Journal article
Effects of Baseline Thrombocytopenia and Platelet Decrease Following Renal Replacement Therapy Initiation in Patients With Severe Acute Kidney Injury
Critical care medicine, Vol.47(4), pp.e325-e331
04/2019
DOI: 10.1097/CCM.0000000000003598
PMCID: PMC7279613
PMID: 30585829
Abstract
Thrombocytopenia is common in critically ill patients with severe acute kidney injury and may be worsened by the use of renal replacement therapy. In this study, we evaluate the effects of renal replacement therapy on subsequent platelet values, the prognostic significance of a decrease in platelets, and potential risk factors for platelet decreases.
Post hoc analysis of the Acute Renal Failure Trial Network Study.
The Acute Renal Failure Trial Network study was a multicenter, prospective, randomized, parallel-group trial of two strategies for renal replacement therapy in critically ill patients with acute kidney injury conducted between November 2003 and July 2007 at 27 Veterans Affairs and university-affiliated medical centers.
The Acute Renal Failure Trial Network study evaluated 1,124 patients with severe acute kidney injury requiring renal replacement therapy.
Predictor variables were thrombocytopenia at initiation of renal replacement therapy and platelet decrease following renal replacement therapy initiation.
Outcomes were mortality at 28 days, 60 days, and 1 year, renal recovery, renal replacement therapy free days, ICU-free days, and hospital-free days. Baseline thrombocytopenia in patients requiring renal replacement therapy was associated with increased mortality and was also associated with lower rates of renal recovery. A decrease in platelet values following renal replacement therapy initiation was associated with increased mortality. Continuous renal replacement therapy was not an independent predictor of worsening thrombocytopenia compared with those treated with intermittent hemodialysis.
Baseline thrombocytopenia and platelet decrease following renal replacement therapy initiation were associated with increased mortality, and baseline thrombocytopenia was associated with decreased rates of renal recovery. Continuous renal replacement therapy did not decrease platelets compared with hemodialysis.
Details
- Title: Subtitle
- Effects of Baseline Thrombocytopenia and Platelet Decrease Following Renal Replacement Therapy Initiation in Patients With Severe Acute Kidney Injury
- Creators
- Benjamin R Griffin - Division of Renal Diseases and Hypertension/Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, COAnna Jovanovich - Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, COZhiying You - Division of Renal Diseases and Hypertension/Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, COPaul Palevsky - Renal Section/Medical Service, VA Pittsburgh HCS and Renal-Electrolyte Division/Department of Medicine, University of Pittsburgh, Pittsburgh, PASarah Faubel - Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, CODiana Jalal - Division of Nephrology/Department of Medicine, University of Iowa, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Critical care medicine, Vol.47(4), pp.e325-e331
- DOI
- 10.1097/CCM.0000000000003598
- PMID
- 30585829
- PMCID
- PMC7279613
- NLM abbreviation
- Crit Care Med
- ISSN
- 0090-3493
- eISSN
- 1530-0293
- Grant note
- T32 DK007135 / NIDDK NIH HHS
- Language
- English
- Date published
- 04/2019
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984094560502771
Metrics
22 Record Views