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Urine output is associated with prognosis in patients with acute kidney injury requiring continuous renal replacement therapy

Title
 Urine output is associated with prognosis in patients with acute kidney injury requiring continuous renal replacement therapy 
Authors
 Hyung Jung Oh ; Dong Ho Shin ; Shin-Wook Kang ; Tae-Hyun Yoo ; Seung Hyeok Han ; Jung Tak Park ; Seong Yeong An ; Kyoung Sook Park ; Ki Heon Nam ; Yung Ly Kim ; Young Eun Kwon ; Fa Mee Doh ; Hyang Mo Koo ; Chan Ho Kim ; Kwang Il Ko ; Mi Jung Lee 
Issue Date
2013
Journal Title
 Oncotarget 
ISSN
 0883-9441 
Citation
 Oncotarget, Vol.28(4) : 379~388, 2013 
Abstract
PURPOSE: Although some studies have found that early initiation of continuous renal replacement therapy (CRRT) is associated with better prognosis, no consensus exists on the best timing to start CRRT. We investigated whether the timing of CRRT initiation was relevant to overall mortality and explored which factors at the time of CRRT initiation were associated with better outcomes in critically ill patients with acute kidney injury (AKI). MATERIALS AND METHODS: A total of 361 patients who received CRRT for AKI between 2009 and 2011 were collected and divided into 2 groups based on the median blood urea nitrogen (BUN) levels or 6-hour urine output immediately before CRRT was started. The impact of the timing of CRRT initiation stratified by BUN concentration or urine output on 28-day all-cause mortality was compared between groups. RESULTS: When the timing of CRRT initiation was stratified by 6-hour urine output, 28-day all-cause mortality rates were significantly lower in the nonoliguric group compared with the oliguric group (P = .02). In contrast, clinical outcomes were not different between the low-BUN and the high-BUN groups (P = .30). Cox regression analysis revealed that 28-day all-cause mortality risk was significantly lower in the nonoliguric group stratified by 6-hour urine output, even after adjusting for age, sex, mean arterial pressure, Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, and serum biomarkers (hazard ratio, 0.85; 95% confidence interval, 0.65-0.99; P = .04). CONCLUSIONS: Urine output but not BUN concentration was significantly associated with a better prognosis in critically ill patients with AKI requiring CRRT.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87194
DOI
10.1016/j.jcrc.2012.11.019
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S088394411200487X
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