The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysis
AbstractSevere rhabdomyolysis frequently results in acute kidney injury (AKI) due to myoglobin accumulation with the need of kidney replacement therapy (KRT). The present study investigated whether the application of Cytosorb® (CS) led to an increased rate of kidney recovery in patients with KRT due...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2259231 |
| _version_ | 1797211785098428416 |
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| author | Caroline Gräfe Uwe Liebchen Antonia Greimel Nils Maciuga Mathias Bruegel Michael Irlbeck Lorenz Weidhase Michael Zoller Michael Paal Christina Scharf |
| author_facet | Caroline Gräfe Uwe Liebchen Antonia Greimel Nils Maciuga Mathias Bruegel Michael Irlbeck Lorenz Weidhase Michael Zoller Michael Paal Christina Scharf |
| author_sort | Caroline Gräfe |
| collection | DOAJ |
| description | AbstractSevere rhabdomyolysis frequently results in acute kidney injury (AKI) due to myoglobin accumulation with the need of kidney replacement therapy (KRT). The present study investigated whether the application of Cytosorb® (CS) led to an increased rate of kidney recovery in patients with KRT due to severe rhabdomyolysis. Adult patients with a myoglobin-concentration >10,000 ng/ml and KRT were included from 2014 to 2021. Exclusion criteria were chronic kidney disease and CS-treatment before study inclusion. Groups 1 and 2 were defined as KRT with and without CS, respectively. The primary outcome parameter was independence from KRT after 30 days. Propensity score (PS) matching was performed (predictors: myoglobin, SAPS-II, and age), and the chi2-test was used. 35 pairings could be matched (mean age: 57 vs. 56 years; mean myoglobin: 27,218 vs. 26,872 ng/ml; mean SAPS-II: 77 vs. 76). The probability of kidney recovery was significantly (p = .04) higher in group 1 (31.4 vs. 11.4%, mean difference: 20.0%, odds ratio (OR): 3.6). Considering patients who survived 30 days, kidney recovery was also significantly (p = .03) higher in patients treated with CS (61.1 vs. 23.5%, mean difference: 37.6%, OR: 5.1). In conclusion, the use of CS might positively affect renal recovery in patients with severe rhabdomyolysis. A prospective randomized controlled trial is needed to confirm this hypothesis. |
| first_indexed | 2024-03-11T23:30:26Z |
| format | Article |
| id | doaj.art-0c4648b2a6f743d99fe093eedc9a5a10 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-04-24T10:32:00Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-0c4648b2a6f743d99fe093eedc9a5a102024-04-12T14:34:28ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145210.1080/0886022X.2023.2259231The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysisCaroline Gräfe0Uwe Liebchen1Antonia Greimel2Nils Maciuga3Mathias Bruegel4Michael Irlbeck5Lorenz Weidhase6Michael Zoller7Michael Paal8Christina Scharf9Department of Anesthesiology, LMU hospital, Munich, GermanyDepartment of Anesthesiology, LMU hospital, Munich, GermanyDepartment of Anesthesiology, LMU hospital, Munich, GermanyDepartment of Anesthesiology, LMU hospital, Munich, GermanyInstitute of Laboratory Medicine, LMU hospital, Munich, GermanyDepartment of Anesthesiology, LMU hospital, Munich, GermanyMedical Intensive Care Unit, University Hospital Leipzig, Leipzig, GermanyDepartment of Anesthesiology, LMU hospital, Munich, GermanyInstitute of Laboratory Medicine, LMU hospital, Munich, GermanyDepartment of Anesthesiology, LMU hospital, Munich, GermanyAbstractSevere rhabdomyolysis frequently results in acute kidney injury (AKI) due to myoglobin accumulation with the need of kidney replacement therapy (KRT). The present study investigated whether the application of Cytosorb® (CS) led to an increased rate of kidney recovery in patients with KRT due to severe rhabdomyolysis. Adult patients with a myoglobin-concentration >10,000 ng/ml and KRT were included from 2014 to 2021. Exclusion criteria were chronic kidney disease and CS-treatment before study inclusion. Groups 1 and 2 were defined as KRT with and without CS, respectively. The primary outcome parameter was independence from KRT after 30 days. Propensity score (PS) matching was performed (predictors: myoglobin, SAPS-II, and age), and the chi2-test was used. 35 pairings could be matched (mean age: 57 vs. 56 years; mean myoglobin: 27,218 vs. 26,872 ng/ml; mean SAPS-II: 77 vs. 76). The probability of kidney recovery was significantly (p = .04) higher in group 1 (31.4 vs. 11.4%, mean difference: 20.0%, odds ratio (OR): 3.6). Considering patients who survived 30 days, kidney recovery was also significantly (p = .03) higher in patients treated with CS (61.1 vs. 23.5%, mean difference: 37.6%, OR: 5.1). In conclusion, the use of CS might positively affect renal recovery in patients with severe rhabdomyolysis. A prospective randomized controlled trial is needed to confirm this hypothesis.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2259231Rhabdomyolysismyoglobinkidney replacement therapyblood purificationkidney recoverycytosorb® |
| spellingShingle | Caroline Gräfe Uwe Liebchen Antonia Greimel Nils Maciuga Mathias Bruegel Michael Irlbeck Lorenz Weidhase Michael Zoller Michael Paal Christina Scharf The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysis Renal Failure Rhabdomyolysis myoglobin kidney replacement therapy blood purification kidney recovery cytosorb® |
| title | The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysis |
| title_full | The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysis |
| title_fullStr | The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysis |
| title_full_unstemmed | The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysis |
| title_short | The effect of cytosorb® application on kidney recovery in critically ill patients with severe rhabdomyolysis: a propensity score matching analysis |
| title_sort | effect of cytosorb r application on kidney recovery in critically ill patients with severe rhabdomyolysis a propensity score matching analysis |
| topic | Rhabdomyolysis myoglobin kidney replacement therapy blood purification kidney recovery cytosorb® |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2259231 |
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