The impact of acute kidney injury stages on the outcomes of veno‐arterial extracorporeal membrane oxygenation

• Published in: Artificial organs Vol. 48; no. 7; pp. 763 - 770
• Main Authors: Kallur, Akhil S., Armijo‐Alba, Julian, Russell, Jacqueline L., Sallam, Tariq, Bien‐Aime, Fred, Sanghavi, Kavya K., Garg, Mohil, Khan, Naveera, Bakri, Mouaz Haj, Zaghlol, Louay, Khan, Imran, El‐Akawi, Shadi, Llama, Adrian, Sawalha, Yazan, Trivedi, Suraj, Alassar, Aiman, Zaaqoq, Akram M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2024
• Subjects: acute kidney injury; Acute Kidney Injury - mortality; Acute Kidney Injury - therapy; Adult; Aged; cardiogenic shock; Extracorporeal Membrane Oxygenation - adverse effects; Extracorporeal Membrane Oxygenation - methods; Female; Hospital Mortality; Humans; Kidney diseases; Kidneys; Male; Middle Aged; Mortality; Oxygenation; Retrospective Studies; Risk Factors; Severity of Illness Index; Treatment Outcome; veno‐arterial extracorporeal membrane oxygenation; veno‐arterial extracorporeal membrane oxygenation; acute kidney injury; cardiogenic shock
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/aor.14714

Background Although acute kidney injury (AKI) has been established as an independent risk factor for in‐hospital mortality for patients on veno‐arterial (V‐A) extracorporeal membranous oxygenation (ECMO), the impact of Kidney Disease Improving Global Outcomes (KDIGO) stages of AKI has yet to be elucidated as a risk factor. Methods We conducted a retrospective analysis of patient outcomes based on KDIGO stages of AKI at a single institution. The analysis was a cohort of 179 patients; 66 without AKI, 19 with stage 1 AKI, 18 with stage 2 AKI, and 76 with stage 3 AKI. Results Every 1‐year increase in age was associated with 4% increased odds of mortality at 30 days (95% confidence interval [CI] 1.01, 1.07; p = 0.004). The presence of AKI at any stage was associated with 59% increased odds of 30‐day mortality (95% CI 0.81, 3.10; p = 0.176). The presence of stage 1 AKI was associated with a 5% decreased odds of 30‐day mortality (95% CI 0.32, 2.89). The presence of stage 2 AKI (odds ratio [OR] 2.29, 95% CI 0.69, 7.55; p = 0.173) and stage 3 AKI (OR 1.68, 95% CI 0.81, 3.46; p = 0.164) was associated with increased odds of 30‐day mortality. Conclusion Based on our single‐center study, higher KDIGO stages of AKI likely have increased odds of mortality at 30 days. Larger studies are needed to confirm these findings. The impact of Kidney Disease Improving Global Outcomes (KDIGO) stages of AKI has yet to be elucidated as a risk factor. We conducted a single‐center retrospective analysis of patient outcomes based on KDIGO stages of AKI. Of 179 patients; 66 were without AKI, 19 were with stage 1 AKI, 18 were with stage 2 AKI, and 76 were with stage 3 AKI. Higher KDIGO stages of AKI likely have increased odds of mortality at 30 days.