Early Continuous Renal Replacement Therapy in Cardiogenic Shock Patients with Severe Acute Kidney Injury Undergoing Extracorporeal Membrane Oxygenation

Cardiorenal Medicine

Chun-Ming Shih¹  Mai-Szu Wu¹  Yen-Chung Lin¹  Feng-Yen Lin¹  Tzen-Wen Chen¹  Chun-Yao Huang¹  Yi-Chun Lin¹  Hsi-Hsien Chen¹  Nai-Wen Tsao¹  Nen-Chun Chang¹ 

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关键词: Continuous renal replacement therapy;    Glomerular filtration rate;    Acute kidney injury;    Extracorporeal membrane oxygenation;   

DOI  :  10.1159/000364835

来源: S Karger AG

【 摘 要 】

Background: Continuous renal replacement therapy (CRRT) may benefit patients requiring extracorporeal membrane oxygenation (ECMO). However, the clinical benefits and timing of CRRT have not been fully elucidated for these patients. Methods: This study was conducted retrospectively at the Taipei Medical University Hospital between January 2008 and December 2010. We included patients who had Acute Kidney Injury Network (AKIN) stage 3 disease at the initiation of ECMO and subsequently underwent CRRT. We excluded patients aged <18 years or those who were chronic dialysis patients. Early dialysis was defined as receiving CRRT <24 h after the initiation of ECMO. The primary outcome was mortality before weaning from ECMO. Results: The median age of the 15 patients included in the study was 72 years. The median interval between ECMO and CRRT was 16 h. No significant difference in survival was observed between the early- and late-dialysis patients (p = 0.58, log-rank test). However, a trend toward a shorter mean duration of ECMO therapy was observed in the early-dialysis patients (124 vs. 169 h, p = 0.16). The median follow-up glomerular filtration rate for the survivors was 38.9 ml/min/1.73 m². Conclusion: No survival benefit is conferred by the use of CRRT within 24 h after initiating ECMO in patients with severe acute kidney injury according to AKIN criteria. © 2014 S. Karger AG, Basel

【 授权许可】

Unknown