The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function

Detalhes bibliográficos
Autor(a) principal: de Souza Oliveira, Marisa Aparecida [UNIFESP]
Data de Publicação: 2017
Outros Autores: Claizoni dos Santos, Thais Oliveira [UNIFESP], Martins Monte, Julio Cesar, Batista, Marcelo Costa [UNIFESP], Pereira, Virgilio Goncalves, Jr., Cardoso dos Santos, Bento Fortunato, Pavao Santos, Oscar Fernando [UNIFESP], Durao, Marcelino de Souza, Jr. [UNIFESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1186/s12882-017-0564-z
https://repositorio.unifesp.br/handle/11600/54471
Resumo: Background: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI. Methods: We conducted a retrospective study investigating patients (>= 16 years old) admitted to an intensive care unit with D AKI from 1999 to 2012. We analyzed D AKI incidence, and outcomes, as well as the most commonly used dialysis modality over time. Outcomes were based on hospital mortality, renal function recovery (estimated glomerular filtration rate-eGFR), and the need for dialysis treatment at hospital discharge. Results: In 1,493 patients with D-AKI, sepsis was the main cause of kidney injury (56.2%). The comparison between the three study periods, (1999-2003, 2004-2008, and 2009-2012) showed an increased in incidence of D-AKI (from 2.56 to 5.17%
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spelling The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney functionAcute kidney injuryDialysisCRRTBackground: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI. Methods: We conducted a retrospective study investigating patients (>= 16 years old) admitted to an intensive care unit with D AKI from 1999 to 2012. We analyzed D AKI incidence, and outcomes, as well as the most commonly used dialysis modality over time. Outcomes were based on hospital mortality, renal function recovery (estimated glomerular filtration rate-eGFR), and the need for dialysis treatment at hospital discharge. Results: In 1,493 patients with D-AKI, sepsis was the main cause of kidney injury (56.2%). The comparison between the three study periods, (1999-2003, 2004-2008, and 2009-2012) showed an increased in incidence of D-AKI (from 2.56 to 5.17%p = 0.001), in the APACHE II score (from 20 to 26p < 0.001), and in the use of continuous renal replacement therapy (CRRT) as initial dialysis modality choice (from 64.2 to 72.2%p < 0.001). The mortality rate (53.9%) and dialysis dependence at hospital discharge (12.3%) remained unchanged over time. Individuals who recovered renal function (33.8%) showed that those who had initially undergone CRRT had a higher eGFR than those in the intermittent hemodialysis group (54.0 x 46.0 ml/min/1.73 m2, respectivelyp = 0.014). In multivariate analysis, type of patient, sepsis-associated AKI and APACHE II score were associated to death. For each additional unit of the APACHE II score, the odds of death increased by 52%. The odds ratio of death for medical patients with sepsis-associated AKI was estimated to be 2.93 (1.81-4.75p < 0.001). Conclusion: Our study showed that the incidence of D AKI increased with illness severity, and the use of CRRT also increased over time. The improvement in renal outcomes observed in the CRRT group may be related to the better baseline kidney function, especially in the dialysis dependence patients at hospital discharge.Hosp Israelita Albert Einstein, Nephrol Div, Ave Albert Einstein 627, BR-05652900 Morumbi, SP, BrazilUniv Fed Sao Paulo, Nephrol Div, Rua Botucatu 740,Vila Clementino, BR-04023062 Sao Paulo, BrazilUniv Fed Sao Paulo, Nephrol Div, Rua Botucatu 740,Vila Clementino, BR-04023062 Sao Paulo, BrazilWeb of ScienceBiomed Central Ltd2020-07-13T11:53:14Z2020-07-13T11:53:14Z2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion-http://dx.doi.org/10.1186/s12882-017-0564-zBmc Nephrology. London, v. 18, p. -, 2017.10.1186/s12882-017-0564-zWOS000400586500001.pdf1471-2369https://repositorio.unifesp.br/handle/11600/54471WOS:000400586500001engBmc NephrologyLondoninfo:eu-repo/semantics/openAccessde Souza Oliveira, Marisa Aparecida [UNIFESP]Claizoni dos Santos, Thais Oliveira [UNIFESP]Martins Monte, Julio CesarBatista, Marcelo Costa [UNIFESP]Pereira, Virgilio Goncalves, Jr.Cardoso dos Santos, Bento FortunatoPavao Santos, Oscar Fernando [UNIFESP]Durao, Marcelino de Souza, Jr. [UNIFESP]reponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2022-02-08T17:50:51Zoai:repositorio.unifesp.br/:11600/54471Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652022-02-08T17:50:51Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
title The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
spellingShingle The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
de Souza Oliveira, Marisa Aparecida [UNIFESP]
Acute kidney injury
Dialysis
CRRT
title_short The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
title_full The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
title_fullStr The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
title_full_unstemmed The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
title_sort The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
author de Souza Oliveira, Marisa Aparecida [UNIFESP]
author_facet de Souza Oliveira, Marisa Aparecida [UNIFESP]
Claizoni dos Santos, Thais Oliveira [UNIFESP]
Martins Monte, Julio Cesar
Batista, Marcelo Costa [UNIFESP]
Pereira, Virgilio Goncalves, Jr.
Cardoso dos Santos, Bento Fortunato
Pavao Santos, Oscar Fernando [UNIFESP]
Durao, Marcelino de Souza, Jr. [UNIFESP]
author_role author
author2 Claizoni dos Santos, Thais Oliveira [UNIFESP]
Martins Monte, Julio Cesar
Batista, Marcelo Costa [UNIFESP]
Pereira, Virgilio Goncalves, Jr.
Cardoso dos Santos, Bento Fortunato
Pavao Santos, Oscar Fernando [UNIFESP]
Durao, Marcelino de Souza, Jr. [UNIFESP]
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv de Souza Oliveira, Marisa Aparecida [UNIFESP]
Claizoni dos Santos, Thais Oliveira [UNIFESP]
Martins Monte, Julio Cesar
Batista, Marcelo Costa [UNIFESP]
Pereira, Virgilio Goncalves, Jr.
Cardoso dos Santos, Bento Fortunato
Pavao Santos, Oscar Fernando [UNIFESP]
Durao, Marcelino de Souza, Jr. [UNIFESP]
dc.subject.por.fl_str_mv Acute kidney injury
Dialysis
CRRT
topic Acute kidney injury
Dialysis
CRRT
description Background: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI. Methods: We conducted a retrospective study investigating patients (>= 16 years old) admitted to an intensive care unit with D AKI from 1999 to 2012. We analyzed D AKI incidence, and outcomes, as well as the most commonly used dialysis modality over time. Outcomes were based on hospital mortality, renal function recovery (estimated glomerular filtration rate-eGFR), and the need for dialysis treatment at hospital discharge. Results: In 1,493 patients with D-AKI, sepsis was the main cause of kidney injury (56.2%). The comparison between the three study periods, (1999-2003, 2004-2008, and 2009-2012) showed an increased in incidence of D-AKI (from 2.56 to 5.17%
publishDate 2017
dc.date.none.fl_str_mv 2017
2020-07-13T11:53:14Z
2020-07-13T11:53:14Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1186/s12882-017-0564-z
Bmc Nephrology. London, v. 18, p. -, 2017.
10.1186/s12882-017-0564-z
WOS000400586500001.pdf
1471-2369
https://repositorio.unifesp.br/handle/11600/54471
WOS:000400586500001
url http://dx.doi.org/10.1186/s12882-017-0564-z
https://repositorio.unifesp.br/handle/11600/54471
identifier_str_mv Bmc Nephrology. London, v. 18, p. -, 2017.
10.1186/s12882-017-0564-z
WOS000400586500001.pdf
1471-2369
WOS:000400586500001
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Bmc Nephrology
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv -
dc.coverage.none.fl_str_mv London
dc.publisher.none.fl_str_mv Biomed Central Ltd
publisher.none.fl_str_mv Biomed Central Ltd
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
_version_ 1814268376214667264

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