Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy
Background Fluid overload is an independent risk factor of mortality in patients with acute kidney injury (AKI) receiving continuous kidney replacement therapy (CKRT). However, the association between fluid status, as assessed by bioelectrical impedance analysis (BIA) or lung ultrasound, and surviva...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2024-01-01
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| Series: | Kidney Research and Clinical Practice |
| Subjects: | |
| Online Access: | http://krcp-ksn.org/upload/pdf/j-krcp-23-162.pdf |
| _version_ | 1797311434315530240 |
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| author | Cheol Ho Park Seung Gyu Han Hyung Woo Kim Jung Tak Park Seung Hyeok Han Seung Jun Kim Shin-Wook Kang |
| author_facet | Cheol Ho Park Seung Gyu Han Hyung Woo Kim Jung Tak Park Seung Hyeok Han Seung Jun Kim Shin-Wook Kang |
| author_sort | Cheol Ho Park |
| collection | DOAJ |
| description | Background Fluid overload is an independent risk factor of mortality in patients with acute kidney injury (AKI) receiving continuous kidney replacement therapy (CKRT). However, the association between fluid status, as assessed by bioelectrical impedance analysis (BIA) or lung ultrasound, and survival in patients with AKI requiring CKRT has not been established. Methods We analyzed 36 participants with sepsis-associated AKI who received CKRT at a tertiary hospital. The main exposures were volume surrogates: 1) overhydration normalized by extracellular water (OH/ECW, L/L) assessed by BIA, 2) the number of B-lines measured by lung ultrasound, and 3) weight change ([body weight at CKRT initiation – body weight at admission] × 100/body weight at admission). The primary outcome was the 28-day mortality. Results Seventeen participants (47.2%) died within 28 days. There were no significant correlations between OH/ECW and weight change (R2 = 0.040, p = 0.24), number of B-lines and OH/ECW (R2 = 0.056, p = 0.16), or weight change and number of B-lines (R2 = 0.014, p = 0.49). Kaplan-Meier analyses revealed that patients in the highest tertile of OH/ECW showed a significantly lower cumulative 28-day survival probability than the others (the lowest + middle tertiles). The survival probability of participants in the highest tertile of the number of B-lines or weight change did not differ from that of their counterparts. In a multivariate Cox proportional hazard model, the hazard ratio for the highest tertile of OH/ECW was 3.83 (95% confidence interval, 1.04–14.03). Conclusion Volume overload assessed using BIA (OH/ECW) was associated with the 28-day survival rate in patients with sepsis-associated AKI who received CKRT. |
| first_indexed | 2024-03-08T01:59:35Z |
| format | Article |
| id | doaj.art-33d46082c3e04eb39165b4184a3b0ddf |
| institution | Directory Open Access Journal |
| issn | 2211-9132 2211-9140 |
| language | English |
| last_indexed | 2024-03-08T01:59:35Z |
| publishDate | 2024-01-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-33d46082c3e04eb39165b4184a3b0ddf2024-02-14T06:28:46ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322211-91402024-01-014319310010.23876/j.krcp.23.1626279Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapyCheol Ho Park0Seung Gyu Han1Hyung Woo Kim2Jung Tak Park3Seung Hyeok Han4Seung Jun Kim5Shin-Wook Kang6 Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of KoreaBackground Fluid overload is an independent risk factor of mortality in patients with acute kidney injury (AKI) receiving continuous kidney replacement therapy (CKRT). However, the association between fluid status, as assessed by bioelectrical impedance analysis (BIA) or lung ultrasound, and survival in patients with AKI requiring CKRT has not been established. Methods We analyzed 36 participants with sepsis-associated AKI who received CKRT at a tertiary hospital. The main exposures were volume surrogates: 1) overhydration normalized by extracellular water (OH/ECW, L/L) assessed by BIA, 2) the number of B-lines measured by lung ultrasound, and 3) weight change ([body weight at CKRT initiation – body weight at admission] × 100/body weight at admission). The primary outcome was the 28-day mortality. Results Seventeen participants (47.2%) died within 28 days. There were no significant correlations between OH/ECW and weight change (R2 = 0.040, p = 0.24), number of B-lines and OH/ECW (R2 = 0.056, p = 0.16), or weight change and number of B-lines (R2 = 0.014, p = 0.49). Kaplan-Meier analyses revealed that patients in the highest tertile of OH/ECW showed a significantly lower cumulative 28-day survival probability than the others (the lowest + middle tertiles). The survival probability of participants in the highest tertile of the number of B-lines or weight change did not differ from that of their counterparts. In a multivariate Cox proportional hazard model, the hazard ratio for the highest tertile of OH/ECW was 3.83 (95% confidence interval, 1.04–14.03). Conclusion Volume overload assessed using BIA (OH/ECW) was associated with the 28-day survival rate in patients with sepsis-associated AKI who received CKRT.http://krcp-ksn.org/upload/pdf/j-krcp-23-162.pdfacute kidney injurybioelectrical impedance analysiscontinuous kidney replacement therapysepsis |
| spellingShingle | Cheol Ho Park Seung Gyu Han Hyung Woo Kim Jung Tak Park Seung Hyeok Han Seung Jun Kim Shin-Wook Kang Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy Kidney Research and Clinical Practice acute kidney injury bioelectrical impedance analysis continuous kidney replacement therapy sepsis |
| title | Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy |
| title_full | Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy |
| title_fullStr | Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy |
| title_full_unstemmed | Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy |
| title_short | Association between volume status assessed by bioelectrical impedance analysis, lung ultrasound, or weight change and mortality in patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy |
| title_sort | association between volume status assessed by bioelectrical impedance analysis lung ultrasound or weight change and mortality in patients with sepsis associated acute kidney injury receiving continuous kidney replacement therapy |
| topic | acute kidney injury bioelectrical impedance analysis continuous kidney replacement therapy sepsis |
| url | http://krcp-ksn.org/upload/pdf/j-krcp-23-162.pdf |
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