Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients
Background Continuous renal replacement therapy (CRRT) is commonly employed for rhabdomyolysis (RM) patients. However, the optimal initiation timing of CRRT and prognostic factors were not well evaluated for patients with RM. We aimed to investigate the efficacy of CRRT timing on mortality and the r...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2132170 |
| _version_ | 1811237569345617920 |
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| author | Xiayin Li Ming Bai Yan Yu Feng Ma Lijuan Zhao Yajuan Li Hao Wu Lei Zhou Shiren Sun |
| author_facet | Xiayin Li Ming Bai Yan Yu Feng Ma Lijuan Zhao Yajuan Li Hao Wu Lei Zhou Shiren Sun |
| author_sort | Xiayin Li |
| collection | DOAJ |
| description | Background Continuous renal replacement therapy (CRRT) is commonly employed for rhabdomyolysis (RM) patients. However, the optimal initiation timing of CRRT and prognostic factors were not well evaluated for patients with RM. We aimed to investigate the efficacy of CRRT timing on mortality and the risk factors for death in RM patients who received CRRT.Methods RM patients who received CRRT between 1 May 2010 and 31 May 2021 in our center were retrospectively included. Univariate and multivariate logistic analyses were performed to identify the risk factors for primary outcome (90-day mortality).Results A total of 134 patients were included in our study. The 90-day mortality rate was 38.06%. The median time from CRRT initiation to peak CK occurrence was 4.8 h (IQR −16, 14), 67 patients received CRRT before 4.8 h after peak CK occurrence (early CRRT), and 67 patients received CRRT beyond 4.8 h after peak CK occurrence (late CRRT). Multivariate logistic regression analysis showed that the time from CRRT initiation to the peak CK (per 1 h, OR 1.026, 95% CI 1.004–1.049, p = 0.023), late CRRT (OR 3.082, 95% CI 1.072–8.859, p = 0.037), elevated serum cardiac troponin I (cTnI) (per 1 ng/mL, OR 1.218, 95% CI 1.011–1.468, p = 0.038), older age (per 1 year, OR 1.042, 95% CI 1.003–1.081, p = 0.032), and need of mechanical ventilation support (OR 4.632, 95% CI 1.292–16.61, p = 0.019) were independent risk factors for 90-day mortality.Conclusions Earlier CRRT initiation before 4.8 h after peak CK occurrence was associated with lower 90-day patient mortality. |
| first_indexed | 2024-04-12T12:26:55Z |
| format | Article |
| id | doaj.art-d055a64793d64a6b93818422bf6b9e9b |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-04-12T12:26:55Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-d055a64793d64a6b93818422bf6b9e9b2022-12-22T03:33:09ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492022-12-014411743175310.1080/0886022X.2022.2132170Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patientsXiayin Li0Ming Bai1Yan Yu2Feng Ma3Lijuan Zhao4Yajuan Li5Hao Wu6Lei Zhou7Shiren Sun8Department of Postgraduate Student, Xi’an Medical University, Xi'an, ChinaThe Nephrology Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaThe Nephrology Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaThe Nephrology Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaThe Nephrology Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaThe Nephrology Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaThe Nephrology Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaThe Clinical Laboratory Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaThe Nephrology Department of Xijing Hospital, The Fourth Military Medical University, Xi’an, ChinaBackground Continuous renal replacement therapy (CRRT) is commonly employed for rhabdomyolysis (RM) patients. However, the optimal initiation timing of CRRT and prognostic factors were not well evaluated for patients with RM. We aimed to investigate the efficacy of CRRT timing on mortality and the risk factors for death in RM patients who received CRRT.Methods RM patients who received CRRT between 1 May 2010 and 31 May 2021 in our center were retrospectively included. Univariate and multivariate logistic analyses were performed to identify the risk factors for primary outcome (90-day mortality).Results A total of 134 patients were included in our study. The 90-day mortality rate was 38.06%. The median time from CRRT initiation to peak CK occurrence was 4.8 h (IQR −16, 14), 67 patients received CRRT before 4.8 h after peak CK occurrence (early CRRT), and 67 patients received CRRT beyond 4.8 h after peak CK occurrence (late CRRT). Multivariate logistic regression analysis showed that the time from CRRT initiation to the peak CK (per 1 h, OR 1.026, 95% CI 1.004–1.049, p = 0.023), late CRRT (OR 3.082, 95% CI 1.072–8.859, p = 0.037), elevated serum cardiac troponin I (cTnI) (per 1 ng/mL, OR 1.218, 95% CI 1.011–1.468, p = 0.038), older age (per 1 year, OR 1.042, 95% CI 1.003–1.081, p = 0.032), and need of mechanical ventilation support (OR 4.632, 95% CI 1.292–16.61, p = 0.019) were independent risk factors for 90-day mortality.Conclusions Earlier CRRT initiation before 4.8 h after peak CK occurrence was associated with lower 90-day patient mortality.https://www.tandfonline.com/doi/10.1080/0886022X.2022.2132170Rhabdomyolysisacute kidney injurycontinue renal replacement therapymortalitycreatine kinase |
| spellingShingle | Xiayin Li Ming Bai Yan Yu Feng Ma Lijuan Zhao Yajuan Li Hao Wu Lei Zhou Shiren Sun Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients Renal Failure Rhabdomyolysis acute kidney injury continue renal replacement therapy mortality creatine kinase |
| title | Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients |
| title_full | Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients |
| title_fullStr | Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients |
| title_full_unstemmed | Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients |
| title_short | Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients |
| title_sort | earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients |
| topic | Rhabdomyolysis acute kidney injury continue renal replacement therapy mortality creatine kinase |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2132170 |
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