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在重症患病的全源造血干细胞移植接受者中,AKI用脏替代疗法治疗
Helena Kim1, Rafia Ali1, Samuel Short2
1Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Bone marrow transplantation
|November 7, 2023
概括
需要置换治疗的急性损伤在重症移植患者中很常见. 这种疾病与极高的90天死亡率有关,这强调了需要仔细做出治疗决策的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血液学 血液学 血液学
- 关键护理医学 关键护理医学
背景情况:
- 急性损伤 (AKI) 是异质造血干细胞移植 (allo-HSCT) 后的一个显著并发症.
- 在严重病 allo-HSCT患者中,需要置换疗法 (AKI-KRT) 的AKI的重点是有限的.
- 了解AKI-KRT的风险因素和结果对于这个脆弱人群至关重要.
研究的目的:
- 调查AKI-KRT的发病率,风险因素和90天死亡率在重症成人allo-HSCT接受者中.
- 确定与AKI-KRT风险增加相关的特定临床因素.
- 为了评估与AKI-KRT相关的死亡率在这个患者队列.
主要方法:
- 对529名患重病的成年allo-HSCT接受者在移植后1年内进入ICU的回顾性分析.
- 收集的数据包括基线特征,ICU入院参数和移植相关并发症.
- 统计分析以确定AKI-KRT的发病率,风险因素和90天死亡率.
主要成果:
- 在21.0%的患者中发生了AKI-KRT.
- AKI-KRT的危险因素包括较低的基线EGFR,静脉封闭性疾病,血栓性微血管病变,早期ICU入院,侵入性机械通风,总 bilirubin升高和较低的动脉pH.
- 在AKI-KRT患者中,90天死亡率为87.4%,在特定高危子组中死亡率为100%.
结论:
- AKI-KRT是重症患者的常见和毁灭性的并发症.
- 几个移植前和ICU入院的因素预测了AKI-KRT的发展.
- 异常高的死亡率凸显了在这些患者开始KRT之前,需要进行多学科决策的必要性.
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