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Submitted: 21 Apr 2024
Accepted: 08 Jun 2024
ePublished: 24 Jun 2024
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J Nephropharmacol. 2024;13(2): e12686.
doi: 10.34172/npj.2024.12686
  Abstract View: 129
  PDF Download: 57

Original

Prognosis and factors affecting mortality in patients with acute kidney injury due to cardiorenal syndrome type 1 treated with sustained low-efficiency dialysis

Thanapon Nilmoje ORCID logo, Dhipsukon Pongborriboon, Ussanee Boonsrirat, Sirihatai Konwai, Suntornwit Praditau-Krit, Atthaphong Phongphithakchai* ORCID logo

1 Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
*Corresponding Author: Atthaphong Phongphithakchai, Email: patthaph@medicine.psu.ac.th, Email: ton331@hotmail.com

Abstract

Introduction: Cardiorenal syndrome (CRS) type 1 is linked to poor outcomes, particularly in-hospital mortality. While diuretics are commonly used, their efficacy may be limited necessitating renal replacement therapy (RRT) often using continuous renal replacement therapy (CRRT). However, the cost and availability limit CRRT usage, prompting exploration of alternative therapies like sustained low efficiency dialysis (SLED).

Objectives: We conducted a retrospective analysis to explore significant factors affecting mortality rates in CRS type 1 patients treated with SLED.

Patients and Methods: This is a retrospective cohort study conducted in a tertiary hospital from 2012 to 2022, including 215 CRS type 1 patients treated with SLED. The patients were categorized into the survivors’ group and the nonsurvivors’ group. The clinical indicators and biochemical markers for each group were compared to identify any disparities. Additionally, multivariate logistic regression analysis was conducted to ascertain the independent risk factors.

Results: The in-hospital mortality was 49.3%. Hydralazine administration prior to admission (odd ratio [OR]: 0.39, 95% CI 0.18–0.86) serum creatinine at SLED initiation (OR: 0.86, 95% CI 0.77–0.96), intra-aortic balloon pumps (IABP) treatment (OR: 2.04, 95% CI 1.28–3.26), and urine output <400 mL/d in 24 hours prior discontinuing SLED (OR: 3.61, 95% CI 2.01–6.49) were associated with increased risk of in-hospital mortality.

Conclusion: SLED-based RRT for acute kidney injury in type 1 CRS is linked to higher in-hospital mortality for patients not previously administered hydralazine, having low serum creatinine, IABP usage, and experiencing oliguria.


Implication for health policy/practice/research/medical education:

Incorporating assessments of pre-admission hydralazine administration, serum creatinine levels, intra-aortic balloon pump treatment, and oliguria into clinical guidelines may significantly enhance management strategies for cardiorenal syndrome type 1 patients treated with sustained low-efficiency dialysis.

Please cite this paper as: Nilmoje T, Pongborriboon D, Boonsrirat U, Konwai S, Praditau-Krit S, Phongphithakchai A. Prognosis and factors affecting mortality in patients with acute kidney injury due to cardiorenal syndrome type 1 treated with sustained low-efficiency dialysis. J Nephropharmacol. 2024;13(2):e12686. DOI: 10.34172/npj.2024.12686.

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