Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy
Objective This single center retrospective study aimed to describe the variables associated with outpatient dialysis dependence in extracorporeal membrane oxygenation (ECMO) patients who needed continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) during their hospitalization.Met...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2343810 |
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| _version_ | 1832591115861098496 |
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| author | Carlos Rodrigo Franco Palacios Rudiona Hoxhaj Catlyn Thigpen Jeffrey Jacob |
| author_facet | Carlos Rodrigo Franco Palacios Rudiona Hoxhaj Catlyn Thigpen Jeffrey Jacob |
| author_sort | Carlos Rodrigo Franco Palacios |
| collection | DOAJ |
| description | Objective This single center retrospective study aimed to describe the variables associated with outpatient dialysis dependence in extracorporeal membrane oxygenation (ECMO) patients who needed continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) during their hospitalization.Methods Retrospective study of patients who required ECMO-CRRT.Results Between the years of 2016 and 2022, 202 patients required ECMO-CRRT. One hundred and six patients (52.5%) survived their hospitalization and were followed up for a median of 391 [133, 1005] days. Eighty-one patients (76.5%) recovered kidney function and were dialysis-free before hospital discharge. Twenty-five patients (23.5%) were hemodialysis-dependent after hospitalization. On multivariate regression analysis, hyperlipidemia (odds ratio, OR 6.08 [1.67–22]) and CRRT duration (OR 1.09 [1.03–1.15]) were associated with the need for dialysis post-hospitalization. In this group, 16 patients eventually became dialysis-free, after a median of 49 [34.7, 78.5] days. These patients had a higher median baseline glomerular filtration rate (GFR) compared to those who never recovered renal function (93 mL/min/1.73 m2 [82.4, 104.3] vs. 63.8 mL/min/1.73 m2 [37.9, 83], p = .009). Their follow-up GFR was lower compared to those who recovered renal function before hospital discharge; (87 mL/min/1.73 m2 [68.2, 98.9] vs. 99 mL/min/1.73 m2 [79, 118], p = .07).Conclusions AKI requiring CRRT was associated with high mortality in patients receiving ECMO. Nonetheless, most ECMO survivors became dialysis-free before hospital discharge. Variables associated with the need for outpatient dialysis included hyperlipidemia and prolonged need for CRRT during hospitalization. |
| format | Article |
| id | doaj-art-9967659cfb4e4effac1df20370700bd3 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-9967659cfb4e4effac1df20370700bd32025-01-23T04:17:48ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2024.2343810Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapyCarlos Rodrigo Franco Palacios0Rudiona Hoxhaj1Catlyn Thigpen2Jeffrey Jacob3Critical Care Medicine, WellStar Health System, Marietta, GA, USAInternal Medicine, WellStar Health System, Marietta, GA, USAInternal Medicine, WellStar Health System, Marietta, GA, USAInternal Medicine, WellStar Health System, Marietta, GA, USAObjective This single center retrospective study aimed to describe the variables associated with outpatient dialysis dependence in extracorporeal membrane oxygenation (ECMO) patients who needed continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) during their hospitalization.Methods Retrospective study of patients who required ECMO-CRRT.Results Between the years of 2016 and 2022, 202 patients required ECMO-CRRT. One hundred and six patients (52.5%) survived their hospitalization and were followed up for a median of 391 [133, 1005] days. Eighty-one patients (76.5%) recovered kidney function and were dialysis-free before hospital discharge. Twenty-five patients (23.5%) were hemodialysis-dependent after hospitalization. On multivariate regression analysis, hyperlipidemia (odds ratio, OR 6.08 [1.67–22]) and CRRT duration (OR 1.09 [1.03–1.15]) were associated with the need for dialysis post-hospitalization. In this group, 16 patients eventually became dialysis-free, after a median of 49 [34.7, 78.5] days. These patients had a higher median baseline glomerular filtration rate (GFR) compared to those who never recovered renal function (93 mL/min/1.73 m2 [82.4, 104.3] vs. 63.8 mL/min/1.73 m2 [37.9, 83], p = .009). Their follow-up GFR was lower compared to those who recovered renal function before hospital discharge; (87 mL/min/1.73 m2 [68.2, 98.9] vs. 99 mL/min/1.73 m2 [79, 118], p = .07).Conclusions AKI requiring CRRT was associated with high mortality in patients receiving ECMO. Nonetheless, most ECMO survivors became dialysis-free before hospital discharge. Variables associated with the need for outpatient dialysis included hyperlipidemia and prolonged need for CRRT during hospitalization.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2343810Chronic kidney diseaseextracorporeal membrane oxygenationcontinuous renal replacement therapydialysis |
| spellingShingle | Carlos Rodrigo Franco Palacios Rudiona Hoxhaj Catlyn Thigpen Jeffrey Jacob Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy Renal Failure Chronic kidney disease extracorporeal membrane oxygenation continuous renal replacement therapy dialysis |
| title | Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy |
| title_full | Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy |
| title_fullStr | Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy |
| title_full_unstemmed | Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy |
| title_short | Factors associated with post-hospitalization dialysis dependence in ECMO patients who required continuous renal replacement therapy |
| title_sort | factors associated with post hospitalization dialysis dependence in ecmo patients who required continuous renal replacement therapy |
| topic | Chronic kidney disease extracorporeal membrane oxygenation continuous renal replacement therapy dialysis |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2343810 |
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