scholarly journals Predialysis Serum Lactate Levels Can Predict Dialysis Withdrawal in Type 1 Cardiorenal Syndrome Patients

2021 ◽  
Author(s):  
Heng-Chih Pan ◽  
Vincent Wu
Keyword(s):  
Lactate Level ◽  
Rescue Therapy ◽  
External Validation ◽  
Cardiorenal Syndrome ◽  
Serum Lactate ◽  
Cox Proportional Hazards ◽  
Dependent Manner ◽  
Serum Lactate Level ◽  
Dialysis Withdrawal

Abstract Type 1 cardiorenal syndrome (CRS) is a complication with grave outcomes, and renal replacement therapy (RRT) is an effective rescue therapy. Serum lactate has been correlated with the risk of mortality in patients with sepsis. However, the association between serum lactate level and the prognosis of type 1 CRS patients requiring RRT is unknown. We prospectively enrolled 500 type 1 CRS patients who received RRT from August 2011 to January 2018. The 90-day mortality rate was 52.8% and the incidence rate of RRT independence was 34.8%. Lower pre-dialysis lactate was correlated with a higher rate of dialysis withdrawal and lower rate of mortality. A generalized additive model showed that 4.2 mmol/L was an adequate cut-off value of lactate to predict renal recovery. Taking mortality as a competing risk, Cox proportional hazards analysis indicated that a low lactate level (≦ 4.2 mmol/L) was an independent prognostic factor for the possibility of dialysis withdrawal, as also shown in external validation. The interaction of quick Sequential Organ Failure Assessment score and lactate was associated with dialysis dependence in a disease severity-dependent manner. In summary, we identified that pre-dialysis serum lactate level could predict the possibility of dialysis withdrawal in type 1 CRS patients.

scholarly journals Predialysis serum lactate levels could predict dialysis withdrawal in Type 1 cardiorenal syndrome patients

2022 ◽  
Vol 44 ◽  
pp. 101232
Author(s):  
Heng-Chih Pan ◽  
Tao-Min Huang ◽  
Chiao-Yin Sun ◽  
Nai-Kuan Chou ◽  
Chun-Hao Tsao ◽  
...  
Keyword(s):  
Cardiorenal Syndrome ◽  
Serum Lactate ◽  
Lactate Levels ◽  
Dialysis Withdrawal

Serum lactate level accurately predicts mortality in critically ill patients with cirrhosis with acute kidney injury

2018 ◽  
Vol 30 (11) ◽  
pp. 1361-1367 ◽  
Author(s):  
Dan-Qin Sun ◽  
Chen-Fei Zheng ◽  
Feng-Bin Lu ◽  
Sven Van Poucke ◽  
Xiao-Ming Chen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lactate Level ◽  
Kidney Injury ◽  
Serum Lactate ◽  
Serum Lactate Level

scholarly journals Serum lactate level predicts 6-months mortality in hospitalized patients with decompensated cirrhosis

2019 ◽  
Author(s):  
Yue Zhang ◽  
Yuan Nie ◽  
Si-Zhe Wan ◽  
Cong Liu ◽  
Xuan Zhu
Keyword(s):  
Lactate Level ◽  
Multivariate Analyses ◽  
Predictive Accuracy ◽  
Roc Curves ◽  
Serum Lactate ◽  
Meld Score ◽  
Decompensated Cirrhosis ◽  
Serum Lactate Level ◽  
Initiation Of Therapy ◽  
Prediction Of Prognosis

Abstract Background The prediction of prognosis is an important part of management in decompensated cirrhosis (DeCi) patients with high long-term mortality. Lactate is a known predictor of outcome in critically ill patients. The aim of this study was to assess the prognostic value of lactate in DeCi patients.Methods We performed a single-center, observational, retrospective study of 456 DeCi patients extracted from hospitalization. Univariate and multivariate analyses were used to determine whether lactate was independently associated with the prognosis of DeCi patients. The AUROC was calculated to assess the predictive accuracy compared with existing scores.Results Serum lactate level was significantly higher in nonsurviving patients than in surviving patients. Univariate and multivariate analyses demonstrated that lactate was a risk-independent factor 6-months mortality (odds ratio: 1.412, P=0.001). ROC curves were drawn to evaluate the prediction efficiencies of lactate for 6-months mortality (AUROC: 0.716, P<0.001). Based on our patient cohort, the new scores (MELD+ lactate score, Child-Pugh+ lactate score) had good accuracy for predicting 6-months mortality (AUROC=0.769, P<0.001; AUROC= 0.766, P<0.001). Additionally, the performance of the new scores was superior to those of existing scores (all P < 0.001).Conclusion Serum lactate at admission may be useful for predicting 6-months mortality in DeCi patients, and the predictive value of the MELD score and Child-Pugh score were improved by adjusting lactate. Lactate should be part of the rapid diagnosis and initiation of therapy to improve clinical outcome.

Assessment of association of serum lactate level with retinopathy of prematurity

2021 ◽  
Vol 30 (1) ◽  
pp. 9
Author(s):  
Serdar OZATES ◽  
Emrah Utku KABATAS ◽  
Dilek DILLI ◽  
Aysegul ZENCIROGLU
Keyword(s):  
Retinopathy Of Prematurity ◽  
Lactate Level ◽  
Serum Lactate ◽  
Serum Lactate Level

scholarly journals Can the Preoperative Serum Lactate Level Predict the Extent of Bowel Ischemia in Patients Presenting to the Emergency Department with Acute Mesenteric Ischemia?

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Peter C. Ambe ◽  
Kai Kang ◽  
Marios Papadakis ◽  
Hubert Zirngibl
Keyword(s):  
Lactate Level ◽  
Mesenteric Ischemia ◽  
Clinical Decision Making ◽  
Elevated Serum ◽  
Acute Mesenteric Ischemia ◽  
Serum Lactate ◽  
Bowel Ischemia ◽  
Serum Lactate Level ◽  
Ischemic Bowel ◽  
Preoperative Serum

Purpose. Early recognition of acute mesenteric ischemia (AMI) can be challenging. Extensive bowel necrosis secondary to AMI is associated with high rates of mortality. The aim of this study was to investigate the association between preoperative serum lactate level and the extent of bowel ischemia in patients with AMI. Methods. Data of patients with abdominal pain and elevated serum lactate undergoing emergency laparotomy for suspected AMI within 24 hours of presentation was retrospectively abstracted. The length of the ischemic bowel segment was compared with the preoperative serum lactate level. Results. 36 female and 39 male patients, with median age 73.1 ± 12.3 years, were included for analysis. The median preoperative lactate was 2.96 ± 2.59 mmol/l in patients with ≤50 cm, 6.86 ± 4.08 mmol/l in patients with 51–100 cm, 4.73 ± 2.76 mmol/l in patients with >100 cm ischemic bowel, and 14.07 ± 4.91 mmol/l in the group with multivisceral ischemia. Conclusion. Although elevated serum lactate might permit an early suspicion and thus influence the clinical decision-making with regard to prioritization of surgery in patients with suspected AMI, a linear relationship between serum lactate and the extent of bowel ischemia could not be established in this study.

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