Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation

Abstract Objective Acute kidney injury (AKI) is one of the most frequent complications in patients treated with extracorporeal membrane oxygenation (ECMO) support. The aim of this study was to investigate the risk factors of AKI in patients undergoing ECMO support. Methods We performed a retrospecti...

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Main Authors: Wan Chen, Mingyu Pei, Chunxia Chen, Ruikai Zhu, Bo Wang, Lei Shi, Guozheng Qiu, Wenlong Duan, Yutao Tang, Qinwei Ji, Liwen Lv
Format: Article
Language:English
Published: BMC 2023-03-01
Series:BMC Nephrology
Subjects:
Online Access:https://doi.org/10.1186/s12882-023-03112-6
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author Wan Chen
Mingyu Pei
Chunxia Chen
Ruikai Zhu
Bo Wang
Lei Shi
Guozheng Qiu
Wenlong Duan
Yutao Tang
Qinwei Ji
Liwen Lv
author_facet Wan Chen
Mingyu Pei
Chunxia Chen
Ruikai Zhu
Bo Wang
Lei Shi
Guozheng Qiu
Wenlong Duan
Yutao Tang
Qinwei Ji
Liwen Lv
author_sort Wan Chen
collection DOAJ
description Abstract Objective Acute kidney injury (AKI) is one of the most frequent complications in patients treated with extracorporeal membrane oxygenation (ECMO) support. The aim of this study was to investigate the risk factors of AKI in patients undergoing ECMO support. Methods We performed a retrospective cohort study which included 84 patients treated with ECMO support at intensive care unit in the People’s Hospital of Guangxi Zhuang Autonomous Region from June 2019 to December 2020. AKI was defined as per the standard definition proposed by the Kidney Disease Improving Global Outcome (KDIGO). Independent risk factors for AKI were evaluated through multivariable logistic regression analysis with stepwise backward approach. Results Among the 84 adult patients, 53.6% presented AKI within 48 h after initiation of ECMO support. Three independent risk factors of AKI were identified. The final logistic regression model included: left ventricular ejection fraction (LVEF) before ECMO initiation (OR, 0.80; 95% CI, 0.70–0.90), sequential organ failure assessment (SOFA) score before ECMO initiation (OR, 1.41; 95% CI, 1.16–1.71), and serum lactate at 24 h after ECMO initiation (OR, 1.27; 95% CI, 1.09–1.47). The area under receiver operating characteristics of the model was 0.879. Conclusion Severity of underlying disease, cardiac dysfunction before ECMO initiation and the blood lactate level at 24 h after ECMO initiation were independent risk factors of AKI in patients who received ECMO support.
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spelling doaj.art-ced43415272c4386a63c557e09cfcfca2023-04-03T05:19:48ZengBMCBMC Nephrology1471-23692023-03-012411810.1186/s12882-023-03112-6Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenationWan Chen0Mingyu Pei1Chunxia Chen2Ruikai Zhu3Bo Wang4Lei Shi5Guozheng Qiu6Wenlong Duan7Yutao Tang8Qinwei Ji9Liwen Lv10Department of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Pharmacy, The People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Cardiology, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesDepartment of Emergency, Research Center of Cardiovascular Disease, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical SciencesAbstract Objective Acute kidney injury (AKI) is one of the most frequent complications in patients treated with extracorporeal membrane oxygenation (ECMO) support. The aim of this study was to investigate the risk factors of AKI in patients undergoing ECMO support. Methods We performed a retrospective cohort study which included 84 patients treated with ECMO support at intensive care unit in the People’s Hospital of Guangxi Zhuang Autonomous Region from June 2019 to December 2020. AKI was defined as per the standard definition proposed by the Kidney Disease Improving Global Outcome (KDIGO). Independent risk factors for AKI were evaluated through multivariable logistic regression analysis with stepwise backward approach. Results Among the 84 adult patients, 53.6% presented AKI within 48 h after initiation of ECMO support. Three independent risk factors of AKI were identified. The final logistic regression model included: left ventricular ejection fraction (LVEF) before ECMO initiation (OR, 0.80; 95% CI, 0.70–0.90), sequential organ failure assessment (SOFA) score before ECMO initiation (OR, 1.41; 95% CI, 1.16–1.71), and serum lactate at 24 h after ECMO initiation (OR, 1.27; 95% CI, 1.09–1.47). The area under receiver operating characteristics of the model was 0.879. Conclusion Severity of underlying disease, cardiac dysfunction before ECMO initiation and the blood lactate level at 24 h after ECMO initiation were independent risk factors of AKI in patients who received ECMO support.https://doi.org/10.1186/s12882-023-03112-6Acute kidney injuryExtracorporeal membrane oxygenationRisk factors
spellingShingle Wan Chen
Mingyu Pei
Chunxia Chen
Ruikai Zhu
Bo Wang
Lei Shi
Guozheng Qiu
Wenlong Duan
Yutao Tang
Qinwei Ji
Liwen Lv
Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation
BMC Nephrology
Acute kidney injury
Extracorporeal membrane oxygenation
Risk factors
title Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation
title_full Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation
title_fullStr Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation
title_full_unstemmed Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation
title_short Independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation
title_sort independent risk factors of acute kidney injury among patients receiving extracorporeal membrane oxygenation
topic Acute kidney injury
Extracorporeal membrane oxygenation
Risk factors
url https://doi.org/10.1186/s12882-023-03112-6
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