Factors Predicting Withdrawal From RRT for AKI Identified

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Ventilator use is among the risk factors that predict patient withdrawal from renal replacement therapy for acute kidney injury.
Ventilator use is among the risk factors that predict patient withdrawal from renal replacement therapy for acute kidney injury.

Researchers have identified factors that predict patient withdrawal from renal replacement therapy (RRT) for acute kidney injury (AKI), according to a report in Clinical and Experimental Nephrology.

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Katsuhito Ihara, MD, of Metropolitan Bokutoh Hospital, Tokyo, Japan, and colleagues conducted a single-center retrospective cohort study in which they examined the clinical records of 334 patients with AKI requiring RRT who were hospitalized in an intensive care unit or general wards from January 2010 through December 2013. Patients had a median age of 68 years and 71.6% were male.

Of the 334 patients, 157 (47%) withdrew from RRT. Multivariable Cox regression analysis revealed that chronic kidney disease, ventilator use, hypoalbuminemia, and a mean arterial pressure (MAP) above 95 mm Hg (compared with 65 to 75 mm Hg) were significantly associated with RRT withdrawal.

Dr Ihara's team concluded that maintaining a higher MAP at RRT initiation may potentially lead to dependence on RRT.

References

Ihara K, Ishigami J, Inoshita S. Predictors of withdrawal from renal replacement therapy among patients with acute kidney injury requiring renal replacement therapy. Clin Exp Nephrol. 2019; published online ahead of print. 

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