7 247

Cited 24 times in

Early initiation of continuous renal replacement therapy improves patient survival in severe progressive septic acute kidney injury

 Hyung Jung Oh  ;  Dong Ho Shin  ;  Mi Jung Lee  ;  Hyang Mo Koo  ;  Fa Mee Doh  ;  Hyoung Rae Kim  ;  Jae Hyun Han  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Kyu Hun Choi  ;  Shin-Wook Kang 
 Journal of Critical Care, Vol.27(6) : 743-18, 2012 
Journal Title
 Journal of Critical Care 
Issue Date
PURPOSE: The definition of "early" in terms of continuous renal replacement therapy (CRRT) initiation has not been uniformly used. Therefore, we tried to elucidate whether the timing of CRRT application, based on the interval between the start time of vasopressors infusion and CRRT initiation, was an independent predictor of mortality in the patients with septic acute kidney injury (AKI). MATERIALS AND METHODS: Progressive septic AKI patients, in whom the infusion doses of vasopressors were increased compared with the initial dose during the first 6 hours of vasopressor treatment and CRRT was performed, between 2009 and 2011, were collected and divided into 2 groups based on the median interval between the 2 points. RESULTS: A total of 210 patients were included. The mean age was 62.4 years, and 126 patients (60.0%) were male. The most common comorbid disease was malignancy (53.8%), followed by hypertension (35.7%) and diabetes mellitus (29.0%). The median interval between the start time of vasopressor infusion and CRRT commencement was 2.0 days. During the study period, 156 patients (74.3%) died within 28 days of CRRT application. The interval between 2 points was significantly shorter in the survivor compared with the death group (P < .001). Moreover, 28-day overall mortality rates in the early CRRT group were significantly lower than those in the late CRRT group (P = .034). Furthermore, early CRRT treatment was independently associated with a lower mortality rate even after adjustment for age, sex, causative organisms, and infection sites (P = .032). CONCLUSIONS: This retrospective cohort study suggests that early initiation of CRRT may be of benefit. Given the complex nature of this intervention, the ongoing controversies regarding early vs late initiation of therapy in acute and chronic situation, there is an urgent need to develop well-designed clinical trials to answer the question definitely.
Full Text
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
구향모(Koo, Hyang Mo)
김형래(Kim, Hyoung Rae)
도화미(Doh, Fa Mee) ORCID logo https://orcid.org/0000-0002-4780-6728
박정탁(Park, Jung Tak) ORCID logo https://orcid.org/0000-0002-2325-8982
오형중(Oh, Hyung Jung)
유태현(Yoo, Tae Hyun) ORCID logo https://orcid.org/0000-0002-9183-4507
이미정(Lee, Mi Jung)
최규헌(Choi, Kyu Hun)
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
한재현(Han, Jae Hyun)
RIS (EndNote)
XLS (Excel)
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.