Objective: Acute kidney injury (AKI) is common in patients on extracorporeal membrane oxygenation (ECMO) support. Studies focusing on AKI in conjunction with ECMO have had varying results. We aimed to explore the risk factors for in-hospital mortality and AKI in our cohort of adult patients requiring ECMO support. Methods: A retrospective, single-center study enrolling 71 patients was performed. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria. The association between demographics and variables associated with ECMO, AKI, and in-hospital mortality were analyzed. Results: Of the 71 patients, 32 (45.1%) survived to hospital discharge and 52 (73.2%) developed AKI. In the non-survivor group, there were more venoarterial (VA) cases (30/39 vs. 16/32) and longer intensive care unit (ICU) stays (24.3 +/- 1.9 vs. 18.0 +/- 7.3). Multivariate Cox-proportional hazard analysis also showed that ECMO configuration and length of ICU staywere associated with in-hospital mortality. AKI patients had longer ICU stays (23.3 +/- 10.2 vs. 16.4 +/- 7.1) and required more blood transfusions (18.5 +/- 8 vs. 8 +/- 2.3) than non-AKI patients. The maximum serum creatinine (sCr) level during ECMO was significantly higher in AKI than non-AKI patients (196.0 +/- 65.1 vs. 132.4 +/- 23.4). Multivariate logistic regression analysis showed VA configuration, length of ICU stay, and infection to be significant risk factors for developing AKI. Conclusions: VA ECMO mode and length of ICU stay were associated with in-hospital mortality. VA ECMO mode, length of ICU stay, red blood cell transfusion, sCr level, and infection were significantly associated with AKI.
[1]Shanghai Jiao Tong Univ, Shanghai Chest Hosp, Dept Extracorporeal Circulat, 241 West Huaihai Rd, Shanghai 200030, Peoples R China.
[2]Fudan Univ, Zhongshan Hosp, Dept Cardiovasc Surg, 180 Fenglin Rd, Shanghai 200032, Peoples R China.
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