Independent risk factors for renal function non-recovery at 28 days after ECMO initiation among patients receiving ECMO complicated with acute kidney injury
10.3760/cma.j.issn.1671-0282.2024.03.010
- VernacularTitle:合并急性肾损伤患者体外膜肺氧合支持上机后28 d肾功能未恢复的独立危险因素
- Author:
Qiao WEI
1
;
Yanlin WEI
;
Mingyu PEI
;
Wenxue JIANG
;
Chi WANG
;
Liwen LYU
Author Information
1. 广西壮族自治区人民医院急诊科，南宁 530000
- Keywords:
Extracorporeal membrane oxygenation;
Acute kidney injury;
Prognosis;
Risk factors
- From:
Chinese Journal of Emergency Medicine
2024;33(3):317-323
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the recovery of renal function and its influencing factors in patients receiving extracorporeal membrane oxygenation (ECMO) support and complicated with acute kidney injury(AKI).Methods:This was a retrospective observational study. The clinical data of patients with ECMO support and AKI admitted to the Emergency intensive care unit of the People's Hospital of Guangxi Zhuang Autonomous Region from October 2019 to December 2021 were collected. The patients were divided into renal function recovery group and renal function non-recovery group according to the recovery of renal function after 28 days of ECMO. With renal function non-recovery at 28 days as the end point of the study, and the variables with significant differences in baseline were selected for stepwise backward regression to determine the independent risk factors. The receiver operator characteristic (ROC) curve was drawn, and the area under the curve (AUC) was used to evaluate the diagnostic value of independent risk factors.Results:A total of 40 patients were enrolled, of which 28 patients (70%) had recovery of renal function, and 12 patients (30%) did not have recovery of renal function. Stepwise backward multivariate logistic regression analysis showed that lactate level at ECMO initiation was an independent risk factor for non-recovery of renal function ( OR = 1.380, 95% CI: 1.096-1.738, P = 0.006). The ROC curve showed that the AUC and 95% CI were 0.863 (0.751-0.975), the sensitivity was 100%, and the specificity was 75%. Conclusion:Lactate level at ECMO initiation was an independent risk factor for non-recovery of renal function on 28 days after ECMO initiation among patients undergoing ECMO support complicated with AKI. Lactate has a high predictive value for the non-recovery of renal function.
