The following is the summary of “Earlier continuous renal replacement therapy is associated with reduced mortality in rhabdomyolysis patients” published in the October 2022 issue of Renal failure by Le, et al.
Patients with rhabdomyolysis (RM) frequently undergo continuous renal replacement therapy (CRRT). Prognostic variables and the best time to begin CRRT for patients with RM were not thoroughly studied, however. Their study’s objective was to examine the impact of CRRT timing on mortality and associated risk variables in RM patients. Patients with RM who were treated with CRRT in our institution between May 1, 2010, and May 31, 2021, were included retrospectively. Risk factors for the primary outcome were determined using univariate and multivariate logistic analyses (90-day mortality).
Their study covered 134 patients in total. With a mortality rate of 38.06% at 90 days, the situation was dire. Initiation of CRRT was followed by peak occurrence of CK in a median of 4.8 hours (interquartile range [IQR] -16 to 14), with 67 patients receiving CRRT within 4.8 hours of peak CK occurrence (early CRRT) and 67 patients receiving CRRT beyond 4.8 hours of peak CK occurrence (late CRRT) (late CRRT).
Multivariate logistic regression analysis revealed that the following factors were significantly associated with mortality: a longer time between CRRT initiation and peak CK (per 1 h, OR 1.026, 95% CI 1.004-1.049, P=0.023), a later initiation of CRRT (OR 3.082, 95% CI 1.072-8.859, P=0.037), an increase in serum cardiac troponin I (cTnI) (per 1 ng/mL, OR 1.218, 95% CI 1.011–1.468, P=0.038), older age (per 1 year, OR 1.042, 95% CI 1.003–1.081, P=0.032), and need of mechanical ventilation support (OR 4.632, 95% CI 1.292–16.61, P=0.019) were independent risk factors for 90-day mortality. The risk of dying within 90 days was reduced among patients who started CRRT sooner, before 4.8 h after peak CK incidence.
Source: tandfonline.com/doi/full/10.1080/0886022X.2022.2132170