Continuous Veno-venous Hemofiltration Yields Better Renal Outcomes Than Intermittent Hemodialysis Among Traumatic Intracranial Hemorrhage Patients with Acute Kidney Injury: A Nationwide Population-based Retrospective Study in Taiwan

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2018 Sep 21

PMID 30235226

Citations 5

Authors

Min-Feng Tseng

Chu-Lin Chou

Chi-Hsiang Chung

Wu-Chien Chien

Ying-Kai Chen

Hsiu-Chien Yang

Chen-Yi Liao

Kuang-Yu Wei

Chia-Chao Wu

Affiliations

Soon will be listed here.

Abstract

Object: Traumatic intracranial hemorrhage (TICH) patients with acute kidney injury (AKI) were reported to have a high mortality rate. Renal replacement therapy (RRT) is indicated for patients with a severe kidney injury. This study aimed to compare the effects of different RRT modalities regarding chronic dialysis rate among adult TICH patients with AKI.

Methods: A retrospective search of computerized hospital records from 2000 to 2010 for patients with a discharge diagnosis of TICH was conducted to identify the index cases. We collected the data of TICH patients with increased intracranial pressure combined with severe AKI who received intermittent hemodialysis (IHD) or continuous veno-venous hemofiltration (CVVH) as RRT. The outcome was dialysis dependence between 2000 and 2010.

Results: From a total of 310 patients who were enrolled in the study, 134 (43%) received CVVH and 176 (57%) received IHD. The risk of dialysis dependency was significantly lower in the CVVH group than in the IHD group (adjusted hazard ratio: 0.368, 95% CI, 0.158-0.858, P = 0.034). Diabetes mellitus and coronary artery disease were risk factors for dialysis dependency. CVVH compared with IHD modality was associated with lower dialysis dependency rate in TICH patients combined with AKI and diabetes mellitus and those with an injury severity score (ISS) ≥16.

Conclusion: CVVH may yield better renal outcomes than IHD among TICH patients with AKI, especially those with diabetes mellitus and an ISS ≥16. The beneficial impact of CVVH on TICH patients needs to be clarified in a large cohort study in future.

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References

Qureshi A, Palesch Y, Martin R, Novitzke J, Cruz Flores S, Ehtisham A . Systolic blood pressure reduction and risk of acute renal injury in patients with intracerebral hemorrhage. Am J Med. 2012; 125(7):718.e1-6. DOI: 10.1016/j.amjmed.2011.09.031. View

Heung M, Steffick D, Zivin K, Gillespie B, Banerjee T, Hsu C . Acute Kidney Injury Recovery Pattern and Subsequent Risk of CKD: An Analysis of Veterans Health Administration Data. Am J Kidney Dis. 2015; 67(5):742-52. PMC: 6837804. DOI: 10.1053/j.ajkd.2015.10.019. View

Krol A, Dzialowski I, Roy J, Puetz V, Subramaniam S, Coutts S . Incidence of radiocontrast nephropathy in patients undergoing acute stroke computed tomography angiography. Stroke. 2007; 38(8):2364-6. DOI: 10.1161/STROKEAHA.107.482778. View

Dittrich R, Akdeniz S, Kloska S, Fischer T, Ritter M, Seidensticker P . Low rate of contrast-induced Nephropathy after CT perfusion and CT angiography in acute stroke patients. J Neurol. 2007; 254(11):1491-7. DOI: 10.1007/s00415-007-0528-5. View

Srisawat N, Wen X, Lee M, Kong L, Elder M, Carter M . Urinary biomarkers and renal recovery in critically ill patients with renal support. Clin J Am Soc Nephrol. 2011; 6(8):1815-23. PMC: 3156420. DOI: 10.2215/CJN.11261210. View

Goldstein J, Fazen L, Wendell L, Chang Y, Rost N, Snider R . Risk of thromboembolism following acute intracerebral hemorrhage. Neurocrit Care. 2008; 10(1):28-34. PMC: 4307935. DOI: 10.1007/s12028-008-9134-3. View

Tang W, Chen Z, Wu W, Qiu H, Bo H, Zhang L . Renal protective effects of early continuous venovenous hemofiltration in rhabdomyolysis: improved renal mitochondrial dysfunction and inhibited apoptosis. Artif Organs. 2013; 37(4):390-400. DOI: 10.1111/j.1525-1594.2012.01574.x. View

Chou C, Hsieh T, Wang C, Hung T, Lai Y, Chen Y . Long-term outcomes of dialysis patients after coronary revascularization: a population-based cohort study in Taiwan. Arch Med Res. 2014; 45(2):188-94. DOI: 10.1016/j.arcmed.2014.01.009. View

Ympa Y, Sakr Y, Reinhart K, Vincent J . Has mortality from acute renal failure decreased? A systematic review of the literature. Am J Med. 2005; 118(8):827-32. DOI: 10.1016/j.amjmed.2005.01.069. View

10.

Vinsonneau C, Camus C, Combes A, Costa de Beauregard M, Klouche K, Boulain T . Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial. Lancet. 2006; 368(9533):379-85. DOI: 10.1016/S0140-6736(06)69111-3. View

11.

Joannidis M . Continuous renal replacement therapy in sepsis and multisystem organ failure. Semin Dial. 2009; 22(2):160-4. DOI: 10.1111/j.1525-139X.2008.00552.x. View

12.

Gotloib L, Shostak A, Lev A, Fudin R, Jaichenko J . Treatment of surgical and non-surgical septic multiorgan failure with bicarbonate hemodialysis and sequential hemofiltration. Intensive Care Med. 1995; 21(2):104-11. DOI: 10.1007/BF01726531. View

13.

Wohlauer M, Sauaia A, Moore E, Burlew C, Banerjee A, Johnson J . Acute kidney injury and posttrauma multiple organ failure: the canary in the coal mine. J Trauma Acute Care Surg. 2012; 72(2):373-8. DOI: 10.1097/TA.0b013e318244869b. View

14.

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

15.

Mehta R, Grab J, OBrien S, Bridges C, Gammie J, Haan C . Bedside tool for predicting the risk of postoperative dialysis in patients undergoing cardiac surgery. Circulation. 2006; 114(21):2208-16. DOI: 10.1161/CIRCULATIONAHA.106.635573. View

16.

Vallon V . Do tubular changes in the diabetic kidney affect the susceptibility to acute kidney injury?. Nephron Clin Pract. 2014; 127(1-4):133-8. DOI: 10.1159/000363554. View

17.

Gallagher M, Cass A, Bellomo R, Finfer S, Gattas D, Lee J . Long-term survival and dialysis dependency following acute kidney injury in intensive care: extended follow-up of a randomized controlled trial. PLoS Med. 2014; 11(2):e1001601. PMC: 3921111. DOI: 10.1371/journal.pmed.1001601. View

18.

Storck M, Hartl W, Zimmerer E, Inthorn D . Comparison of pump-driven and spontaneous continuous haemofiltration in postoperative acute renal failure. Lancet. 1991; 337(8739):452-5. DOI: 10.1016/0140-6736(91)93393-n. View

19.

Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P . Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet. 2000; 356(9223):26-30. DOI: 10.1016/S0140-6736(00)02430-2. View

20.

Bagshaw S, Berthiaume L, Delaney A, Bellomo R . Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: a meta-analysis. Crit Care Med. 2008; 36(2):610-7. DOI: 10.1097/01.CCM.0B013E3181611F552. View