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Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy
BACKGROUND: Acidosis frequently occurs in severe acute kidney injury (AKI), and continuous renal replacement therapy (CRRT) can control this pathologic condition. Nevertheless, acidosis may be aggravated; thus, monitoring is essential after starting CRRT. Herein, we addressed the longitudinal trajec...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9792158/ https://www.ncbi.nlm.nih.gov/pubmed/36572862 http://dx.doi.org/10.1186/s12882-022-03047-4 |
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author | Lee, Jinwoo Kim, Seong Geun Yun, Donghwan Kang, Min Woo Kim, Yong Chul Kim, Dong Ki Oh, Kook-Hwan Joo, Kwon Wook Kim, Yon Su Koo, Ho Seok Han, Seung Seok |
author_facet | Lee, Jinwoo Kim, Seong Geun Yun, Donghwan Kang, Min Woo Kim, Yong Chul Kim, Dong Ki Oh, Kook-Hwan Joo, Kwon Wook Kim, Yon Su Koo, Ho Seok Han, Seung Seok |
author_sort | Lee, Jinwoo |
collection | PubMed |
description | BACKGROUND: Acidosis frequently occurs in severe acute kidney injury (AKI), and continuous renal replacement therapy (CRRT) can control this pathologic condition. Nevertheless, acidosis may be aggravated; thus, monitoring is essential after starting CRRT. Herein, we addressed the longitudinal trajectory of acidosis on CRRT and its relationship with worse outcomes. METHODS: The latent growth mixture model was applied to classify the trajectories of pH during the first 24 hours and those of C-reactive protein (CRP) after 24 hours on CRRT due to AKI (n = 1815). Cox proportional hazard models were used to calculate hazard ratios of all-cause mortality after adjusting multiple variables or matching their propensity scores. RESULTS: The patients could be classified into 5 clusters, including the normally maintained groups (1st cluster, pH = 7.4; and 2nd cluster, pH = 7.3), recovering group (3rd cluster with pH values from 7.2 to 7.3), aggravating group (4th cluster with pH values from 7.3 to 7.2), and ill-being group (5th cluster, pH < 7.2). The pH clusters had different trends of C-reactive protein (CRP) after 24 hours; the 1st and 2nd pH clusters had lower levels, but the 3rd to 5th pH clusters had an increasing trend of CRP. The 1st pH cluster had the best survival rates, and the 3rd to 5th pH clusters had the worst survival rates. This survival difference was significant despite adjusting for other variables or matching propensity scores. CONCLUSIONS: Initial trajectories of acidosis determine subsequent worse outcomes, such as mortality and inflammation, in patients undergoing CRRT due to AKI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-022-03047-4. |
format | Online Article Text |
id | pubmed-9792158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-97921582022-12-27 Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy Lee, Jinwoo Kim, Seong Geun Yun, Donghwan Kang, Min Woo Kim, Yong Chul Kim, Dong Ki Oh, Kook-Hwan Joo, Kwon Wook Kim, Yon Su Koo, Ho Seok Han, Seung Seok BMC Nephrol Research BACKGROUND: Acidosis frequently occurs in severe acute kidney injury (AKI), and continuous renal replacement therapy (CRRT) can control this pathologic condition. Nevertheless, acidosis may be aggravated; thus, monitoring is essential after starting CRRT. Herein, we addressed the longitudinal trajectory of acidosis on CRRT and its relationship with worse outcomes. METHODS: The latent growth mixture model was applied to classify the trajectories of pH during the first 24 hours and those of C-reactive protein (CRP) after 24 hours on CRRT due to AKI (n = 1815). Cox proportional hazard models were used to calculate hazard ratios of all-cause mortality after adjusting multiple variables or matching their propensity scores. RESULTS: The patients could be classified into 5 clusters, including the normally maintained groups (1st cluster, pH = 7.4; and 2nd cluster, pH = 7.3), recovering group (3rd cluster with pH values from 7.2 to 7.3), aggravating group (4th cluster with pH values from 7.3 to 7.2), and ill-being group (5th cluster, pH < 7.2). The pH clusters had different trends of C-reactive protein (CRP) after 24 hours; the 1st and 2nd pH clusters had lower levels, but the 3rd to 5th pH clusters had an increasing trend of CRP. The 1st pH cluster had the best survival rates, and the 3rd to 5th pH clusters had the worst survival rates. This survival difference was significant despite adjusting for other variables or matching propensity scores. CONCLUSIONS: Initial trajectories of acidosis determine subsequent worse outcomes, such as mortality and inflammation, in patients undergoing CRRT due to AKI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-022-03047-4. BioMed Central 2022-12-26 /pmc/articles/PMC9792158/ /pubmed/36572862 http://dx.doi.org/10.1186/s12882-022-03047-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lee, Jinwoo Kim, Seong Geun Yun, Donghwan Kang, Min Woo Kim, Yong Chul Kim, Dong Ki Oh, Kook-Hwan Joo, Kwon Wook Kim, Yon Su Koo, Ho Seok Han, Seung Seok Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy |
title | Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy |
title_full | Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy |
title_fullStr | Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy |
title_full_unstemmed | Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy |
title_short | Longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy |
title_sort | longitudinal trajectory of acidosis and mortality in acute kidney injury requiring continuous renal replacement therapy |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9792158/ https://www.ncbi.nlm.nih.gov/pubmed/36572862 http://dx.doi.org/10.1186/s12882-022-03047-4 |
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