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Long-term renal function after burn-related acute kidney injury with continuous renal replacement therapy

医学 肾脏替代疗法 急性肾损伤 肾功能 透析 回顾性队列研究 人口 队列 重症监护医学 烧伤 肌酐 队列研究 内科学 急诊医学 外科 环境卫生
作者
Travis Gordon,Bader Al-Zeer,Bingyue Zhu,Alexandra Romann,Peter Neufeld,Donald Griesdale,Anthony Papp
出处
期刊:Burns [Elsevier]
卷期号:50 (7): 1762-1768
标识
DOI:10.1016/j.burns.2024.05.019
摘要

Acute kidney injury (AKI) is a common complication of severe burn injury and is associated with significant morbidity and mortality. Continuous Renal Replacement Therapy (CRRT) is the preferred treatment for stage 3 AKI due to severe burn. This retrospective cohort study at a single institution aimed to examine the long-term renal outcomes after discharge of burn survivors who underwent CRRT during their ICU stay between 2012-2021 due to burn-related AKI, hypothesizing a return to baseline renal function in the long term. Among the 31 patients meeting inclusion criteria, 22 survived their burn injuries, resulting in a 29 % mortality rate. No significant disparities were observed in demographics, comorbidities, burn characteristics, or critical care interventions between survivors and non-survivors. Serum creatinine and eGFR values normalized for 91 % of patients at discharge. Impressively, 91 % of survivors demonstrated a return to baseline renal function during long-term (>3 years) follow-up. Furthermore, only 18 % underwent dialysis after discharge, primarily within the first year. Cumulative mortality rates were 18.2 %, 22.7 %, and 31.8 % at 1, 3, and > 3 years after discharge, respectively. Causes of death were primarily non-renal. These results suggest that burn-related AKI with CRRT results in lower rates of conversion to ongoing renal dysfunction compared to general ICU cohorts. Despite limitations, this study contributes vital insights into the underexplored issue of long-term outcomes after dicharge in this patient population.

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