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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’...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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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. |
format | Online Article Text |
id | pubmed-6415889 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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