PURPOSE: The objective of this study is to study the epidemiology, outcome, and prognostic factors of critically ill patients treated with continuous venovenous hemodiafiltration (CVVHDF). MATERIALS AND METHODS: Observational cohort was done in a French 16-bed intensive care unit (ICU) from a university-affiliated urban hospital. All patients requiring, in the opinion of the treating physician, the initiation of CVVHDF were included in the study. RESULTS: One hundred ninety-seven patients with acute renal failure (ARF) treated with CVVHDF were studied. The incidence of ARF treated with CVVHDF was 5.9% in the ICU with a mortality rate of 71.6%. A multivariate analysis identified 3 independent factors associated with fatal outcome: mechanical ventilation, sepsis, and septic shock requiring vasoactive drug. In contrast, 2 independent factors predicted a favorable outcome: nonoliguric ARF and serum creatinine concentration higher than 34 mg/L at CVVHDF initiation. A flowchart determined by the chi2 Automatic Interaction and Detection statistical method allowed for the identification of patients' subgroups with different mortality rates ranging from 25% to 100%. CONCLUSIONS: In our series, ARF treated with CVVHDF was associated with a high overall ICU mortality rate (71.6%). However, our prognostic flowchart identified patients with low mortality rates for which renal replacement therapy must be initiated with no discussion as soon as required.
PURPOSE: The objective of this study is to study the epidemiology, outcome, and prognostic factors of critically illpatients treated with continuous venovenous hemodiafiltration (CVVHDF). MATERIALS AND METHODS: Observational cohort was done in a French 16-bed intensive care unit (ICU) from a university-affiliated urban hospital. All patients requiring, in the opinion of the treating physician, the initiation of CVVHDF were included in the study. RESULTS: One hundred ninety-seven patients with acute renal failure (ARF) treated with CVVHDF were studied. The incidence of ARF treated with CVVHDF was 5.9% in the ICU with a mortality rate of 71.6%. A multivariate analysis identified 3 independent factors associated with fatal outcome: mechanical ventilation, sepsis, and septic shock requiring vasoactive drug. In contrast, 2 independent factors predicted a favorable outcome: nonoliguric ARF and serum creatinine concentration higher than 34 mg/L at CVVHDF initiation. A flowchart determined by the chi2 Automatic Interaction and Detection statistical method allowed for the identification of patients' subgroups with different mortality rates ranging from 25% to 100%. CONCLUSIONS: In our series, ARF treated with CVVHDF was associated with a high overall ICU mortality rate (71.6%). However, our prognostic flowchart identified patients with low mortality rates for which renal replacement therapy must be initiated with no discussion as soon as required.
Authors: F Perry Wilson; Wei Yang; Carlos A Machado; Laura H Mariani; Yuliya Borovskiy; Jeffrey S Berns; Harold I Feldman Journal: Clin J Am Soc Nephrol Date: 2014-03-20 Impact factor: 8.237
Authors: Antoine G Schneider; Rinaldo Bellomo; Sean M Bagshaw; Neil J Glassford; Serigne Lo; Min Jun; Alan Cass; Martin Gallagher Journal: Intensive Care Med Date: 2013-02-27 Impact factor: 17.440
Authors: Bolanle A Omotoso; Emaad M Abdel-Rahman; Wenjun Xin; Jennie Z Ma; Kenneth W Scully; Fatiu A Arogundade; Rasheed A Balogun Journal: J Nephrol Date: 2016-06-15 Impact factor: 3.902
Authors: In Myung Oh; Jang Han Lee; Kyoung Hwa Yoo; Ji Eun Park; Dong Hyun Oh; Mi Jung Kim; Seung Hea Ha; Gi Jong Lee; Jung Hee Kim; Yoon Chul Jung Journal: Kidney Res Clin Pract Date: 2012-10-05