Document Detail

Timing of replacement therapy for acute renal failure after cardiac surgery.
MedLine Citation:
PMID:  15108784     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Acute renal failure (ARF) following cardiac surgery remains a significant cause of mortality. The aim of this study is to compare early and intensive use of continuous veno-venous hemodiafiltration (CVVHDF) with conservative usage of CVVHDF in patients with ARF after cardiac surgery. MATERIALS AND METHODS: Due to ARF, CVVHDF was required in two groups of a total of 61 adult patients (1.79% of all patients). Group 1 included 27 patients while Group 2 included 34 patients. CVVHDF was performed on Group 1 when creatinine level exceeded 5 mg/dL, or potassium level exceeded 5.5 mEq/L irrespective of the urine output. CVVHDF was performed on Group 2 when urine output was less than 100 mL within consecutive 8 hours, with no response to 50 mg furosemide with the supplementary criterion that urine sodium concentration should be >40 mEq/L before the administration of furosemide. RESULTS: The mean elapsed time between the surgery and the initiation of CVVHDF was 2.56 +/- 1.67 days in Group 1 and 0.88 +/- 0.33 days in Group 2 (p = 0.0001). The mean intensive care unit (ICU) stay for Group 1 was 12 +/- 3.44 days and 7.85 +/- 1.26 days for Group 2 (p = 0.0001). ICU mortality rate was 48.1% for Group 1 and 17.6% for Group 2 (p = 0.014). The overall hospital mortality rate was 55.5% for Group 1 and 23.5% for Group 2 (p = 0.016). CONCLUSION: Recognition of ARF and early beginning of the CVVHDF are extremely important. The sooner the ARF after surgery is recognized and CVVHDF is performed, the higher the likelihood of the reduction of the hospital mortality.
Ufuk Demirkiliç; Erkan Kuralay; Müjdat Yenicesu; Kayser Cağlar; Bilgehan Savaş Oz; Faruk Cingöz; Celalettin Günay; Vedat Yildirim; Süleyman Ceylan; Mehmet Arslan; Abdulgaffar Vural; Harun Tatar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  19     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2004 Jan-Feb
Date Detail:
Created Date:  2004-04-27     Completed Date:  2004-06-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-20     Citation Subset:  IM    
Cardiovascular Surgery Department, Etlik, Ankara, Turkey.
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MeSH Terms
Cardiac Surgical Procedures / adverse effects*,  methods*
Chi-Square Distribution
Cohort Studies
Hemodiafiltration / adverse effects,  methods*
Kidney Failure, Acute / etiology,  mortality,  therapy*
Kidney Function Tests
Middle Aged
Postoperative Complications / therapy*
Retrospective Studies
Risk Assessment
Severity of Illness Index
Statistics, Nonparametric
Survival Analysis
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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