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Rev Med Inst Mex Seguro Soc. 2017 Nov-Dec;55(6):696-703.

[Prediction of acute kidney injury in critically ill patients treated with intermittent hemodialysis versus CRRT].

[Article in Spanish; Abstract available in Spanish from the publisher]

Author information

1
Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México baltazartorres@aol.com.

Abstract

in English, Spanish

BACKGROUND:

Acute kidney injury (AKI) is common in critically ill patients and it is associated with poor outcome. Some patients require renal replacement therapy (RRT), and the most frequently used are intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT). Current evidence is insufficient to conclude which modality is most appropriate to treat critically ill patients with AKI.

METHODS:

We reviewed the clinical records of critically ill patients with stage 3 AKI treated with RRT. We recorded demographic and clinical data and serum creatinine. We compared the evolution and prognosis of patients treated with IHD versus those treated with CRRT by Student's t test, chi squared, Kaplan-Meier curves, and Cox regression. Logistic regression was performed to determine the association between RRT and mortality.

RESULTS:

We analyzed 221 patients; the mean age was 49.8 years, and 55.2% were men. Mortality was 36.7%. IHD was used in 73.8% and CRRT in 26.2% of cases. In the group treated with CRRT, the severity of disease was higher, the recovery of renal function less frequent, the need for long-term RRT less frequent, and mortality higher, compared with those treated with IHD. CRRTs had an odds ratio (OR) of 8.64 for mortality (p = 0.063).

CONCLUSIONS:

IHD is the RRT most frequently used. Mortality is higher in patients treated with CRRT. CRRTs are not an independent risk factor for death.

KEYWORDS:

Mortality; Acute Kidney Injury; Renal Dialisis; Renal Replacement Theraphy

PMID:
29190861
[Indexed for MEDLINE]

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