Prognosis of Patients with Acute Kidney Injury due to Type 1 Cardiorenal Syndrome Receiving Continuous Renal Replacement Therapy.

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiorenal Medicine Pub Date : 2023-01-01 Epub Date: 2023-03-24 DOI:10.1159/000527111

Yusuke Watanabe, Tsutomu Inoue, Shintaro Nakano, Hirokazu Okada

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引用次数: 0

Abstract

Introduction: The prognosis of patients with acute kidney injury (AKI) caused by type 1 cardiorenal syndrome (CRS) requiring continuous renal replacement therapy (CRRT) is unclear. We investigated the in-hospital mortality and prognostic factors in these patients.

Methods: We retrospectively identified 154 consecutive adult patients who received CRRT for AKI caused by type 1 CRS between January 1, 2013, and December 31, 2019. We excluded patients who underwent cardiovascular surgery and those with stage 5 chronic kidney disease. The primary outcome was in-hospital mortality. Cox proportional hazards analysis was performed to analyze independent predictors of in-hospital mortality.

Results: The median age of patients at admission was 74.0 years (interquartile range: 63.0-80.0); 70.8% were male. The in-hospital mortality rate was 68.2%. Age ≥80 years (hazard ratio [HR], 1.87; 95% confidence interval [CI], 1.21-2.87; p = 0.004), previous hospitalization for acute heart failure (HR, 1.67; 95% CI, 1.13-2.46; p = 0.01), vasopressor or inotrope use (HR, 5.88; 95% CI, 1.43-24.1; p = 0.014), and mechanical ventilation at CRRT initiation (HR, 2.24; 95% CI, 1.46-3.45; p < 0.001) were associated with in-hospital mortality.

Conclusion: In our single-center study, the use of CRRT for AKI due to type 1 CRS was associated with high in-hospital mortality.

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接受持续肾脏替代疗法的 1 型心肾综合征急性肾损伤患者的预后。

简介由1型心肾综合征（CRS）引起的急性肾损伤（AKI）患者需要持续肾脏替代治疗（CRRT），其预后尚不明确。我们调查了这些患者的院内死亡率和预后因素：我们回顾性地确定了 2013 年 1 月 1 日至 2019 年 12 月 31 日期间因 1 型 CRS 引起的 AKI 而接受 CRRT 的 154 例连续成人患者。我们排除了接受心血管手术的患者和慢性肾脏病 5 期患者。主要结果是院内死亡率。我们对院内死亡率的独立预测因素进行了Cox比例危险分析：患者入院时的中位年龄为 74.0 岁（四分位间范围：63.0-80.0），70.8% 为男性。院内死亡率为 68.2%。年龄≥80 岁（危险比 [HR]，1.87；95% 置信区间 [CI]，1.21-2.87；P = 0.004）、曾因急性心力衰竭住院（HR，1.67；95% CI，1.13-2.46；P = 0.01）、使用血管加压素或肌力药物（HR，5.88；95% CI，1.43-24.1；p = 0.014）、CRRT 启动时机械通气（HR，2.24；95% CI，1.46-3.45；p <0.001）与院内死亡率相关：在我们的单中心研究中，因1型CRS导致的AKI使用CRRT与较高的院内死亡率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiorenal Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-UROLOGY & NEPHROLOGY

CiteScore

5.40

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The journal ''Cardiorenal Medicine'' explores the mechanisms by which obesity and other metabolic abnormalities promote the pathogenesis and progression of heart and kidney disease (cardiorenal metabolic syndrome). It provides an interdisciplinary platform for the advancement of research and clinical practice, focussing on translational issues.