The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study
1,3-β-d-Glucan (BDG) is commonly used for diagnosing invasive fungal infections (IFIs). While exposure to cellulose-based hemodialyzers is known to cause false-positive BDG results, the impact of modern hemofilters used in continuous renal replacement therapy (CRRT) remains unclear. This retrospecti...
| 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.2023.2255680 |
| _version_ | 1827233722654523392 |
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| author | M. Gabriela Cabanilla Matthew J. Briski Zachary Bruss Lisa Saa Pamela C. Vasquez Chelsea N. Rodriguez Jessica A. Mitchell Michael L. Bernauer Christos P. Argyropoulos Cameron S. Crandall J. Pedro Teixeira |
| author_facet | M. Gabriela Cabanilla Matthew J. Briski Zachary Bruss Lisa Saa Pamela C. Vasquez Chelsea N. Rodriguez Jessica A. Mitchell Michael L. Bernauer Christos P. Argyropoulos Cameron S. Crandall J. Pedro Teixeira |
| author_sort | M. Gabriela Cabanilla |
| collection | DOAJ |
| description | 1,3-β-d-Glucan (BDG) is commonly used for diagnosing invasive fungal infections (IFIs). While exposure to cellulose-based hemodialyzers is known to cause false-positive BDG results, the impact of modern hemofilters used in continuous renal replacement therapy (CRRT) remains unclear. This retrospective, single-center cohort study aimed to evaluate the effect of CRRT on BDG levels in critically ill patients. We included adult intensive care unit (ICU) patients with ≥1 BDG measurement between December 2019 and December 2020. The primary outcome was the rate of false-positive BDG results in patients exposed to CRRT compared to unexposed patients. Propensity score analysis was performed to control for confounding factors. A total of 103 ICU patients with ≥1 BDG level were identified. Most (72.8%) were medical ICU patients. Forty patients underwent CRRT using hemofilter membranes composed of sodium methallyl sulfonate copolymer (AN 69 HF) (82.5%) and of polyarylethersulfone (PAES) (17.5%). Among the 91 patients without proven IFI, 31 (34.1%) had false-positive BDG results. Univariable analysis showed an association between CRRT exposure and false-positive BDG results. However, the association between CRRT exposure and false-positive BDG results was no longer significant across three propensity score models employed: 1:1 match (n = 32) (odds ratio (OR) 1.65, p = .48), model-adjusted (n = 91) (OR 1.75, p = .38), quintile-adjusted (n = 91) (OR 1.78, p = .36). In this single-center retrospective analysis, exposure to synthetic CRRT membranes did not independently increase the risk of false-positive BDG results. Larger prospective studies are needed to further evaluate the association between CRRT exposure and false-positive BDG results in critically ill patients with suspected IFI. |
| first_indexed | 2024-03-11T20:31:38Z |
| format | Article |
| id | doaj.art-b4f903158513463fabe249226e4a7a43 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2025-03-21T19:37:51Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-b4f903158513463fabe249226e4a7a432024-06-03T10:02:14ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145210.1080/0886022X.2023.2255680The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score studyM. Gabriela Cabanilla0Matthew J. Briski1Zachary Bruss2Lisa Saa3Pamela C. Vasquez4Chelsea N. Rodriguez5Jessica A. Mitchell6Michael L. Bernauer7Christos P. Argyropoulos8Cameron S. Crandall9J. Pedro Teixeira10Department of Internal Medicine and Department of Pharmacy, Division of Infectious Diseases, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Internal Medicine, Division of Nephrology, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USAData Science, RS21, Albuquerque, NM, USADepartment of Internal Medicine, Division of Nephrology, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USADepartment of Internal Medicine, Division of Nephrology, Division of Pulmonary, Critical Care and Sleep Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA1,3-β-d-Glucan (BDG) is commonly used for diagnosing invasive fungal infections (IFIs). While exposure to cellulose-based hemodialyzers is known to cause false-positive BDG results, the impact of modern hemofilters used in continuous renal replacement therapy (CRRT) remains unclear. This retrospective, single-center cohort study aimed to evaluate the effect of CRRT on BDG levels in critically ill patients. We included adult intensive care unit (ICU) patients with ≥1 BDG measurement between December 2019 and December 2020. The primary outcome was the rate of false-positive BDG results in patients exposed to CRRT compared to unexposed patients. Propensity score analysis was performed to control for confounding factors. A total of 103 ICU patients with ≥1 BDG level were identified. Most (72.8%) were medical ICU patients. Forty patients underwent CRRT using hemofilter membranes composed of sodium methallyl sulfonate copolymer (AN 69 HF) (82.5%) and of polyarylethersulfone (PAES) (17.5%). Among the 91 patients without proven IFI, 31 (34.1%) had false-positive BDG results. Univariable analysis showed an association between CRRT exposure and false-positive BDG results. However, the association between CRRT exposure and false-positive BDG results was no longer significant across three propensity score models employed: 1:1 match (n = 32) (odds ratio (OR) 1.65, p = .48), model-adjusted (n = 91) (OR 1.75, p = .38), quintile-adjusted (n = 91) (OR 1.78, p = .36). In this single-center retrospective analysis, exposure to synthetic CRRT membranes did not independently increase the risk of false-positive BDG results. Larger prospective studies are needed to further evaluate the association between CRRT exposure and false-positive BDG results in critically ill patients with suspected IFI.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2255680Beta-d-glucancontinuous renal replacement therapyinvasive fungal infectioninvasive candidiasiscritical care |
| spellingShingle | M. Gabriela Cabanilla Matthew J. Briski Zachary Bruss Lisa Saa Pamela C. Vasquez Chelsea N. Rodriguez Jessica A. Mitchell Michael L. Bernauer Christos P. Argyropoulos Cameron S. Crandall J. Pedro Teixeira The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study Renal Failure Beta-d-glucan continuous renal replacement therapy invasive fungal infection invasive candidiasis critical care |
| title | The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study |
| title_full | The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study |
| title_fullStr | The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study |
| title_full_unstemmed | The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study |
| title_short | The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study |
| title_sort | influence of continuous renal replacement therapy on 1 3 β d glucan levels in critically ill patients a single center retrospective propensity score study |
| topic | Beta-d-glucan continuous renal replacement therapy invasive fungal infection invasive candidiasis critical care |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2255680 |
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