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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2016 ; 95
(40
): e5112
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Lactate clearance is associated with mortality in septic patients with acute
kidney injury requiring continuous renal replacement therapy: A cohort study
#MMPMID27749594
Passos RDH
; Ramos JGR
; Gobatto A
; Mendonça EJB
; Miranda EA
; Dutra FRD
; Coelho MFR
; Pedroza AC
; Batista PBP
; Dutra MMD
Medicine (Baltimore)
2016[Oct]; 95
(40
): e5112
PMID27749594
show ga
The aim of the study was to assess the clinical utility of lactate measured at
different time points to predict mortality at 48 hours and 28 days in septic
patients with acute kidney injury (AKI) requiring continuous renal replacement
therapy (CRRT).Consecutive critically ill patients with septic AKI requiring CRRT
were prospectively studied. Variables were collected at initiation of CRRT and
24?hours later.In total, 186 patients were analyzed. Overall mortality at
48?hours was 28% and at 28 days was 69%. Initial lactate, lactate at 24?hours and
the proportion of patients with a lactate clearance superior to 10% were
different between survivors at 28 days [2.0 mmol/L, 1.95 mmol/L and 18/45 (40%)]
and nonsurvivors [3.46 mmol, 4.66 mmol, and 18/94 (19%)]. Multivariate analysis
demonstrated that lactate at 24?hours and lactate clearance, but not initial
lactate, were independently associated to mortality. Area under the ROC curves
for 28-day mortality was 0.635 for initial lactate; 0.828 for lactate at 24?hours
and 0.701 for lactate clearance.Lactate clearance and lactate after 24?hours of
CRRT, but not initial lactate, were independently associated with mortality in
septic AKI patients undergoing CRRT. Serial lactate measurements may be useful
prognostic markers than initial lactate in these patients.