Open AccessInitiation and Cessation Timing of Renal Replacement Therapy in Patients with Type 1 Cardiorenal Syndrome: An Observational Study
Author(s) -
Buyun Wu,
Wenyan Yan,
Xing Li,
Xiangqing Kong,
Xiangbao Yu,
Yamei Zhu,
Changying Xing
Publication year - 2017
Publication title -
cardiorenal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.661
H-Index - 21
eISSN - 1664-3828
pISSN - 1664-5502
DOI - 10.1159/000454932
Subject(s) - medicine , renal replacement therapy , cardiorenal syndrome , weaning , gastroenterology , heart failure
Background/Aims: Renal replacement therapy (RRT) is a rescue therapy for patients with type 1 cardiorenal syndrome (CRS) with poor prognoses. However, the optimal timing for initiation and cessation of RRT remains controversial. The purpose of this study was to determine the optimal timing of initiation and cessation of RRT for patients with type 1 CRS. Methods: In this retrospective analysis, patients with refractory type 1 CRS receiving RRT were divided into 3 groups according to weaning from RRT and death within 90 days. Baseline characteristics, underlying heart disease, comorbidities, drug use before RRT, indicators of RRT initiation, and prognosis were compared between the 3 groups. Results: Fifty-two patients were enrolled, which included 27 males and 25 females with a mean age of 70.7 ± 16.1 years and a 90-day mortality rate of 65.4%. The mean urine output before RRT initiation was 800 mL/ 24 h in the RRT-independent group, 650 mL/24 h in the RRT-dependent group, and 345 mL/ 24 h in the death group (p = 0.021). Additionally, there were obvious differences in fluid balance between the 3 groups (167, 250, and 1,270 mL, respectively, p = 0.016). Patients could be successfully weaned from RRT when urine output was >880 mL and fluid balance volume was 880 mL/24 h and volume balance is <150 mL/24 h.