Please use this identifier to cite or link to this item:
https://observatorio.fm.usp.br/handle/OPI/4432
Title: | Timing of renal replacement therapy initiation by AKIN classification system |
Authors: | LEITE, Tacyano T.; MACEDO, Etienne; PEREIRA, Samuel M.; BANDEIRA, Sandro R. C.; PONTES, Pedro H. S.; GARCIA, Andre S.; MILITAO, Fernanda R.; SOBRINHO, Irineu M. M.; ASSUNCAO, Livia M.; LIBORIO, Alexandre B. |
Citation: | CRITICAL CARE, v.17, n.2, article ID R62, 9p, 2013 |
Abstract: | Introduction: Previous studies using Acute Kidney Injury Network (AKIN)/RIFLE criteria to classify early initiation of renal replacement therapy (RRT) have defined it as the therapy started in less severe AKIN/RIFLE stages. Generally, these studies failed in demonstrating measurable benefits. Methods: We compared RRT initiation in critically ill patients and defined early or late RRT in reference to timing after stage 3 AKIN was met: patients beginning RRT within 24 hours after acute kidney injury (AKI) stage 3 were considered early starters. AKIN criteria were evaluated by both urine output (UO) and serum creatinine (sCr) and patients with acute-on-chronic kidney disease were excluded. A propensity score methodology was used to control variables. Results: A total of 358 critically ill patients were submitted to RRT. Only 150 patients with pure AKI at stage 3 were analyzed. Mortality was lower in the early RRT group (51.5 vs. 77.9%, P = 0.001). After achieving balance between the groups using a propensity score, there was a significant 30.5 (95% confidence interval [CI] 14.4 to 45.2%, P = 0.002) relative decrease of mortality in the early RRT group. Moreover, patients on the early RRT group had lower duration of mechanical ventilation, time on RRT and a trend to lower intensive care unit (ICU) length of stay. Conclusions: For the first time, AKIN was used with UO criterion to evaluate early and late RRT. Using a time-based approach could be a better parameter to access the association between RRT initiation and outcomes in patients with AKI. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - ODS/03 |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
art_MACEDO_Timing_of_renal_replacement_therapy_initiation_by_AKIN_2013.PDF Restricted Access | publishedVersion (English) | 393.41 kB | Adobe PDF | View/Open Request a copy |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.