ArticleBMC nephrology2025
Analysis of factors associated with the initiation of renal replacement therapy in patients on veno-arterial extracorporeal membrane oxygenation: a case-control study.
Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Veno-arterial ECMO in fulminant myocarditis: a retrospective single-center case series.BMC cardiovascular disorders · 2026Article
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6 authors.
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Abstract
backgroundVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a therapeutic strategy for refractory cardiogenic shock. However, it is associated with a high risk of complications, including acute kidney injury (AKI), which increases the need of renal replacement therapy (RRT) and is linked to worse clinical outcomes.
objectiveTo identify clinical and biochemical factors independently associated with the initiation of renal replacement therapy (RRT) in adult patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO).
methodsA retrospective case-control study that included patients who received VA-ECMO and were admitted to the intensive care unit between 2019 and 2023. The incidence of RRT, along with associated severity and mortality scores, was analyzed using multivariate analysis.
resultsA total of 279 patients were included, among whom 98 received VA-ECMO support. Of these, 26.5% required RRT, and the mortality rate was 57.7%. The majority of patients were male (62.2%), with a mean age of 45.3 years (SD ± 13.8). Factors associated with the need for RRT included the duration of mechanical ventilation (OR, 1.03; 95% CI, 1.00-1.06), history of hypothyroidism (OR, 4.05; 95% CI, 1.27-12.86), and elevated creatinine levels prior to ECMO initiation (OR, 1.54; 95% CI, 1.12-2.09). Additionally, the APACHE II score (OR, 1.04; 95% CI, 0.98-1.10) and renal angina index (OR, 5.29; 95% CI, 1.77-15.77) were predictors of mortality.
conclusionsPatients undergoing VA-ECMO who require RRT have a high mortality risk. Associated factors include hypothyroidism, elevated creatinine levels before ECMO initiation, and a higher renal angina index. The early identification of these factors may facilitate the early detection of AKI risk and optimize clinical management. CLINICAL TRIAL NUMBER: Not applicable.
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