Outcomes of continuous renal replacement therapy versus peritoneal dialysis as a renal replacement therapy modality in patients undergoing Venoarterial extracorporeal membrane oxygenation.

Acute kidney injury CRRT ECMO Extracorporeal membrane oxygenation Mortality PD Renal replacement therapy

Journal

Journal of critical care
ISSN: 1557-8615
Titre abrégé: J Crit Care
Pays: United States
ID NLM: 8610642

Informations de publication

Date de publication:
07 Aug 2024
Historique:
received: 11 05 2024
revised: 30 07 2024
accepted: 01 08 2024
medline: 9 8 2024
pubmed: 9 8 2024
entrez: 8 8 2024
Statut: aheadofprint

Résumé

The optimal modality for renal replacement therapy (RRT) in patients venoarterial extracorporeal membrane oxygenation (VA-ECMO) remains unclear. This study aimed to compare outcomes between continuous renal replacement therapy (CRRT) and peritoneal dialysis (PD) in VA-ECMO patients. This single-center retrospective study included VA-ECMO patients who developed AKI and subsequently required CRRT or PD. Data on patient demographics, comorbidities, clinical characteristics, RRT modality, and outcomes were collected. The primary outcome was in-hospital mortality, with secondary outcomes including length of stays, RRT durations, and complications associated with RRT. A total of 43 patients were included (72.1% male, mean age 58.2 ± 15.7 years). Of these, 21 received CRRT and 22 received PD during ECMO therapy. In-hospital mortality rates did not significantly differ between CRRT and PD groups (80.9% vs 90.9%, p = 0.35). However, PD was associated with a higher incidence of catheter-related complications, including malposition (31.8% vs 4.7%, p = 0.046), infection (22.7% vs 4.7%, p = 0.19), and bleeding (18.2% vs 9.5%, p = 0.66), respectively. Among patients receiving VA-ECMO-supported RRT, our study revealed comparable in-hospital mortality rates between CRRT and PD, although PD was associated with a higher incidence of catheter-related complications.

Identifiants

pubmed: 39116642
pii: S0883-9441(24)00382-4
doi: 10.1016/j.jcrc.2024.154895
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

154895

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no competing interests.

Auteurs

Peerapat Thanapongsatorn (P)

Division of Nephrology, Department of Medicine, Thammasat University Hospital, Pathum Thani, Thailand; Nephrology Unit, Central Chest Institute of Thailand, Nonthaburi, Thailand.

Nisha Wanichwecharungruang (N)

Nephrology Unit, Central Chest Institute of Thailand, Nonthaburi, Thailand.

Nattachai Srisawat (N)

Division of Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center of Excellence in Critical Care Nephrology, Chulalongkorn University, Bangkok, Thailand. Electronic address: drnattachai@yahoo.com.

Classifications MeSH