patients assessed, 130 (54.2%) died within seven days of CRRT initiation. Multivariate logistic regression models revealed that low mean arterial pressure, low arterial pH, and high Sequential Organ Failure Assessment score before CRRT initiation were significantly associated with increased early mortality in patients requiring CRRT. In conclusion, the mortality within seven days following CRRT initiation was very high in this study. We identified several factors that are associated with early mortality in patients undergoing CRRT, which may be useful in predicting early outcomes, despite active treatment with CRRT.

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“…The results of multivariate logistic regression analysis identified age ≥ 60 years, traditional herbal medicine intake, HIV infection, anemia, hyperkalemia, respiratory distress, and coma as predictors of mortality in AKI patients requiring HD. Several studies reported the association between advanced age and mortality in patients with AKI in HD [ 10 , 25 ]. As in the present study, a US study of 725 AKI patients who received HD reported that age over 60 years was an independent risk factor for in-hospital mortality [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Mortality in Adults with Acute Kidney Injury Requiring Dialysis: A Cohort Analysis

Kahindo

Mukuku

Mokoli

et al. 2022

International Journal of Nephrology

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Introduction. Acute kidney injury (AKI) requiring renal replacement therapy is accompanied by considerable mortality. This present study evaluated predictors of mortality at initiation of hemodialysis (HD) in AKI patients in Goma (in the Democratic Republic of the Congo (DRC)). Methods. A single-centre cohort survey evaluated the clinical profile and survival rates of AKI patients admitted to HD in the only HD centre in Goma, North Kivu province (DRC). Data were collected from patients who underwent HD for AKI. Patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. The survival study used the Kaplan–Meier curve. Predictors of mortality were evaluated using Cox regression. Results. Of the 131 eligible patients, the mean age was 43.69 ± 16.56 years (range: 18–90 years). Men represented 54.96% of the cohort. The overall HD mortality rate was 25.19% (n = 33). In multivariate analysis, independent predictors of mortality in AKI stage 3 patients admitted to HD were as follows: age ≥ 60 years (adjusted hazard ratio (AHR) = 15.89; 95% CI: 3.98–63.40; p < 0.0001 ), traditional herbal medicine intake (AHR = 5.10; 95% CI: 2.10–12.38; p < 0.0001 ), HIV infection (AHR = 5.55; 95% CI: 1.48–20.73; p = 0.011 ), anemia (AHR = 9.57; 95% CI: 2.08–43.87; p = 0.004 ), hyperkalemia (AHR = 6.23; 95% CI: 1.26–30.72; p = 0.025 ), respiratory distress (AHR = 4.66; 95% CI: 2.07–10.50; p < 0.0001 ), and coma (AHR = 11.39; 95% CI: 3.51–36.89; p < 0.0001 ). Conclusion. Initiation of hemodialysis with AKI has improved survival in patients with different complications.

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Early mortality risk factors at the beginning of continuous renal replacement therapy for acute kidney injury

Cited by 4 publications

References 9 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

Factors Associated with Early Mortality in Critically Ill Patients Following the Initiation of Continuous Renal Replacement Therapy

Predictors of Mortality in Adults with Acute Kidney Injury Requiring Dialysis: A Cohort Analysis

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