Mortality predictors in acute kidney injury patients who underwent continuous venovenous hemodiafiltration: A retrospective, single-center study

Continuous renal replacement therapy (CRRT) is an increasingly preferred treatment that is easier to use in patients with hemodynamic impairment and can be applied in critical care settings. There are various subtypes of CRRT, one of which is continuous venovenous hemodiafiltration (CVVHDF). In this study, we examined the general characteristics of intensive care patients who underwent CVVHDF. Methods. The clinical and biochemical data of 123 patients who underwent CVVHDF in the intensive care units of our center between February 2012 and November 2014 were analyzed retrospectively. Patients who died during the course of therapy were compared with those who survived. Results. The study included 123 patients, 73 males (59.3%) and 50 females (40.7%). The mean age was 64.4 years. Eighty-eight patients (71.5%) died during CVVHDF while 35 patients survived (28.5%). Hemodynamic parameters such as systolic and diastolic arterial blood pressure, mean arterial pressure, and pulse pressure were significantly lower in patients who died compared to survivors (p<0.001). Mean lactic acid level was significantly higher in the deceased group than in the surviving group (8.54 mmol/L vs. 3.68 mmol/L, p<0.001, chi-square test). Conclusions. Low bicarbonate level, low systolic arterial blood pressure, and older age were significant independent predictors of mortality in this study. Mortality rates were significantly higher among patients with lactic acidosis and those over 66 years of age. Lactic acid levels can be used to predict mortality in patients undergoing CVVHDF.

[1]  D. Noritomi,et al.  Acid base variables predict survival early in the course of treatment with continuous venovenous hemodiafiltration , 2018, Medicine.

[2]  C. Droege,et al.  Evaluation of Thrombocytopenia in Critically Ill Patients Receiving Continuous Renal Replacement Therapy , 2018, The Annals of pharmacotherapy.

[3]  J. A. Llompart-Pou,et al.  Successful weaning from continuous renal replacement therapy. Associated risk factors , 2018, Journal of critical care.

[4]  G. Jian,et al.  Is the mean platelet volume a predictive marker of a high in-hospital mortality of acute cardiorenal syndrome patients receiving continuous renal replacement therapy? , 2018, Medicine.

[5]  R. Bellomo,et al.  Renal replacement therapy intensity for acute kidney injury and recovery to dialysis independence: a systematic review and individual patient data meta-analysis , 2017, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[6]  J. Monte,et al.  Outcomes from a cohort of patients with acute kidney injury subjected to continuous venovenous hemodiafiltration: The role of negative fluid balance , 2017, PloS one.

[7]  Qing-lin Li,et al.  Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men , 2016, Clinical interventions in aging.

[8]  T. Yoo,et al.  High-Dose Versus Conventional-Dose Continuous Venovenous Hemodiafiltration and Patient and Kidney Survival and Cytokine Removal in Sepsis-Associated Acute Kidney Injury: A Randomized Controlled Trial. , 2016, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[9]  Dong Won Lee,et al.  Use of Multifrequency Bioimpedance Analysis in Male Patients with Acute Kidney Injury Who Are Undergoing Continuous Veno-Venous Hemodiafiltration , 2015, PloS one.

[10]  H. Yasuda,et al.  Who may not benefit from continuous renal replacement therapy in acute kidney injury? , 2013, Hemodialysis international. International Symposium on Home Hemodialysis.

[11]  Jiang‐hua Chen,et al.  Hypophosphatemia during continuous veno-venous hemofiltration is associated with mortality in critically ill patients with acute kidney injury , 2013, Critical Care.

[12]  A. Muriel,et al.  Nephrology Referral and Outcomes in Critically Ill Acute Kidney Injury Patients , 2013, PloS one.

[13]  T. Yoo,et al.  Urine output is associated with prognosis in patients with acute kidney injury requiring continuous renal replacement therapy. , 2013, Journal of critical care.

[14]  D. Treacher,et al.  Heparin algorithm for anticoagulation during continuous renal replacement therapy , 2010, Critical care.

[15]  John A Kellum,et al.  Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury , 2007, Critical care.

[16]  J. Chiche,et al.  Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial , 2006, The Lancet.

[17]  U. Demirkılıç,et al.  Timing of Replacement Therapy for Acute Renal Failure After Cardiac Surgery , 2004, Journal of cardiac surgery.

[18]  J. Tijssen,et al.  Effects of early high-volume continuous venovenous hemofiltration on survival and recovery of renal function in intensive care patients with acute renal failure: A prospective, randomized trial , 2002, Critical care medicine.