期刊
RENAL FAILURE
卷 44, 期 1, 页码 1743-1753出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/0886022X.2022.2132170
关键词
Rhabdomyolysis; acute kidney injury; continue renal replacement therapy; mortality; creatine kinase
资金
- National Natural Science Foundation of China [82070699]
- Clinical Application Research Program of the Xijing Hospital [JSYXZ05]
- Nephrology Department of Xijing Hospital
- Fourth Military Medical University
This study aimed to evaluate the impact of the timing of continuous renal replacement therapy (CRRT) on the prognosis of patients with rhabdomyolysis (RM). The results showed that initiating CRRT before 4.8 hours after peak CK occurrence was associated with lower 90-day patient mortality.
Background Continuous renal replacement therapy (CRRT) is commonly employed for rhabdomyolysis (RM) patients. However, the optimal initiation timing of CRRT and prognostic factors were not well evaluated for patients with RM. We aimed to investigate the efficacy of CRRT timing on mortality and the risk factors for death in RM patients who received CRRT. Methods RM patients who received CRRT between 1 May 2010 and 31 May 2021 in our center were retrospectively included. Univariate and multivariate logistic analyses were performed to identify the risk factors for primary outcome (90-day mortality). Results A total of 134 patients were included in our study. The 90-day mortality rate was 38.06%. The median time from CRRT initiation to peak CK occurrence was 4.8 h (IQR -16, 14), 67 patients received CRRT before 4.8 h after peak CK occurrence (early CRRT), and 67 patients received CRRT beyond 4.8 h after peak CK occurrence (late CRRT). Multivariate logistic regression analysis showed that the time from CRRT initiation to the peak CK (per 1 h, OR 1.026, 95% CI 1.004-1.049, p = 0.023), late CRRT (OR 3.082, 95% CI 1.072-8.859, p = 0.037), elevated serum cardiac troponin I (cTnI) (per 1 ng/mL, OR 1.218, 95% CI 1.011-1.468, p = 0.038), older age (per 1 year, OR 1.042, 95% CI 1.003-1.081, p = 0.032), and need of mechanical ventilation support (OR 4.632, 95% CI 1.292-16.61, p = 0.019) were independent risk factors for 90-day mortality. Conclusions Earlier CRRT initiation before 4.8 h after peak CK occurrence was associated with lower 90-day patient mortality.
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