An epidemiologic study of early renal replacement therapy after orthotopic liver transplantation
An epidemiologic study of early renal replacement therapy after orthotopic liver transplantation
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DOI：
10.1681/asn.v131228
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发表时间：
2002-01-01
影响因子：
13.6
通讯作者：
Gomez, E
中科院分区：
文献类型：
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作者：
Contreras, G;Garces, G;Gomez, E
术前肾功能损害与肝移植患者术后肾替代治疗（RRT）的需求相关，本研究的主要目的是确定移植前或移植中与移植后早期RRT需求独立相关的其他因素。共研究了260例连续接受原发性肝移植的成年患者。28例患者需要早期RRT（移植后1周内开始RRT） 23来控制容量过载。术前血尿素氮（优势比[95% CI]）。每10毫克/分升1.52[1.15至2.01])。血清肌酐（1.91 [1.06 ~ 3.44]/ 1 mg/dl）和尿量（0.12 [0.03 ~ 0.44]L/d）是早期RRT需要的独立预测指标，两者结合形成了一个判别性较好的简约模型（受试者工作特征曲线下面积，0.877），具有很好的拟合性（P=0.699，拒绝模型拟合）。没有其他潜在的预测因子有意义地改善哪些患者需要早期RRT的预测。需要早期RRT的患者比不需要早期RRT的患者消耗更多的医疗资源，在重症监护中花费更多的时间（15 +/- 13 d vs 7 +/- 11 d）
The preoperative impairment of renal function is associated with the need for postoperative renal replacement therapy (RRT) in patients undergoing liver transplantation, The principal goal of this investigation was to identify other factors apparent before or during transplant that were independently associated with the need for RRT in the early posttransplant period. A total of 260 consecutive adult patients who received a primary liver transplant were studied. Twenty-eight patients required early RRT (RRT initiated within I wk of transplant) 23 for control of volume overload. Preoperative blood urea nitrogen (odds ratio [95% CI]. 1.52 [1.15 to 2.01] per 10 mg/dl). serum creatinine ( 1.91 [1.06 to 3.44] per 1 mg/dl), and urine output (0.12 [0.03 to 0.44] L/d) were independently predictive of the need for early RRT and in combination formed a parsimonious model that discriminated well (area under the receiver operating characteristic curve, 0.877) and had excellent fit (P=0.699 to reject model Fit). No other potential predictors meaningfully improved predictions of which patients would require early RRT. Patients requiring early RRT consumed more healthcare resources than patients who did not require early RRT, spending more time in intensive care (15 +/- 13 d versus 7 +/- 11 d; P