Use of Vasopressors in Patients with Acute Kidney Injury on Continuous Kidney Replacement Therapy
Author Information
Author(s): Ramesh Ambika, Doddi Akshith, Abbasi Aisha, Al-Mamun Mohammad A., Sakhuja Ankit, Shawwa Khaled
Primary Institution: West Virginia University
Hypothesis
Is the use of a specific vasopressor associated with increased mortality or adverse outcomes in patients with acute kidney injury receiving continuous kidney replacement therapy?
Conclusion
The use of norepinephrine and vasopressin was associated with higher in-hospital mortality in patients with acute kidney injury on continuous kidney replacement therapy.
Supporting Evidence
- In-hospital mortality occurred in 318 (49.6%) patients.
- Patients who died were older and had higher SOFA scores.
- Increasing doses of norepinephrine and vasopressin were associated with in-hospital mortality.
- Baseline vasopressor doses were not associated with mortality.
- All vasopressors were associated with positive fluid balance.
- Among survivors at day 30, mean doses of vasopressors were not associated with persistent kidney dysfunction.
Takeaway
This study found that using certain medications called vasopressors in sick patients with kidney problems can lead to more deaths in the hospital.
Methodology
This was a retrospective study analyzing patients with acute kidney injury who required continuous kidney replacement therapy from 2012 to 2021.
Potential Biases
Potential unmeasured biases due to the retrospective nature of the study.
Limitations
The study is retrospective and conducted at a single center, which may limit generalizability.
Participant Demographics
The study included 641 patients with acute kidney injury, with an average age of 63 years, and 40% were female.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI: 2.3–7 for norepinephrine, 95% CI: 1.9–3.2 for vasopressin
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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