scholarly journals Risk Factors Analysis of Acute Kidney Injury in Adult Patients Receiving Extracorporeal Membrane Oxygenation

2020 ◽  
Author(s):  
Zhixiang Mou
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Liver Cirrhosis ◽  
Extracorporeal Membrane Oxygenation ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Ecmo Support ◽  
Adult Patients ◽  
Severe Bleeding ◽  
Membrane Oxygenation

AbstractBackgroundAcute kidney injury (AKI) has been reported as one of the most common complication in patients receiving extracorporeal membrane oxygenation (ECMO), the risk factors of AKI on ECMO is unknown. This meta-analysis aimed to find out the risk factors of AKI among adult patients receiving ECMO.MethodsA literature search was performed using PubMed,Web of Science, and Embase fulfilled the pre-specified criteria until April 2020 to include studies reported the necessary clinic characteristics, then the gender, cancer, diffuse intravascular coagulation (DIC), massive/severe Bleeding, intra-aortic balloon pump (IABP), post-cardiotomy, diabetes mellitus, liver cirrhosis and ECMO support duration were pooled for further analysis by STATA to get conclusion.ResultsThis research is first time to provide the evidence that patients developed AKI/severe AKI with a longer ECMO support duration (pooled WMD, 4.09 days; 95% CI: 2.45-5.73 days, Z= 4.89, P= 0.000, I2= 73.4%, χ2P= 0.023/pooled WMD, 1.52 days; 95% CI: 0.19-2.85 days, Z= 2.25, P= 0.025, I2= 77.4%, χ2P= 0.001) and the risk of severe AKI requiring RRT was higher (pooled OR, 2.22; 95% CI: 1.24-3.99, Z= 2.68, P= 0.007, I2= 0.0%, χ2P= 0.634) in liver cirrhosis patients by systemic analysis, indicated ECMO support duration and liver cirrhosis may act as risk factors of AKI in adult patients received ECMO.

scholarly journals No Difference in Risk of Acute Kidney Injury Between Adult Patients Receiving Different Types of Extracorporeal Membrane Oxygenation

2020 ◽  
Author(s):  
Zhixiang Mou ◽  
Xu Zhang
Keyword(s):  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Web Of Science ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Adult Patients ◽  
Membrane Oxygenation ◽  
Significant Difference ◽  
Different Types ◽  
Va Ecmo

AbstractAcute kidney injury (AKI) has been reported as one of the most common complications in patients receiving extracorporeal membrane oxygenation (ECMO), yet the risk of AKI on different types of ECMO remains unclear. This meta-analysis aimed to compare risk of AKI among adult patients requiring different types of ECMO. Two authors independently performed a literature search using PubMed, Web of Science, and Embase, encompassing publications up until Arpril 20, 2020 (inclusive). The number of AKI patients, non-AKI patients, patients required RRT and patients not required RRT receiving different types of ECMO were derived and analyzed by STATA. The results indicated there was no significant difference in risk of AKI (OR, 1.54; 95% CI: 0.75-3.16; P= 0.235) and severe AKI required RRT (OR, 1.0; 95% CI: 0.66-1.5, P= 0.994) in patients receiving different types of ECMO. In Conclusion, no difference in risk of AKI and severe AKI required RRT between patients receiving VA ECMO and VV ECMO. More studies are required to support the findings.

scholarly journals Incidence and Impact of Acute Kidney Injury in Patients Receiving Extracorporeal Membrane Oxygenation: A Meta-Analysis

2019 ◽  
Vol 8 (7) ◽  
pp. 981 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Ploypin Lertjitbanjong ◽  
Narothama Reddy Aeddula ◽  
Tarun Bathini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Incidence Rates ◽  
Adult Patients ◽  
Membrane Oxygenation ◽  
The Impact

Background: Although acute kidney injury (AKI) is a frequent complication in patients receiving extracorporeal membrane oxygenation (ECMO), the incidence and impact of AKI on mortality among patients on ECMO remain unclear. We conducted this systematic review to summarize the incidence and impact of AKI on mortality risk among adult patients on ECMO. Methods: A literature search was performed using EMBASE, Ovid MEDLINE, and Cochrane Databases from inception until March 2019 to identify studies assessing the incidence of AKI (using a standard AKI definition), severe AKI requiring renal replacement therapy (RRT), and the impact of AKI among adult patients on ECMO. Effect estimates from the individual studies were obtained and combined utilizing random-effects, generic inverse variance method of DerSimonian-Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42018103527). Results: 41 cohort studies with a total of 10,282 adult patients receiving ECMO were enrolled. Overall, the pooled estimated incidence of AKI and severe AKI requiring RRT were 62.8% (95%CI: 52.1%–72.4%) and 44.9% (95%CI: 40.8%–49.0%), respectively. Meta-regression showed that the year of study did not significantly affect the incidence of AKI (p = 0.67) or AKI requiring RRT (p = 0.83). The pooled odds ratio (OR) of hospital mortality among patients receiving ECMO with AKI on RRT was 3.73 (95% CI, 2.87–4.85). When the analysis was limited to studies with confounder-adjusted analysis, increased hospital mortality remained significant among patients receiving ECMO with AKI requiring RRT with pooled OR of 3.32 (95% CI, 2.21–4.99). There was no publication bias as evaluated by the funnel plot and Egger’s regression asymmetry test with p = 0.62 and p = 0.17 for the incidence of AKI and severe AKI requiring RRT, respectively. Conclusion: Among patients receiving ECMO, the incidence rates of AKI and severe AKI requiring RRT are high, which has not changed over time. Patients who develop AKI requiring RRT while on ECMO carry 3.7-fold higher hospital mortality.

scholarly journals INCIDENCE AND IMPACT OF ACUTE KIDNEY INJURY IN PATIENTS RECEIVING EXTRACORPOREAL MEMBRANE OXYGENATION: A META-ANALYSIS

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A1139
Author(s):  
Ploypin Lertjitbanjong ◽  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Michael Mao ◽  
Kianoush Kashani
Keyword(s):  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Membrane Oxygenation

Acute Kidney Injury in Extracorporeal Membrane Oxygenation Patients: National Analysis of Impact of Age

2021 ◽  
pp. 1-10
Author(s):  
Ankit Sakhuja ◽  
Paul McCarthy ◽  
Jeremiah A. Hayanga ◽  
Steven Turley ◽  
Gordon Smith ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Independent Predictor ◽  
Kidney Injury ◽  
International Classification Of Diseases ◽  
Ecmo Support ◽  
Membrane Oxygenation ◽  
Nationwide Inpatient Sample Database ◽  
The Usa ◽  
National Analysis

<b><i>Background:</i></b> The aim of this study was to determine epidemiology and outcomes of acute kidney injury (AKI) in patients on extracorporeal membrane oxygenation (ECMO) and to assess if age modifies the effect of AKI on mortality. <b><i>Methods:</i></b> Using National (Nationwide) Inpatient Sample Database for hospitalizations in the USA from 2003 to 2014, we identified adult patients on ECMO support. Using International Classification of Diseases 9th Revision, we assessed the rates of AKI and AKI requiring dialysis (AKI-D) among them and associated survival. We used a multivariable logistic regression to identify risk factors of and differential effect of age on mortality from AKI. <b><i>Results:</i></b> AKI was seen in 63.9% of 17,942 ECMO hospitalizations: 21.9% of those with AKI required dialysis. The percentage of those with AKI increased steadily. Mortality was higher in those with AKI, with highest in those with AKI-D (70.8% vs. 61.7%; <i>p</i> &#x3c; 0.001). While both age and AKI were independent predictors of mortality, age was neither a risk factor for AKI nor did it modify the effect of AKI on mortality. <b><i>Conclusions:</i></b> AKI is common and is increasing among patients on ECMO support. Patients on ECMO have high mortality and AKI is an independent predictor of mortality. Though age is also an independent predictor of mortality in patients on ECMO, it is neither a predictor of AKI nor does not modify the relationship between AKI and mortality.

scholarly journals Risk Factors for Acute Kidney Injury and In-Hospital Mortality in Patients Receiving Extracorporeal Membrane Oxygenation

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0140674 ◽  
Author(s):  
Sung Woo Lee ◽  
Mi-yeon Yu ◽  
Hajeong Lee ◽  
Shin Young Ahn ◽  
Sejoong Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Membrane Oxygenation

scholarly journals Risk Factors for Acute Kidney Injury in Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyue Cai ◽  
Guiming Wu ◽  
Jie Zhang ◽  
Lichuan Yang
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Significant Risk ◽  
Kidney Injury ◽  
Adult Patients ◽  
Cochrane Library ◽  
Male Sex

Background and Objective: Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly around the world. Studies found that the incidence of acute kidney injury (AKI) in COVID-19 patients was more than double the incidence of AKI in non-COVID-19 patients. Some findings confirmed that AKI is a strong independent risk factor for mortality in patients with COVID-19 and is associated with a three-fold increase in the odds of in-hospital mortality. However, little information is available about AKI in COVID-19 patients. This study aimed to analyse the risk factors for AKI in adult patients with COVID-19.Methods: A systematic literature search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, VIP and WanFang Data from 1 December 2019 to 30 January 2021. We extracted data from eligible studies to compare the effects of age, sex, chronic diseases and potential risk factors for AKI on the prognosis of adult patients with COVID-19.Results: In total, 38 studies with 42,779 patients were included in this analysis. The meta-analysis showed that male sex (OR = 1.37), older age (MD = 5.63), smoking (OR = 1.23), obesity (OR = 1.12), hypertension (OR=1.85), diabetes (OR=1.71), pneumopathy (OR = 1.36), cardiovascular disease (OR = 1.98), cancer (OR = 1.26), chronic kidney disease (CKD) (OR = 4.56), mechanical ventilation (OR = 8.61) and the use of vasopressors (OR = 8.33) were significant risk factors for AKI (P &lt; 0.05).Conclusions: AKI is a common and serious complication of COVID-19. Overall, male sex, age, smoking, obesity, hypertension, diabetes, pneumopathy, cardiovascular disease, cancer, CKD, mechanical ventilation and the use of vasopressors were independent risk factors for AKI in adult patients with COVID-19. Clinicians need to be aware of these risk factors to reduce the incidence of AKI.System Review Registration: PROSPERO, identifier [CRD42021282233].

Acute Kidney Injury During Extracorporeal Membrane Oxygenation: VA ECMO Versus VV ECMO

2021 ◽  
pp. 088506662110353
Author(s):  
Zhixiang Mou ◽  
Jinxuan He ◽  
Tianjun Guan ◽  
Lan Chen
Keyword(s):  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Web Of Science ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Patient Deterioration ◽  
Membrane Oxygenation ◽  
Different Types ◽  
Va Ecmo ◽  
Vv Ecmo

Purpose Acute kidney injury (AKI) has been reported to be one of the most common complications in patients receiving extracorporeal membrane oxygenation (ECMO), yet variations in AKI between different types of ECMO remain unclear. This meta-analysis systematically compares AKI/severe AKI in adult patients requiring different types of ECMO. Methods Two authors independently performed a literature search using PubMed, Web of Science, and Embase, encompassing publications up until April 20, 2020 (inclusive). The number of AKI patients, including patients who required/did not require renal replacement therapy (RRT), and deceased patients with AKI/severe AKI, who received different types of ECMO were collated and analyzed using STATA. Results The results indicated that there were no significant differences in the risk of AKI/severe AKI among different types of ECMO. However, the presence of AKI and severe AKI during veno-arterial (VA) ECMO was more strongly associated with mortality. Conclusions Although mortality rates related to AKI/severe AKI during VV ECMO are high, the occurrence of AKI/severe AKI during VA ECMO should be given greater attention, as these instances are considered strong indicators of patient deterioration and even death. Additional studies are needed to corroborate these findings.

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