Renal Replacement Therapy Modality in the ICU and Renal Recovery at Hospital Discharge.
Details
Serval ID
serval:BIB_A59AFD9205E2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Renal Replacement Therapy Modality in the ICU and Renal Recovery at Hospital Discharge.
Journal
Critical care medicine
Working group(s)
AzuRéa Group
Contributor(s)
Perrigault P.F., Jabaudon M., Allaouchiche B., Leone M., Orban J.C., Legrand M., Perbet S., Roger C., Julia J.M., Molliex S., Chabanne R., Antonini F., Kauffmann S., Danin P.E., Godet T., Langeron O., Friggeri A., Geeraerts T., Muller L., Ripart J., Baldesi O., Barbar S., Morel J., Lepape A., Bertrand P.M., Bazin J.E., Mofredj A., Riu-Poulenc B., Lakhal K., Minville V., Futier E., Guerci P., Novy E., Bouzat P., Lu Q., Debbat K.
ISSN
1530-0293 (Electronic)
ISSN-L
0090-3493
Publication state
Published
Issued date
02/2018
Peer-reviewed
Oui
Volume
46
Number
2
Pages
e102-e110
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Acute kidney injury requiring renal replacement therapy is a major concern in ICUs. Initial renal replacement therapy modality, continuous renal replacement therapy or intermittent hemodialysis, may impact renal recovery. The aim of this study was to assess the influence of initial renal replacement therapy modality on renal recovery at hospital discharge.
Retrospective cohort study of all ICU stays from January 1, 2010, to December 31, 2013, with a "renal replacement therapy for acute kidney injury" code using the French hospital discharge database.
Two hundred ninety-one ICUs in France.
A total of 1,031,120 stays: 58,635 with renal replacement therapy for acute kidney injury and 25,750 included in the main analysis.
None.
PPatients alive at hospital discharge were grouped according to initial modality (continuous renal replacement therapy or intermittent hemodialysis) and included in the main analysis to identify predictors of renal recovery. Renal recovery was defined as greater than 3 days without renal replacement therapy before hospital discharge. The main analysis was a hierarchical logistic regression analysis including patient demographics, comorbidities, and severity variables, as well as center characteristics. Three sensitivity analyses were performed. Overall mortality was 56.1%, and overall renal recovery was 86.2%. Intermittent hemodialysis was associated with a lower likelihood of recovery at hospital discharge; odds ratio, 0.910 (95% CI, 0.834-0.992) p value equals to 0.0327. Results were consistent across all sensitivity analyses with odds/hazards ratios ranging from 0.883 to 0.958.
In this large retrospective study, intermittent hemodialysis as an initial modality was associated with lower renal recovery at hospital discharge among patients with acute kidney injury, although the difference seems somewhat clinically limited.
Retrospective cohort study of all ICU stays from January 1, 2010, to December 31, 2013, with a "renal replacement therapy for acute kidney injury" code using the French hospital discharge database.
Two hundred ninety-one ICUs in France.
A total of 1,031,120 stays: 58,635 with renal replacement therapy for acute kidney injury and 25,750 included in the main analysis.
None.
PPatients alive at hospital discharge were grouped according to initial modality (continuous renal replacement therapy or intermittent hemodialysis) and included in the main analysis to identify predictors of renal recovery. Renal recovery was defined as greater than 3 days without renal replacement therapy before hospital discharge. The main analysis was a hierarchical logistic regression analysis including patient demographics, comorbidities, and severity variables, as well as center characteristics. Three sensitivity analyses were performed. Overall mortality was 56.1%, and overall renal recovery was 86.2%. Intermittent hemodialysis was associated with a lower likelihood of recovery at hospital discharge; odds ratio, 0.910 (95% CI, 0.834-0.992) p value equals to 0.0327. Results were consistent across all sensitivity analyses with odds/hazards ratios ranging from 0.883 to 0.958.
In this large retrospective study, intermittent hemodialysis as an initial modality was associated with lower renal recovery at hospital discharge among patients with acute kidney injury, although the difference seems somewhat clinically limited.
Keywords
Acute Kidney Injury/therapy, Aged, Cohort Studies, Female, Humans, Intensive Care Units, Male, Middle Aged, Patient Discharge, Renal Replacement Therapy, Retrospective Studies
Pubmed
Web of science
Create date
09/11/2017 17:17
Last modification date
20/08/2019 15:10
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