| アブストラクト | PURPOSE: This study was undertaken to assess recent trends of the choice of renal replacement therapy (RRT) modalities in Japanese intensive care units (ICUs). MATERIALS AND METHODS: Data were extracted from the Japanese Diagnosis Procedure Combination database for 2011. We identified adult patients without end-stage renal disease who had been admitted to ICUs for 3 days or longer and started continuous RRT (CRRT) or intermittent RRT (IRRT). Logistic regression was used to analyze which factors affected the modality choice. We further evaluated in-hospital mortality according to the choice of RRT. RESULTS: Of 7353 eligible patients, 5854 (79.6%) initially received CRRT. The choice of CRRT was independently associated with sex (female), diagnosis of sepsis, hospital type (academic) and volume, vasoactive agents, mechanical ventilation, colloid administration, blood transfusion, intra-aortic balloon pumping, and venoarterial extracorporeal membrane oxygenation. Particularly, the number of vasoactive drugs was strongly associated with the CRRT choice. Overall in-hospital mortality in the CRRT group was higher than that in the IRRT group (50.0% vs 31.1%) and was increased when IRRT was switched to CRRT (59.1%). CONCLUSIONS: Continuous RRT is apparently preferred in actual ICU practice, especially for hemodynamically unstable patients, and subsequent RRT modality switch is associated with mortality. |
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| ジャーナル名 | Journal of critical care |
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| 投稿日 | 2014/12/2 |
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| 投稿者 | Iwagami, Masao; Yasunaga, Hideo; Noiri, Eisei; Horiguchi, Hiromasa; Fushimi, Kiyohide; Matsubara, Takehiro; Yahagi, Naoki; Nangaku, Masaomi; Doi, Kent |
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| 組織名 | Department of Hemodialysis and Apheresis, The University of Tokyo Hospital,;Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Tokyo, Japan; Department of Nephrology and Endocrinology, The University of Tokyo;Hospital, Tokyo, Japan.;Department of Clinical Data Management and Research, Clinical Research Center,;National Hospital Organization Headquarters, Tokyo, Japan.;Department of Health Informatics and Policy, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan.;Department of Emergency and Critical Care Medicine, The University of Tokyo;Tokyo, Japan; Department of Emergency and Critical Care Medicine, The University;of Tokyo Hospital, Tokyo, Japan. Electronic address: kdoi-tky@umin.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25434720/ |
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