Hypophosphatemia during continuous veno-venous hemofiltration is associated with mortality in critically ill patients with acute kidney injury.
Hypophosphatemia during continuous veno-venous hemofiltration is associated with mortality in critically ill patients with acute kidney injury.
复制标题
连续静脉-静脉血液滤过期间的低磷血症与急性肾损伤危重患者的死亡率相关
DOI：
10.1186/cc12900
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发表时间：
2013-09-19
期刊：
影响因子：
--
通讯作者：
Chen J
中科院分区：
文献类型：
--
作者：
Yang Y;Zhang P;Cui Y;Lang X;Yuan J;Jiang H;Lei W;Lv R;Zhu Y;Lai E;Chen J
本研究的主要目的是确定连续性静脉-静脉血液滤过（CVVH）期间低磷血症是否与急性肾损伤（阿基）危重患者的总体结局相关。将CVVH开始后28天内的死亡和28天的生存率作为终点。人口统计学和临床数据（包括血清磷水平）以及临床结局均沿着记录。根据比色法，低磷血症定义为血清磷水平< 0.81 mmol/L（2.5 mg/dL），重度低磷血症定义为血清磷水平< 0.32 mmol/L（1 mg/dL）。计算CVVH治疗日与低磷血症的总CVVH治疗日的比率，以反映低磷血症的持续性。ResultsThe考克斯比例风险生存模型分析表明，低磷血症，甚至严重的低磷血症的发病率与28天的死亡率无关（p= 0.700）。对CVVH治疗期间发生低磷血症的患者子队列的进一步分析表明，发生低磷血症的CVVH治疗天数与总CVVH治疗天数的平均比值为0.58，该比值与总体结局独立相关。与低比率（< 0.58）患者相比，高比率（≥ 0.58）患者的28天死亡率增加1.451倍（95%CI 1.103- 1.910，p = 0.008）。低磷血症CVVH治疗天数与总CVVH治疗天数的比值与28天死亡率独立相关，比值越高，死亡率越高。
IntroductionThe primary aim of this study was to determine whether hypophosphatemia during continuous veno-venous hemofiltration (CVVH) is associated with the global outcome of critically ill patients with acute kidney injury (AKI).Methods760 patients diagnosed with AKI and had received CVVH therapy were retrospectively recruited. Death during the 28-day period and survival at 28 days after initiation of CVVH were used as endpoints. Demographic and clinical data including serum phosphorus levels were recorded along with clinical outcome. Hypophosphatemia was defined according to the colorimetric method as serum phosphorus levels < 0.81 mmol/L (2.5 mg/dL), and severe hypophosphatemia was defined as serum phosphorus levels < 0.32 mmol/L (1 mg/dL). The ratio of CVVH therapy days with hypophosphatemia over total CVVH therapy days was calculated to reflect the persistence of hypophosphatemia.ResultsThe Cox proportional hazard survival model analysis indicated that the incidence of hypophosphatemia or even severe hypophosphatemia was not associated with 28-day mortality independently (p= 0.700). Further analysis with the sub-cohort of patients who had developed hypophosphatemia during the CVVH therapy period indicated that the mean ratio of CVVH therapy days with hypophosphatemia over total CVVH therapy days was 0.58, and the ratio independently associated with the global outcome. Compared with the patients with low ratio (< 0.58), those with high ratio (≥ 0.58) conferred a 1.451-fold increase in 28-day mortality rate (95% CI 1.103–1.910,p= 0.008).ConclusionsHypophosphatemia during CVVH associated with the global clinical outcome of critically ill patients with AKI. The ratio of CVVH therapy days with hypophosphatemia over total CVVH therapy days was independently associated with the 28-day mortality, and high ratio conferred higher mortality rate.
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影响因子：
168.9
作者：
Weisinger, JR;Bellorín-Font, E
通讯作者：
Bellorín-Font, E
影响因子：
1.1
作者：
OGNIBENE, A;CINIGLIO, R;WHITTIER, F
通讯作者：
WHITTIER, F
影响因子：
11.1
作者：
Håglin, L;Burman, LÅ;Nilsson, M
通讯作者：
Nilsson, M
影响因子：
8.8
作者：
ROSEN, GH;BOULLATA, JI;SHIN, B
通讯作者：
SHIN, B
影响因子：
120.7
作者：
Uchino, S;Kellum, JA;Ronco, C
通讯作者：
Ronco, C