Norepinephrine Administration Is Associated with Higher Mortality in Dialysis Requiring Acute Kidney Injury Patients with Septic Shock

Overview

Journal J Clin Med

Specialty General Medicine

Date 2018 Sep 15

PMID 30213107

Citations 9

Authors

Ying-Ying Chen

Vin-Cent Wu

Wei-Chieh Huang

Yu-Chang Yeh

Mai-Szu Wu

Chiu-Ching Huang

Kwan-Dun Wu

Ji-Tseng Fang

Chih-Jen Wu

Affiliations

Soon will be listed here.

Abstract

(1) Background: Norepinephrine (NE) is the first-line vasoactive agent used in septic shock patients; however, the effect of norepinephrine on dialysis-required septic acute kidney injury (AKI-D) patients is uncertain. (2) Methods: To evaluate the impact of NE on 90-day mortality and renal recovery in septic AKI-D patients, we enrolled patients in intensive care units from 30 hospitals in Taiwan. (3) Results: 372 patients were enrolled and were divided into norepinephrine users and non-users. After adjustment by Inverse probability of treatment weighted (IPTW), there was no significant difference of baseline comorbidities between the two groups. NE users had significantly higher 90-day mortality rate and using NE is a strong predictor of 90-day mortality in the multivariate Cox regression (HR = 1.497, = 0.027) after adjustment. The generalized additive model disclosed norepinephrine alone exerted a dose⁻dependent effect on 90-day mortality, while other vasoactive agents were not. (4) Conclusion: Using norepinephrine in septic AKI-D patients is associated with higher 90-day mortality and the effect is dose-dependent. Further study to explore the potential mechanism is needed.

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