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Prognostic factors in continuous hemofiltration therapy for patients with cardiorenal syndrome
Xing Li1, Huijuan Mao, Xiangbao Yu
1Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Insights
Continuous hemofiltration (CHF) shows promise for cardiorenal syndrome (CRS) patients. Prognostic factors like cardiac function and dehydration volume are key, with infection and fluid overload impacting mortality.
Area of Science:
- Nephrology
- Cardiology
- Critical Care Medicine
Background:
- Cardiorenal syndrome (CRS) presents complex challenges in patient management.
- Continuous hemofiltration (CHF) is a therapeutic option for CRS patients.
- Identifying prognostic factors is crucial for optimizing CHF therapy.
Purpose of the Study:
- To evaluate the efficacy of CHF in CRS patients.
- To identify factors predicting patient outcomes.
- To guide patient selection for CHF therapy.
Main Methods:
- Retrospective analysis of 59 CRS patients (Type 1 or 2) treated with CHF.
- Comparison of clinical data between survival and non-survival groups.
- Analysis of factors influencing in-hospital mortality.
Main Results:
- Significant differences observed in serum creatinine, bilirubin levels, WBC count, hemoglobin, hematocrit, cardiac dimensions, blood pressure, and dehydration volume between groups.
- Leukocytosis identified as a risk factor for mortality (OR 1.242).
- Elevated serum creatinine was not a significant negative prognostic factor (OR 0.994).
Conclusions:
- Pre-hemofiltration cardiac function and dehydration volume significantly impact CRS patient prognosis.
- Infection and initial fluid overload are independent predictors of in-hospital mortality.
Aims:
The aims of this study were to investigate the efficacy and identify the prognostic factors of continuous hemofiltration in patients with cardiorenal syndrome (CRS) and, finally, to optimally select patients who could benefit more from this therapy.
Methods:
A total of 59 patients with CRS type 1 or type 2 treated with continuous hemofiltration were enrolled. We collected their clinical data and divided them into 2 groups according to their survival or death during hospitalization to conduct a retrospective analysis on factors affecting mortality.
Results:
The following items were significantly different between the survival (n = 30) and death (n = 29) groups: serum creatinine, serum total bilirubin, direct bilirubin, white blood cells, hemoglobin, hematocrit, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, systolic blood pressure and mean arterial pressure before hemofiltration, and average dehydration volume during the hemofiltration process. Leukocytosis was a risk factor for death (OR 1.242, 95% CI 1.242-1.480), and elevated sCr was not a key negative factor in the prognosis of CRS (OR 0.994, 95% CI 0.989-1.000).
Conclusions:
Cardiac function before hemofiltration and the amount of dehydration during the hemofiltration process both affected the prognosis. Infection and fluid overload condition at the beginning of hemofiltration were independently associated with mortality during hospitalization.
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