Dataset Information

Effect of diuretic use on 30-day postdialysis mortality in critically ill patients receiving acute dialysis.

ABSTRACT:

Background

The impact of diuretic usage and dosage on the mortality of critically ill patients with acute kidney injury is still unclear.

Methods and results

In this prospective, multicenter, observational study, 572 patients with postsurgical acute kidney injury receiving hemodialysis were recruited and followed daily. Thirty-day postdialysis mortality was analyzed using Cox's proportional hazards model with time-dependent covariates. The mean age of the 572 patients was 60.8±16.6 years. Patients with lower serum creatinine (p?=?0.031) and blood lactate (p?=?0.033) at ICU admission, lower predialysis urine output (p?=?0.001) and PaO(2)/FiO(2) (p?=?0.039), as well as diabetes (p?=?0.037) and heart failure (p?=?0.049) were more likely to receive diuretics. A total of 280 (49.0%) patients died within 30 days after acute dialysis initiation. The analysis of 30-day postdialysis mortality by fitting propensity score-adjusted Cox's proportional hazards models with time-dependent covariates showed that higher 3-day accumulated diuretic doses after dialysis initiation (HR?=?1.449, p?=?0.021) could increase the hazard rate of death. Moreover, higher time-varying 3-day accumulative diuretic doses were associated with hypotension (p<0.001) and less intense hemodialysis (p<0.001) during the acute dialysis period.

Background and significance

Higher time-varying 3-day accumulative diuretic dose predicts mortality in postsurgical critically ill patients requiring acute dialysis. Higher diuretic doses are associated with hypotension and a lower intensity of dialysis. Caution should be employed before loop diuretics are administered to postsurgical patients during the acute dialysis period.

SUBMITTER: Wu VC

PROVIDER: S-EPMC3303770 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

Effect of diuretic use on 30-day postdialysis mortality in critically ill patients receiving acute dialysis.

Wu Vin-Cent VC Lai Chun-Fu CF Shiao Chih-Chung CC Lin Yu-Feng YF Wu Pei-Chen PC Chao Chia-Ter CT Hu Fu-Chang FC Huang Tao-Min TM Yeh Yu-Chang YC Tsai I-Jung IJ Kao Tze-Wah TW Han Yin-Yi YY Wu Wen-Chung WC Hou Chun-Cheng CC Young Guang-Huar GH Ko Wen-Je WJ Tsai Tun-Jun TJ Wu Kwan-Dun KD

PloS one 20120314 3

<h4>Background</h4>The impact of diuretic usage and dosage on the mortality of critically ill patients with acute kidney injury is still unclear.<h4>Methods and results</h4>In this prospective, multicenter, observational study, 572 patients with postsurgical acute kidney injury receiving hemodialysis were recruited and followed daily. Thirty-day postdialysis mortality was analyzed using Cox's proportional hazards model with time-dependent covariates. The mean age of the 572 patients was 60.8±16. ...[more]

PMID: 22431960

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Dataset Information

Effect of diuretic use on 30-day postdialysis mortality in critically ill patients receiving acute dialysis.

Background

Methods and results

Background and significance

Publications

Effect of diuretic use on 30-day postdialysis mortality in critically ill patients receiving acute dialysis.

Similar Datasets

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