2012
DOI: 10.1371/journal.pone.0042952
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U-Curve Association between Timing of Renal Replacement Therapy Initiation and In-Hospital Mortality in Postoperative Acute Kidney Injury

Abstract: BackgroundPostoperative acute kidney injury (AKI) is associated with poor outcomes in surgical patients. This study aims to evaluate whether the timing of renal replacement therapy (RRT) initiation affects the in-hospital mortality of patients with postoperative AKI.MethodologyThis multicenter retrospective observational study, which was conducted in the intensive care units (ICUs) in a tertiary hospital (National Taiwan University Hospital) and its branch hospitals in Taiwan between January, 2002, and April, … Show more

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Cited by 41 publications
(41 citation statements)
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“…Prior studies examining the initiation of dialysis for AKI have not generated consensus (13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Significantly heterogenous, these studies fail to include an adequate nondialyzed control group.…”
Section: Discussionmentioning
confidence: 99%
“…Prior studies examining the initiation of dialysis for AKI have not generated consensus (13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Significantly heterogenous, these studies fail to include an adequate nondialyzed control group.…”
Section: Discussionmentioning
confidence: 99%
“…The minimal increase of SCr less than 0.5 mL/dL might be regarded as AKI in KDIGO criteria. AKI event is not an accurate predictor of in-hospital mortality for those with AKI less than 3 d. 17,30 In this study, most of the AKI duration were less than 14 d (92.1%) and only 8.9% of the AKI duration were less than 48 h. 27,29,30 As the previous study, the endpoint of the present study was in-hospital mortality censored at 180 d. 17 However, patients might join the hospital for other reasons, especially those with prolonged hospitalization.…”
Section: Discussionmentioning
confidence: 99%
“…16 All of the included critically ill non-dialysis patients were followed until death or discharge. As previous study, the endpoint of the study is inhospital mortality censored at 180 d. 17 The definitions of AKI are based on the KDIGO and AKIN criteria. 13 The baseline SCr, were defined as the last SCr obtained before admission, and the SCr on ICU admission and within 48 h, the initiation date for AKI and peak AKI were also recorded for KDIGO and AKIN classification.…”
Section: Methodsmentioning
confidence: 99%
“…Inter-hospital transfers are associated with potential adverse events and the theoretical risk of clinical instability during transport [11,12]. These factors are compounded by data suggesting that delays in nephrology consultation and RRT initiation in hospitalized patients with AKI are associated with inferior clinical outcomes [3,[13][14][15][16]. Although the controversy surrounding the timing of RRT initiation in AKI generally assumes that RRT is available on-site and that clinician decision-making is the main factor that determines timing of RRT initiation, the lack of RRT capability at many hospitals in Ontario presented a natural setting in which to study the effects of delayed initiation of RRT in the setting of AKI.…”
Section: Discussionmentioning
confidence: 99%