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Kidney Week

Abstract: SA-PO552

Analysis of Survival After Initiation of Continuous Renal Replacement Therapy in Patients with Extracorporeal Membrane Oxygenation

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Author

  • Kuo, George, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
Background

No study has specifically investigated the duration of continuous renal replacement therapy (CRRT) in patients who suffered acute kidney injury during extracorporeal membrane oxygenation (ECMO) support. However, there are concerns that prolonged CRRT may be futile.

Methods

A retrospective population-based cohort study using Taiwan National Health Insurance Research Database data collected between January 1, 2007 and December 31, 2013. Patients who received ECMO and CRRT during the study period were included. We divided the patients into three groups based on the duration of CRRT received: ≤ 3 days, 4–6 days, and ≥ 7 days.

Results

The overall survival after discharge did differ significantly among the three CRRT groups. The patients who received CRRT ≥ 7 days had a higher risk of ESRD than did those who received CRRT ≤ 3 days (adjusted hazard ratio [aHR] 3.46, 95% confidence interval [CI] 1.47–8.14) and between 4 and 6 days (aHR 3.10, 95% CI 1.03–9.29). The incidence of ventilator dependent was higher in the patients with CRRT ≥ 7 days than in those with ≤ 3 days (aHR 2.45, 95% CI 1.32–4.54). The CRRT ≥ 7 days group also exhibited a higher readmission rate than did the 4–6 days and ≤ 3 days groups (aHR 1.43, 95% CI 1.04–1.96 and aHR 1.67, 95% CI 1.13–2.47, respectively).

Conclusion

Our study found similar long-term survival but increased long-term ESRD and ventilator dependency among the ECMO patients who underwent CRRT for 7 days or more. These results offer reason to be concerned that this aggressive form of life support may maintain patient survival but do so at the cost of long-term disabilities and, consequently, a lower quality of life

Funding

  • Private Foundation Support