Norepinephrine Administration Is Associated with Higher Mortality in Dialysis Requiring Acute Kidney Injury Patients with Septic Shock
Journal
Journal of clinical medicine
Journal Volume
7
Journal Issue
9
Date Issued
2018-09-12
Author(s)
Chen, Ying-Ying
Huang, Wei-Chieh
Wu, Mai-Szu
Huang, Chiu-Ching
Fang, Ji-Tseng
Wu, Chih-Jen
Chang, Yu-Hsing
Lai, Chien-Heng
Tseng, Li-Jung
Wang, Jian-Jhong
Chen, Cheng-Yi
Shiao, Chih-Chung
Wang, Wei-Jie
Lin, Jui-Hsiang
Wu, Che-Hsiung
Wu, Chih-Jen
Lu, Kuo-Cheng
Kan, Wei-Chih
Huang, Chiu-Ching
Chou, Che-Yi
Yang, Ya-Fei
Tsai, Jen-Pi
Hu, Fu-Chang
Lee, Chien-Te
Chen, Jin-Bor
Lee, Chih-Hsiung
Lee, Wen-Chin
Li, Lung-Chih
Chen, Te-Chuan
Lin, Hugo You-Hsien
Chen, Yung-Chang
Lee, Chin-Chan
Sun, Chiao-Yin
Pan, Heng-Chih
Chang, Ming-Yang
Jenq, Chang-Chyi
Lin, Chan-Yu
Chang, Chih-Hsiang
Tsai, Tsung-Yu
Chen, Cheng-Min
Lin, En-Tzu
Lin, Cheng-Jua
Wu, Pei-Chen
Kuo, Feng-Chi
Weng, Chih-Jen
Chen, Li-Kwang
Hsu, Wen-Ding
Leu, Jyh-Gang
Chang, Jui-Ting
Liou, Hung-Hsiang
Hsu, Kuo-Hsiung
Wu, Ming-Ju
Huang, Chun-Te
You, Zi-Hong
Chang, Chao-Fu
Chen, Tzen-Wen
Chen, Hsi-Hsien
Lin, Yen-Chung
Wu, Mai-Szu
Kao, Chih-Chin
Hung, Szu-Chun
Kuo, Ko-Lin
Wu, Che-Hsiung
Tarng, Der-Cherng
Chen, Jinn-Yang
Yang, Chih-Yu
Lee, Kuo-Hua
Ko, Sheng-Wen
The NSARF, CAKS Group
Abstract
(1) Background: Norepinephrine (NE) is the first-line vasoactive agent used in septic shock patients; however, the effect of norepinephrine on dialysis-required septic acute kidney injury (AKI-D) patients is uncertain. (2) Methods: To evaluate the impact of NE on 90-day mortality and renal recovery in septic AKI-D patients, we enrolled patients in intensive care units from 30 hospitals in Taiwan. (3) Results: 372 patients were enrolled and were divided into norepinephrine users and non-users. After adjustment by Inverse probability of treatment weighted (IPTW), there was no significant difference of baseline comorbidities between the two groups. NE users had significantly higher 90-day mortality rate and using NE is a strong predictor of 90-day mortality in the multivariate Cox regression (HR = 1.497, p = 0.027) after adjustment. The generalized additive model disclosed norepinephrine alone exerted a dose⁻dependent effect on 90-day mortality, while other vasoactive agents were not. (4) Conclusion: Using norepinephrine in septic AKI-D patients is associated with higher 90-day mortality and the effect is dose-dependent. Further study to explore the potential mechanism is needed.
Subjects
acute kidney injury; critical care; dialysis; norepinephrine; sepsis; vasoactive agents
Acute kidney injury; Critical care; Dialysis; Norepinephrine; Sepsis; Vasoactive agents
SDGs
Other Subjects
noradrenalin; acute kidney failure; adult; aged; APACHE; Article; cohort analysis; comorbidity assessment; continuous renal replacement therapy; creatinine blood level; disease severity; female; fluid resuscitation; geographic distribution; Glasgow coma scale; heart failure; heart output; hemodialysis; hepatorenal syndrome; hospital discharge; human; intensive care unit; international normalized ratio; major clinical study; male; mean arterial pressure; middle aged; mortality rate; observational study; prospective study; renal replacement therapy; respiratory failure; septic shock; Sequential Organ Failure Assessment Score; urea nitrogen blood level
Type
journal article