Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in Korea
Background Data on liver cirrhosis (LC) patients undergoing continuous renal replacement therapy (CRRT) are lacking despite of the dismal prognosis. We therefore evaluated clinical characteristics and predictive factors related to mortality in LC patients undergoing CRRT. Methods We performed a retr...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2021-12-01
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| Series: | Kidney Research and Clinical Practice |
| Subjects: | |
| Online Access: | http://www.krcp-ksn.org/upload/pdf/j-krcp-21-033.pdf |
| _version_ | 1828359540406484992 |
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| author | You Hyun Jeon Il Young Kim Gum Sook Jang Sang Heon Song Eun Young Seong Dong Won Lee Soo Bong Lee Hyo Jin Kim |
| author_facet | You Hyun Jeon Il Young Kim Gum Sook Jang Sang Heon Song Eun Young Seong Dong Won Lee Soo Bong Lee Hyo Jin Kim |
| author_sort | You Hyun Jeon |
| collection | DOAJ |
| description | Background Data on liver cirrhosis (LC) patients undergoing continuous renal replacement therapy (CRRT) are lacking despite of the dismal prognosis. We therefore evaluated clinical characteristics and predictive factors related to mortality in LC patients undergoing CRRT. Methods We performed a retrospective observational study at two tertiary hospitals in Korea. A total of 229 LC patients who underwent CRRT were analyzed. Patients were classified into survivor and non-survivor groups. We used multivariable Cox regression analyses to identify predictive factors of in-hospital mortality. Results During a median follow-up of 5 days (interquartile range, 1–19 days), in-hospital mortality rate was 66.4%. In multivariable analysis, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.01–1.06; p = 0.02), Model for End-Stage Liver Disease (MELD) score (HR, 1.08; 95% CI, 1.04–1.11; p < 0.001), and delivered CRRT dose (HR, 0.95; 95% CI, 0.92–0.98; p = 0.002) were significant risk factors for in-hospital mortality. Patients with a CRRT delivered dose < 25 mL/kg/hr had a higher mortality rate than those with a delivered dose > 35 mL/kg/hr (HR, 3.13; 95% CI, 1.62–6.05; p = 0.001). Subgroup analysis revealed that a CRRT delivered dose < 25 mL/kg/hr was a significant risk factor for in-hospital mortality among LC patients with a MELD score ≥ 30. Conclusion High APACHE II score, high MELD score, and low delivered CRRT dose were significant risk factors for in-hospital mortality. CRRT delivered dose impacted mortality significantly, especially in patients with a MELD score ≥ 30. |
| first_indexed | 2024-04-14T03:43:29Z |
| format | Article |
| id | doaj.art-980d604b59194124b6515fa5baad6980 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 2211-9140 |
| language | English |
| last_indexed | 2024-04-14T03:43:29Z |
| publishDate | 2021-12-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-980d604b59194124b6515fa5baad69802022-12-22T02:14:25ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322211-91402021-12-0140468769710.23876/j.krcp.21.0336065Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in KoreaYou Hyun Jeon0Il Young Kim1Gum Sook Jang2Sang Heon Song3Eun Young Seong4Dong Won Lee5Soo Bong Lee6Hyo Jin Kim7 Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of KoreaBackground Data on liver cirrhosis (LC) patients undergoing continuous renal replacement therapy (CRRT) are lacking despite of the dismal prognosis. We therefore evaluated clinical characteristics and predictive factors related to mortality in LC patients undergoing CRRT. Methods We performed a retrospective observational study at two tertiary hospitals in Korea. A total of 229 LC patients who underwent CRRT were analyzed. Patients were classified into survivor and non-survivor groups. We used multivariable Cox regression analyses to identify predictive factors of in-hospital mortality. Results During a median follow-up of 5 days (interquartile range, 1–19 days), in-hospital mortality rate was 66.4%. In multivariable analysis, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.01–1.06; p = 0.02), Model for End-Stage Liver Disease (MELD) score (HR, 1.08; 95% CI, 1.04–1.11; p < 0.001), and delivered CRRT dose (HR, 0.95; 95% CI, 0.92–0.98; p = 0.002) were significant risk factors for in-hospital mortality. Patients with a CRRT delivered dose < 25 mL/kg/hr had a higher mortality rate than those with a delivered dose > 35 mL/kg/hr (HR, 3.13; 95% CI, 1.62–6.05; p = 0.001). Subgroup analysis revealed that a CRRT delivered dose < 25 mL/kg/hr was a significant risk factor for in-hospital mortality among LC patients with a MELD score ≥ 30. Conclusion High APACHE II score, high MELD score, and low delivered CRRT dose were significant risk factors for in-hospital mortality. CRRT delivered dose impacted mortality significantly, especially in patients with a MELD score ≥ 30.http://www.krcp-ksn.org/upload/pdf/j-krcp-21-033.pdfacute kidney injurycontinuous renal replacement therapyliver cirrhosismortalityprognosis |
| spellingShingle | You Hyun Jeon Il Young Kim Gum Sook Jang Sang Heon Song Eun Young Seong Dong Won Lee Soo Bong Lee Hyo Jin Kim Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in Korea Kidney Research and Clinical Practice acute kidney injury continuous renal replacement therapy liver cirrhosis mortality prognosis |
| title | Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in Korea |
| title_full | Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in Korea |
| title_fullStr | Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in Korea |
| title_full_unstemmed | Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in Korea |
| title_short | Clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in Korea |
| title_sort | clinical outcomes and prognostic factors of mortality in liver cirrhosis patients on continuous renal replacement therapy in two tertiary hospitals in korea |
| topic | acute kidney injury continuous renal replacement therapy liver cirrhosis mortality prognosis |
| url | http://www.krcp-ksn.org/upload/pdf/j-krcp-21-033.pdf |
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