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Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study

BACKGROUND: Acute kidney injury (AKI) is a common complication of extracorporeal membrane oxygenation (ECMO) treatment. The aim of this study was to elucidate the long-term outcomes of adult patients with AKI who receive ECMO. MATERIALS AND METHODS: The study analyzed encrypted datasets from Taiwan’...

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Autores principales: Chen, Shao-Wei, Lu, Yueh-An, Lee, Cheng-Chia, Chou, An-Hsun, Wu, Victor Chien-Chia, Chang, Su-Wei, Fan, Pei-Chun, Tian, Ya-Chung, Tsai, Feng-Chun, Chang, Chih-Hsiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415889/
https://www.ncbi.nlm.nih.gov/pubmed/30865662
http://dx.doi.org/10.1371/journal.pone.0212352
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author Chen, Shao-Wei
Lu, Yueh-An
Lee, Cheng-Chia
Chou, An-Hsun
Wu, Victor Chien-Chia
Chang, Su-Wei
Fan, Pei-Chun
Tian, Ya-Chung
Tsai, Feng-Chun
Chang, Chih-Hsiang
author_facet Chen, Shao-Wei
Lu, Yueh-An
Lee, Cheng-Chia
Chou, An-Hsun
Wu, Victor Chien-Chia
Chang, Su-Wei
Fan, Pei-Chun
Tian, Ya-Chung
Tsai, Feng-Chun
Chang, Chih-Hsiang
author_sort Chen, Shao-Wei
collection PubMed
description BACKGROUND: Acute kidney injury (AKI) is a common complication of extracorporeal membrane oxygenation (ECMO) treatment. The aim of this study was to elucidate the long-term outcomes of adult patients with AKI who receive ECMO. MATERIALS AND METHODS: The study analyzed encrypted datasets from Taiwan’s National Health Insurance Research Database. The data of 3251 patients who received first-time ECMO treatment between January 1, 2003, and December 31, 2013, were analyzed. Characteristics and outcomes were compared between patients who required dialysis for AKI (D-AKI) and those who did not in order to evaluate the impact of D-AKI on long-term mortality and major adverse kidney events. RESULTS: Of the 3251 patients, 54.1% had D-AKI. Compared with the patients without D-AKI, those with D-AKI had higher rates of all-cause mortality (52.3% vs. 33.3%; adjusted hazard ratio [aHR] 1.82, 95% confidence interval [CI] 1.53–2.17), chronic kidney disease (13.7% vs. 8.1%; adjusted subdistribution HR [aSHR] 1.66, 95% CI 1.16–2.38), and end-stage renal disease (5.2% vs. 0.5%; aSHR 14.28, 95% CI 4.67–43.62). The long-term mortality of patients who survived more than 90 days after discharge was 22.0% (153/695), 32.3% (91/282), and 50.0% (10/20) in the patients without D-AKI, with recovery D-AKI, and with nonrecovery D-AKI who required long-term dialysis, respectively, demonstrating a significant trend (Pfor trend <0.001). CONCLUSION: AKI is associated with an increased risk of long-term mortality and major adverse kidney events in adult patients who receive ECMO.
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spelling pubmed-64158892019-04-02 Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study Chen, Shao-Wei Lu, Yueh-An Lee, Cheng-Chia Chou, An-Hsun Wu, Victor Chien-Chia Chang, Su-Wei Fan, Pei-Chun Tian, Ya-Chung Tsai, Feng-Chun Chang, Chih-Hsiang PLoS One Research Article BACKGROUND: Acute kidney injury (AKI) is a common complication of extracorporeal membrane oxygenation (ECMO) treatment. The aim of this study was to elucidate the long-term outcomes of adult patients with AKI who receive ECMO. MATERIALS AND METHODS: The study analyzed encrypted datasets from Taiwan’s National Health Insurance Research Database. The data of 3251 patients who received first-time ECMO treatment between January 1, 2003, and December 31, 2013, were analyzed. Characteristics and outcomes were compared between patients who required dialysis for AKI (D-AKI) and those who did not in order to evaluate the impact of D-AKI on long-term mortality and major adverse kidney events. RESULTS: Of the 3251 patients, 54.1% had D-AKI. Compared with the patients without D-AKI, those with D-AKI had higher rates of all-cause mortality (52.3% vs. 33.3%; adjusted hazard ratio [aHR] 1.82, 95% confidence interval [CI] 1.53–2.17), chronic kidney disease (13.7% vs. 8.1%; adjusted subdistribution HR [aSHR] 1.66, 95% CI 1.16–2.38), and end-stage renal disease (5.2% vs. 0.5%; aSHR 14.28, 95% CI 4.67–43.62). The long-term mortality of patients who survived more than 90 days after discharge was 22.0% (153/695), 32.3% (91/282), and 50.0% (10/20) in the patients without D-AKI, with recovery D-AKI, and with nonrecovery D-AKI who required long-term dialysis, respectively, demonstrating a significant trend (Pfor trend <0.001). CONCLUSION: AKI is associated with an increased risk of long-term mortality and major adverse kidney events in adult patients who receive ECMO. Public Library of Science 2019-03-13 /pmc/articles/PMC6415889/ /pubmed/30865662 http://dx.doi.org/10.1371/journal.pone.0212352 Text en © 2019 Chen et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chen, Shao-Wei
Lu, Yueh-An
Lee, Cheng-Chia
Chou, An-Hsun
Wu, Victor Chien-Chia
Chang, Su-Wei
Fan, Pei-Chun
Tian, Ya-Chung
Tsai, Feng-Chun
Chang, Chih-Hsiang
Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study
title Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study
title_full Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study
title_fullStr Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study
title_full_unstemmed Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study
title_short Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study
title_sort long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415889/
https://www.ncbi.nlm.nih.gov/pubmed/30865662
http://dx.doi.org/10.1371/journal.pone.0212352
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