Timing of Acute Kidney Injury Affects Outcomes in VA-ECMO Patients
A study suggests that the timing of acute kidney injury affects ICU mortality rates in patients receiving VA-ECMO.
NEW DELHI, Nov 4: A recent study indicates that the timing of acute kidney injury (AKI) can influence outcomes for patients undergoing veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Conducted across two centers in Thailand, the retrospective analysis involved 172 adults receiving this form of circulatory support.
Researchers used Kidney Disease: Improving Global Outcomes (KDIGO) criteria to classify patients based on when AKI occurred: before ECMO initiation, after initiation, or not at all. Findings revealed that 81 patients (47.1%) developed AKI prior to ECMO, while 82 (47.7%) experienced it afterward. Only nine patients (5.2%) had no AKI.
The study found unadjusted ICU mortality was higher for those who developed AKI before starting ECMO at 82.7%, compared to 69.5% for those with AKI afterward.
“The observed mortality difference could partly reflect the severity of the patient’s underlying condition,” the researchers noted.
However, after adjusting for factors such as age, sex, chronic kidney disease, and illness severity, the initial association weakened. The adjusted hazard ratio for mortality related to pre-ECMO AKI was 1.39 and fell to 1.28 with further adjustments, neither establishing significant statistical links. AKI occurring post-ECMO was not significantly linked to ICU mortality.
The researchers suggest the timing of AKI may provide context for assessing overall illness severity and other organ injuries. They recommend that while AKI prior to ECMO can be relevant, it should not restrict treatment access. Further research is necessary to clarify the independent prognostic impact of AKI timing in this patient demographic.
Sources
Bhupendra Singh Chundawat is a seasoned technology journalist with over 22 years of experience in the media industry. He specializes in covering the global technology landscape, with a deep focus on manufacturing trends and the geopolitical impact on tech companies. Currently serving as the Editor at Udaipur Kiran, his insights are shaped by decades of hands-on reporting and editorial leadership in the fast-evolving world of technology.