Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury
Introduction Severe pneumonia is a crucial issue in the development of acute kidney injury (AKI). This study evaluated the efficacy of early goal-directed renal replacement therapy (GDRRT) for the treatment of severe pneumonia-associated AKI.Methods In this real-world retrospective cohort study, we...
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| Format: | Article |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2392844 |
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| author | Abuduxiukuer Yusufu Yeqing Xie Yanting Shi Wuhua Jiang Jiachang Hu Wenlv Lv Xiaoqiang Ding Jie Teng Bo Shen Jing Bi Jianzhou Zou Jiarui Xu |
| author_facet | Abuduxiukuer Yusufu Yeqing Xie Yanting Shi Wuhua Jiang Jiachang Hu Wenlv Lv Xiaoqiang Ding Jie Teng Bo Shen Jing Bi Jianzhou Zou Jiarui Xu |
| author_sort | Abuduxiukuer Yusufu |
| collection | DOAJ |
| description | Introduction Severe pneumonia is a crucial issue in the development of acute kidney injury (AKI). This study evaluated the efficacy of early goal-directed renal replacement therapy (GDRRT) for the treatment of severe pneumonia-associated AKI.Methods In this real-world retrospective cohort study, we recruited 180 patients with severe pneumonia who were hospitalized and received GDRRT in a third-class general hospital in East China between January 1, 2017, and December 31, 2021. Clinical data on baseline characteristics, biochemical indicators, and renal replacement therapy were collected. Patients were divided into Early and Late RRT groups according to fluid status, inflammation progression, and pulmonary radiology. We investigated in-hospital all-cause mortality (primary endpoint) and renal recovery (secondary endpoint) between the two groups.Results Among the 154 recruited patients, 80 and 74 were in the early and late RRT groups, respectively. There were no significant differences in the demographic characteristics between the two groups. The duration of admission to RRT initiation was significantly shorter in Early RRT group [2.5(1.0, 8.7) d vs. 5.0(1.5,13.5) d, p = 0.027]. At RRT initiation, the patients in the Early RRT group displayed a lower percentage of fluid overload, lower doses of vasoactive agents, higher CRP levels, and higher rates of radiographic progression than those in the Late RRT group. The all-cause in-hospital mortality was significantly lower in the Early RRT group than in Late group (52.5% vs. 86.5%, p < 0.001). Patients in the Early RRT group displayed a significantly higher proportion of complete renal recovery at discharge (40.0% vs. 8.1%, p < 0.001).Conclusion This study clarified that early GDRRT for the treatment of severe pneumonia-associated AKI based on fluid status and inflammation progression, was associated with reduced hospital mortality and better recovery of renal function. Our preliminary study suggests that early initiation of RRT may be an effective approach for severe pneumonia-associated AKI. |
| format | Article |
| id | doaj-art-a4661d32c0a84c5dbe6e8cd405d29560 |
| institution | OA Journals |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-a4661d32c0a84c5dbe6e8cd405d295602025-08-20T02:38:10ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2392844Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injuryAbuduxiukuer Yusufu0Yeqing Xie1Yanting Shi2Wuhua Jiang3Jiachang Hu4Wenlv Lv5Xiaoqiang Ding6Jie Teng7Bo Shen8Jing Bi9Jianzhou Zou10Jiarui Xu11Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Xiamen Branch, Zhongshan Hospital, Fudan University, Nephrology Clinical Quality Control Center of Xiamen, Xiamen, Fujian, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Medical Center of Kidney, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, ChinaIntroduction Severe pneumonia is a crucial issue in the development of acute kidney injury (AKI). This study evaluated the efficacy of early goal-directed renal replacement therapy (GDRRT) for the treatment of severe pneumonia-associated AKI.Methods In this real-world retrospective cohort study, we recruited 180 patients with severe pneumonia who were hospitalized and received GDRRT in a third-class general hospital in East China between January 1, 2017, and December 31, 2021. Clinical data on baseline characteristics, biochemical indicators, and renal replacement therapy were collected. Patients were divided into Early and Late RRT groups according to fluid status, inflammation progression, and pulmonary radiology. We investigated in-hospital all-cause mortality (primary endpoint) and renal recovery (secondary endpoint) between the two groups.Results Among the 154 recruited patients, 80 and 74 were in the early and late RRT groups, respectively. There were no significant differences in the demographic characteristics between the two groups. The duration of admission to RRT initiation was significantly shorter in Early RRT group [2.5(1.0, 8.7) d vs. 5.0(1.5,13.5) d, p = 0.027]. At RRT initiation, the patients in the Early RRT group displayed a lower percentage of fluid overload, lower doses of vasoactive agents, higher CRP levels, and higher rates of radiographic progression than those in the Late RRT group. The all-cause in-hospital mortality was significantly lower in the Early RRT group than in Late group (52.5% vs. 86.5%, p < 0.001). Patients in the Early RRT group displayed a significantly higher proportion of complete renal recovery at discharge (40.0% vs. 8.1%, p < 0.001).Conclusion This study clarified that early GDRRT for the treatment of severe pneumonia-associated AKI based on fluid status and inflammation progression, was associated with reduced hospital mortality and better recovery of renal function. Our preliminary study suggests that early initiation of RRT may be an effective approach for severe pneumonia-associated AKI.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2392844Acute kidney injurysevere pneumoniarenal replacement therapy (RRT)prognosis |
| spellingShingle | Abuduxiukuer Yusufu Yeqing Xie Yanting Shi Wuhua Jiang Jiachang Hu Wenlv Lv Xiaoqiang Ding Jie Teng Bo Shen Jing Bi Jianzhou Zou Jiarui Xu Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury Renal Failure Acute kidney injury severe pneumonia renal replacement therapy (RRT) prognosis |
| title | Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury |
| title_full | Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury |
| title_fullStr | Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury |
| title_full_unstemmed | Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury |
| title_short | Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury |
| title_sort | early goal directed renal replacement therapy in severe pneumonia associated acute kidney injury |
| topic | Acute kidney injury severe pneumonia renal replacement therapy (RRT) prognosis |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2392844 |
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