Outcomes from a cohort of patients with acute kidney injury subjected to continuous venovenous hemodiafiltration: The role of negative fluid balance

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dc.citation.issue4
dc.citation.volume12
dc.contributor.authorClaizoni dos Santos, Thais Oliveira [UNIFESP]
dc.contributor.authorde Souza Oliveira, Marisa Aparecida [UNIFESP]
dc.contributor.authorMartins Monte, Julio Cesar
dc.contributor.authorBatista, Marcelo Costa [UNIFESP]
dc.contributor.authorPereira Junior, Virgilio Goncalves
dc.contributor.authorCardoso dos Santos, Bento Fortunato
dc.contributor.authorPavao Santos, Oscar Fernando [UNIFESP]
dc.contributor.authorDurao Junior, Marcelino de Souza [UNIFESP]
dc.coverageSan Francisco
dc.date.accessioned2020-07-17T14:02:16Z
dc.date.available2020-07-17T14:02:16Z
dc.date.issued2017
dc.description.abstractBackground Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. Results This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice. The patients were predominantly male (62.8%) and their median age was 65 (55-76) years. The most frequent comorbidities were cardiovascular disease (39.3%), hypertension (32.8%), diabetes (24%), and cirrhosis (20.7%). The main cause of AKI was sepsis (52.5%). At beginning of CVVHDF, 152 patients (83%) were using vasopressors. The median SAPS 3 and SOFA score at ICU admission was 61 (50-74) and 10 (7-12), respectively. The dialysis dose delivered was 33.2 (28.9-38.7) ml/kg/h. The median time between ICU admission and CVVHDF initiation was 2 (1-4) days. The median cumulative fluid balance during the CVVHDF period was -1838 (-5735 +2993) ml. The mortality rate up to90 days was 58%. The independent mortality risk factors in propensity score model were: chronic obstructive pulmonary disease (OR = 3.44[1.14-10.4en
dc.description.abstractp = 0.028]), hematologic malignancy (OR = 5.14[1.66-15.95en
dc.description.abstractp = 0.005]), oliguria (OR = 2.36[1.15-4.9en
dc.description.abstractp = 0.02]), positive daily fluid balance during CVVHDF (OR = 4.55[2.75-13.1en
dc.description.abstractp < 0.001]), and total SOFA score on first dialysis day (OR = 1.27[1.12-1.45en
dc.description.abstractp < 0.001]). Conclusions Dialysis-related factors may influence the outcomes. In our cohort, positive daily fluid balance during CRRT was associated with lower survival. Multicenter, randomized studies are needed to assess fluid balance as a primary outcome to define the best strategy in this patient population.en
dc.description.affiliationUniv Fed Sao Paulo, Nephrol Div, Sao Paulo, SP, Brazil
dc.description.affiliationHosp Israelite Albert Einstein, Nephrol Div, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Nephrol Div, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundacao de Ampan a Pesquisa do Estado de Sao Paulo (FAPESP)
dc.description.sponsorshipIDFAPESP: 2012/19020-9
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1371/journal.pone.0175897
dc.identifier.citationPlos One. San Francisco, v. 12, n. 4, p. -, 2017.
dc.identifier.doi10.1371/journal.pone.0175897
dc.identifier.fileWOS000399875900066.pdf
dc.identifier.issn1932-6203
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54712
dc.identifier.wosWOS:000399875900066
dc.language.isoeng
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleOutcomes from a cohort of patients with acute kidney injury subjected to continuous venovenous hemodiafiltration: The role of negative fluid balanceen
dc.typeinfo:eu-repo/semantics/article
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