Short and Late Term Mortality and Quality of Life in Patients Requiring Continuous Veno-Venous Hemofiltration after Cardiac Surgery
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Purpose
Acute kidney injury (AKI) is a significant cause of morbidity and mortality post cardiac surgery sometimes requiring intermittent hemodialysis (IHD) or continuous veno-venous hemofiltration (CVVH). Previous studies included only procedures utilizing cardiopulmonary bypass (CPB). We reviewed CPB and non-CPB patients who developed AKI and required CVVH versus no CVVH.
Materials and Methods
141 patients undergoing adult cardiac surgery developed AKI. 70 required CVVH (group1) and 71 did not (group2). We compared 30 day mortality, renal recovery, respiratory status and late mortality between both groups.
Results
73% of patients in group1 required CVVH compared to 51% in group2 (p=0.007). Mortality was 38% versus 25% respectively at 1year (p=0.23) and 54% versus 17% respectively at 30 days (p<0.0001). Renal recovery was found in 47% versus 85%, freedom from ventilator support in 59% versus 83%, and discharge to long term nursing facility (LTNF) in 69% versus 44% respectively.
Conclusion
Mortality was significantly higher in CVVH group at 30 days but not at 1 year suggesting a long term benefit in those who survive the acute episode. The CVVH group demonstrated a higher rate of discharge to LTNF and lower rates of full renal recovery and freedom from ventilator support at discharge.
