End-stage renal disease should not Be considered a contraindication for veno-arterial extracorporeal membrane oxygenation.
Journal
Journal of the Formosan Medical Association
Journal Volume
123
Journal Issue
9
Start Page
985
End Page
991
ISSN
0929-6646
0929-6646
Date Issued
2024-09
Author(s)
Pai, Chen-Hsu
Tseng, Li-Jung
Lai, Chien-Heng
Abstract
Background: This study aims to determine whether end-stage renal disease (ESRD) is a true contraindication for extracorporeal membrane oxygenation in adult patients.
Materials and methods: Adult patients who received VA-ECMO at National Taiwan University Hospital between January 2010 and December 2021 were included. Patients who received regular dialysis before the index admission were included in the ESRD group. The primary outcome was in-hospital mortality.
Results: 1341 patients were included in the analysis, 121 of whom had ESRD before index admission. The ESRD group was older (62.3 versus 56.8 years; P < 0.01) and had more comorbidities. Extracorporeal cardiopulmonary resuscitation (ECPR) was used more frequently in the ESRD group (66.1% versus 51.6%; P < 0.001). The ESRD group had higher in-hospital mortality rates (72.7% versus 63.3%; P = 0.03). In the ECPR subgroup, there was no difference of survival between ESRD and others(P = 0.56). In the multivariate Cox regression, ESRD was not an independent predictor for mortality (P = 0.20).
Conclusion: ESRD was not an independent predictor of in-hospital mortality after VA-ECMO. The survival of ESRD patients was not inferior to those without ESRD when receiving ECPR. Therefore, ESRD should not be considered a contraindication to VA-ECMO in adults.
Subjects
Dialysis
End-stage kidney disease
End-stage renal disease
Extracorporeal cardiopulmonary resuscitation
Extracorporeal life support
Extracorporeal membrane oxygenation
Publisher
Elsevier B.V.
Type
journal article