Renal replacement therapy in patients with acute respiratory distress syndrome: a single-center retrospective study
Kadambi, Pradeep V
AffiliationUniv Arizona, Dept Med, Div Pulm Allergy Crit Care & Sleep Med
Univ Arizona, Dept Med, Div Nephrol
Univ Arizona, Dept Med, Gen Internal Med
MetadataShow full item record
PublisherDOVE MEDICAL PRESS LTD
CitationDill, J., Bixby, B., Ateeli, H., Sarsah, B., Goel, K., Buckley, R., ... & Bime, C. (2018). Renal replacement therapy in patients with acute respiratory distress syndrome: a single-center retrospective study. International journal of nephrology and renovascular disease, 11, 249.
Rights© 2018 Dill et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractPatients with acute respiratory distress syndrome (ARDS) who develop acute kidney injury have increased mortality and frequently require renal replacement therapy (RRT). The optimal timing for initiation of RRT after onset o f ARDS to improve survival is not known. Methods: We retrospectively reviewed clinical data on patients admitted to our health system over a 2-year period. Individual charts were carefully reviewed to ascertain that patients met the Berlin criteria for ARDS and to categorize RRT utilization. The Kaplan Meier analysis was conducted to compare early (48 pound hours postintubation) versus late (>48 hours postintubation) initiation of RRT. Associations between RRT initiation and mortality were evaluated using Cox proportional hazards regression. Results: A total of 75 patients were identified with ARDS, 95% of whom received RRT. Mortality of patients who required RRT was 56%. The main indications for RRT initiation were fluid overload (75%), metabolic acidosis (64%), and hyperkalemia (33%). The Kaplan-Meier analysis comparing early initiation of RRT to late initiation of RRT showed no survival benefit. Cox proportional hazard models testing the association between timing of RRT initiation with survival and adjusting for sex, race, ethnicity, and Acute Physiology and Chronic Health Evaluation II score did not reach statistical significance (HR=0.94, 95% CI=0.48-1.86). Conclusion: Timing of RRT initiation was not associated with a survival benefit. Prospective study in the utilization and outcomes of RRT in ARDS could assist in optimizing its usage in this population.
NoteOpen access journal.
VersionFinal published version
- Timing of Renal Support and Outcome of Septic Shock and Acute Respiratory Distress Syndrome. A Post Hoc Analysis of the AKIKI Randomized Clinical Trial.
- Authors: Gaudry S, Hajage D, Schortgen F, Martin-Lefevre L, Verney C, Pons B, Boulet E, Boyer A, Chevrel G, Lerolle N, Carpentier D, de Prost N, Lautrette A, Bretagnol A, Mayaux J, Nseir S, Megarbane B, Thirion M, Forel JM, Maizel J, Yonis H, Markowicz P, Thiery G, Tubach F, Ricard JD, Dreyfuss D
- Issue date: 2018 Jul 1
- Long-term outcome in ICU patients with acute kidney injury treated with renal replacement therapy: a prospective cohort study.
- Authors: De Corte W, Dhondt A, Vanholder R, De Waele J, Decruyenaere J, Sergoyne V, Vanhalst J, Claus S, Hoste EA
- Issue date: 2016 Aug 12
- Impact of timing of renal replacement therapy initiation on outcome of septic acute kidney injury.
- Authors: Chou YH, Huang TM, Wu VC, Wang CY, Shiao CC, Lai CF, Tsai HB, Chao CT, Young GH, Wang WJ, Kao TW, Lin SL, Han YY, Chou A, Lin TH, Yang YW, Chen YM, Tsai PR, Lin YF, Huang JW, Chiang WC, Chou NK, Ko WJ, Wu KD, Tsai TJ, NSARF Study Group.
- Issue date: 2011
- Timing of renal replacement therapy and long-term risk of chronic kidney disease and death in intensive care patients with acute kidney injury.
- Authors: Christiansen S, Christensen S, Pedersen L, Gammelager H, Layton JB, Brookhart MA, Christiansen CF
- Issue date: 2017 Dec 28
- Fluid overload at initiation of renal replacement therapy is associated with lack of renal recovery in patients with acute kidney injury.
- Authors: Heung M, Wolfgram DF, Kommareddi M, Hu Y, Song PX, Ojo AO
- Issue date: 2012 Mar