The online version of this article (doi:10.1186/cc12900) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
YY and JC conceived the study, participated in its design and coordination and drafted the manuscript. PZ participated in the study design and coordination and helped to draft the manuscript. YC and HJ participated in the study design and performed the statistical analysis. XL participated in the experimental activity and contributed to drafting the manuscript. JY participated in the experimental activity and interpretation of the results. WL participated in the experimental activity. RL performed the statistical analysis. YZ participated in the experimental activity. EL discussed the study and revised the manuscript. All authors read and approved the final manuscript.
The primary aim of this study was to determine whether hypophosphatemia during continuous veno-venous hemofiltration (CVVH) is associated with the global outcome of critically ill patients with acute kidney injury (AKI).
760 patients diagnosed with AKI and had received CVVH therapy were retrospectively recruited. Death during the 28-day period and survival at 28 days after initiation of CVVH were used as endpoints. Demographic and clinical data including serum phosphorus levels were recorded along with clinical outcome. Hypophosphatemia was defined according to the colorimetric method as serum phosphorus levels < 0.81 mmol/L (2.5 mg/dL), and severe hypophosphatemia was defined as serum phosphorus levels < 0.32 mmol/L (1 mg/dL). The ratio of CVVH therapy days with hypophosphatemia over total CVVH therapy days was calculated to reflect the persistence of hypophosphatemia.
The Cox proportional hazard survival model analysis indicated that the incidence of hypophosphatemia or even severe hypophosphatemia was not associated with 28-day mortality independently (p = 0.700). Further analysis with the sub-cohort of patients who had developed hypophosphatemia during the CVVH therapy period indicated that the mean ratio of CVVH therapy days with hypophosphatemia over total CVVH therapy days was 0.58, and the ratio independently associated with the global outcome. Compared with the patients with low ratio (< 0.58), those with high ratio (≥ 0.58) conferred a 1.451-fold increase in 28-day mortality rate (95% CI 1.103–1.910, p = 0.008).
Hypophosphatemia during CVVH associated with the global clinical outcome of critically ill patients with AKI. The ratio of CVVH therapy days with hypophosphatemia over total CVVH therapy days was independently associated with the 28-day mortality, and high ratio conferred higher mortality rate.
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- Hypophosphatemia during continuous veno-venous hemofiltration is associated with mortality in critically ill patients with acute kidney injury
Xia Bing Lang
Wen Hua Lei
Yi Ling Zhu
En Yin Lai
Jiang Hua Chen
- BioMed Central
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