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Time to Continuous Renal Replacement Therapy Initiation and 90-Day Major Adverse Kidney Events in Children and Young Adults

Title: Time to Continuous Renal Replacement Therapy Initiation and 90-Day Major Adverse Kidney Events in Children and Young Adults
Authors: Gist, Katja M.; Menon, Shina; Anton-Martin, Pilar; Bigelow, Amee M.; Cortina, Gerard; Deep, Akash; De la Mata-Navazo, Sara; Gelbart, Ben; Gorga, Stephen; Guzzo, Isabella; Mah, Kenneth E.; Ollberding, Nicholas J.; Shin, H. Stella; Thadani, Sameer; Uber, Amanda; Zang, Huaiyu; Zappitelli, Michael; Selewski, David T.; Ahern, Emily; Akcan Arikan, Ayse; Alhamoud, Issa; Alobaidi, Rashid; Balani, Shanthi S; Barhight, Matthew; Basalely, Abby; Bottari, Gabriella; Cappoli, Andrea; Ciccia, Eileen A; Collins, Michaela; Colosimo, Denise; Damian, Mihaela A; DeAbreu, Gabrielle; Ding, Kathy L; Dolan, Kristin J; Fernandez LaFever, Sarah N; Fuhrman, Dana Y; Guzzi, Francesco; Haga, Taiki; Harvey, Elizabeth; Hasson, Denise C; Hill-Horowitza, Taylor; Inthavong, Haleigh; Joseph, Catherine; Kaddourah, Ahmad; Kakajiwala, Aadil; Kessel, Aaron D; Korn, Sarah; Krallman, Kelli A; Kwiatkowski, David M; Lee, Jasmine
Source: JAMA Network Open ; volume 7, issue 1, page e2349871 ; ISSN 2574-3805
Publisher Information: American Medical Association (AMA)
Publication Year: 2024
Description: Importance In clinical trials, the early or accelerated continuous renal replacement therapy (CRRT) initiation strategy among adults with acute kidney injury or volume overload has not demonstrated a survival benefit. Whether the timing of initiation of CRRT is associated with outcomes among children and young adults is unknown. Objective To determine whether timing of CRRT initiation, with and without consideration of volume overload (VO; 25% decline in estimated glomerular filtration rate from baseline]). Results Data from 996 patients were entered into the registry. After exclusions (n = 27), 969 patients (440 [45.4%] female; 16 (1.9%) American Indian or Alaska Native, 40 (4.7%) Asian or Pacific Islander, 127 (14.9%) Black, 652 (76.4%) White, 18 (2.1%) more than 1 race; median [IQR] patient age, 8.8 [1.7-15.0] years) with data for the primary outcome (MAKE-90) were included. Median (IQR) time to CRRT initiation was 2 (1-6) days. MAKE-90 occurred in 630 patients (65.0%), of which 368 (58.4%) died. Among the 601 patients who survived, 262 (43.6%) had persistent kidney dysfunction. Of patients with persistent dysfunction, 91 (34.7%) were dependent on dialysis. Time to CRRT initiation was approximately 1 day longer among those with MAKE-90 (median [IQR], 3 ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1001/jamanetworkopen.2023.49871
Availability: https://doi.org/10.1001/jamanetworkopen.2023.49871; https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2813451/gist_2024_oi_231451_1712585101.12592.pdf
Accession Number: edsbas.C31CDC06
Database: BASE