دورية أكاديمية
Predicting successful continuous renal replacement therapy liberation in critically ill patients with acute kidney injury.
العنوان: | Predicting successful continuous renal replacement therapy liberation in critically ill patients with acute kidney injury. |
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المؤلفون: | Liu C; Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA., Peng Z; Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China., Dong Y; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA., Li Z; Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA., Andrijasevic NM; Department of Anesthesia Clinical Research Unit, Mayo Clinic, Rochester, MN, USA., Albright RC Jr; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA., Kashani KB; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: kashani.kianoush@mayo.edu. |
المصدر: | Journal of critical care [J Crit Care] 2021 Dec; Vol. 66, pp. 6-13. Date of Electronic Publication: 2021 Aug 03. |
نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8610642 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-8615 (Electronic) Linking ISSN: 08839441 NLM ISO Abbreviation: J Crit Care Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Philadelphia Pa : W.B. Saunders Original Publication: Orlando, FL : Grune & Stratton, c1986- |
مواضيع طبية MeSH: | Acute Kidney Injury*/therapy , Continuous Renal Replacement Therapy*, Adult ; Critical Illness ; Humans ; Renal Replacement Therapy ; Retrospective Studies |
مستخلص: | Purpose: No standardized criteria for continuous renal replacement therapy (CRRT) liberation have been established. We sought to develop and internally validate prediction models for successful CRRT liberation in critically ill patients with acute kidney injury (AKI). Materials and Methods: This single-center, retrospective cohort study included adult patients admitted to intensive care units (ICUs) with AKI and treated with CRRT from January 1, 2007, to May 4, 2018, at a tertiary referral hospital. The cohort was randomly divided into derivation and validation sets. The outcomes were successful CRRT liberation, defined as renal replacement therapy (RRT)-free survival within 72 h after the liberation and hospital discharge. Multivariate logistic regression models were developed and internally validated. Results: Of 1135 AKI patients requiring CRRT, successful CRRT liberation and RRT-free survival at hospital discharge were observed in 228 (20%) and 395 (35%) individuals, respectively. The independent predictors included mean hourly urine output within 12 h before liberation, mean serum creatinine value within 24 h before liberation, cumulative fluid balance from ICU admission to liberation, CRRT duration before liberation, and the requirement of vasoactive agents within 24 h before liberation. The models demonstrated good discrimination (AUROC, 0.76 and 0.78; positive predictive value, 36% and 48%; negative predictive value, 92% and 94%; respectively) and calibration in the validation set. Conclusions: These validated models could assist the decision-making related to the CRRT liberation in critically ill patients with AKI. Competing Interests: Declaration of Competing Interest All authors disclosed that they do not have any conflicts of interest regarding this study. (Copyright © 2021 Elsevier Inc. All rights reserved.) |
فهرسة مساهمة: | Keywords: Acute kidney injury; Continuous renal replacement therapy; Intensive care units; Prognosis; Recovery of function |
تواريخ الأحداث: | Date Created: 20210806 Date Completed: 20211027 Latest Revision: 20220531 |
رمز التحديث: | 20231215 |
DOI: | 10.1016/j.jcrc.2021.07.020 |
PMID: | 34358675 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1557-8615 |
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DOI: | 10.1016/j.jcrc.2021.07.020 |