Abstract:
:The specific timing for discontinuing renal replacement therapy (RRT) in acute kidney injury (AKI) patients is debatable. The predictive abilities of variables at the time of discontinuation of RRT for the long-term prognoses of patients have not been explored. This study aimed to explore the prognostic factors upon discontinuation of RRT for long-term chronic dialysis and death of patients with acute RRT-requiring AKI, thus improving decision making regarding the discontinuation of RRT and the follow-up of patients thereafter. A cohort of 302 AKI patients who required acute RRT and remained alive and free of dialysis for at least 30 days after discharge from January 2009 to December 2012 were followed up. The predictive abilities of general characteristics, RRT details, and variables upon discontinuation of RRT for long-term chronic dialysis and all-cause death were evaluated using Cox proportional hazards models. Kaplan-Meier analysis with a log-rank test was used to compare the survival curves between the strata of levels of good predictors upon discontinuation of RRT. After a median follow-up time of 4.1 years, 20 (6.6%) patients initiated chronic dialysis and 56 (18.5%) patients died. A higher CysC level upon discontinuation of RRT (HR 1.520, 95% CI 1.082-2.135; P = 0.016), comorbid chronic kidney disease, and a higher non-renal Charlson comorbidity index (CCI) were independently predictive for chronic dialysis. The hemoglobin level upon discontinuation of RRT was inversely predictive of death (HR 0.986, 95% CI 0.973-0.999; P = 0.035), and comorbid malignancy, the presence of multiple organ dysfunction syndrome, and a higher non-renal CCI also predicted death. Urine output upon discontinuation of RRT was marginally inversely predictive of death (HR 0.997, 95% CI 0.994-1.000; P = 0.056). Patients who discontinued RRT with CysC levels <2.97 mg/L, hemoglobin levels >85 g/L, and urine output >1130 mL/24 h showed significantly higher non-chronic dialysis and survival rates according to a log-rank test. Our study suggested that upon discontinuation of RRT, higher serum CysC levels had the most promising predictive value for long-term chronic dialysis, and lower hemoglobin levels predicted long-term death; lower urine output also marginally predicted long-term death. Based on the remission of the comprehensive condition, lower CysC levels and higher hemoglobin levels and urine output should be considered in the decision to stop RRT. Patients showing worse levels of these indices upon discontinuation of RRT should undergo stricter follow-up and treatment to improve long-term outcomes.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Yang T,Sun S,Lin L,Han M,Liu Q,Zeng X,Zhao Y,Li Y,Su B,Huang S,Yang Ldoi
10.1111/aor.12927subject
Has Abstractpub_date
2017-12-01 00:00:00pages
1127-1134issue
12eissn
0160-564Xissn
1525-1594journal_volume
41pub_type
杂志文章abstract:BACKGROUND:The use of ventricular assist devices (VAD) as a bridge to heart transplant (HT) is increasing, while HT volume remains stagnant. This may portend longer waiting times and an otherwise more competitive environment for all patients on the HT waiting list. METHODS:A retrospective analysis of patients who were...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13833
更新日期:2020-10-01 00:00:00
abstract::This article reports preliminary results of pilot studies of a new implantable two channel drop foot stimulator. The stimulator consists of an externally worn transmitter inductively coupled to an implanted receiver unit located in the lower leg, lateral and distal to the knee. The receiver is connected to electrodes ...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章
doi:10.1046/j.1525-1594.2002.06949.x
更新日期:2002-03-01 00:00:00
abstract::The aim of the study is to measure the volume of homologous blood needed for one pediatric patient during his hospital stay. Over a 4-month period, all the patients operated upon with a blood prime or requiring blood transfusion during their hospital stay were included in this study.The cardiopulmonary bypass protocol...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2010.01158.x
更新日期:2010-11-01 00:00:00
abstract::A compact three-dimensional (3D) module is needed for hepatocyte culture in order to develop an effective hybrid artificial liver system that can retain hepatocellular structure and differentiated functions. We treated the 3D module with collagen gel to entrap rat hepatocytes. This method yielded a high hepatocellular...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1995.tb02310.x
更新日期:1995-02-01 00:00:00
abstract::A multi-compartment capillary membrane culture model with independently perfused three-dimensionally woven capillaries was developed for immobilization of hepatocytes in bioreactors. This enables spatial restructuring of cells and enhanced mass transfer performance with more efficient oxygenation and metabolite exchan...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb02181.x
更新日期:1994-03-01 00:00:00
abstract::Doppler ultrasound is a noninvasive technique for monitoring moving objects such as flowing blood while ignoring stationary objects such as shunt tubing. A Doppler system was investigated to determine its sensitivity in detecting particulate release in blood during hemodialysis. Seven hemodialysis procedures with dogs...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1984.tb04275.x
更新日期:1984-05-01 00:00:00
abstract::To expand the usage of the centrifugal pump (CP) in open heart surgery, we performed two studies. In the first, we evaluated pulsatile flow in the CP. In vitro pump performance of the Terumo Capiox pump (TCP) and the Sarns Delphin pump (SDP) and increase of free hemoglobin (mg/dl) after driving 6 h were investigated u...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb03393.x
更新日期:1994-09-01 00:00:00
abstract::In 1976, the authors became the codevelopers of the first successful bileaflet heart valve which has become the standard in valvular surgery. However, there still remains a significant rate of thromboembolism and thrombosis which can be attributed to the inherent design of cavities in the pivot area. These cavities co...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2002.06999.x
更新日期:2002-05-01 00:00:00
abstract::Tissue-engineered heart valves constructed from a xenogeneic or allogeneic decellularized matrix might overcome the disadvantages of current heart valve substitutes. One major necessity besides effective decellularization is to preserve the biomechanical properties of the valve. Native and decellularized porcine pulmo...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2007.00452.x
更新日期:2008-01-01 00:00:00
abstract::Myointimal hyperplasia (MIH) is an arterial wall smooth muscle cell (SMC) proliferative disorder. This process is responsible for a significant number of early and long-term arterial reconstructive and graft failures. Histopathologically, this process is characterized by a proliferation of SMC in the intima of traumat...
journal_title:Artificial organs
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1594.1991.tb00758.x
更新日期:1991-02-01 00:00:00
abstract::During revision of a failed acetabular component with well-fixed antiquated femoral stem, the same variant of metal head is usually not available in the inventory production. We gathered the stems retrieved from revision surgeries and tried to reassemble with the commercially available femoral heads. This study report...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2010.01015.x
更新日期:2010-08-01 00:00:00
abstract::A magnetically levitated (maglev) centrifugal blood pump (CBP), intended for use as a ventricular assist device, needs to be highly durable and reliable for long-term use without any mechanical failure. Furthermore, maglev CBPs should be small enough to be implanted into patients of various size and weight. We have de...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2006.00202.x
更新日期:2006-03-01 00:00:00
abstract::This article reviews the clinical, biological, radiological, and pathological procedures and their respective indications for the practical diagnosis of the following various histological patterns of renal osteodystrophy: osteitis fibrosa due to parathyroid hormone (PTH) hypersecretion: osteomalacia or rickets due to ...
journal_title:Artificial organs
pub_type: 杂志文章,评审
doi:10.1046/j.1525-1594.1998.06198.x
更新日期:1998-07-01 00:00:00
abstract::In a multicenter study including 5 dialysis units, blood acetate changes during 4 h dialysis sessions in 141 patients treated with a 4 mM acetate-containing bicarbonate dialysate (ABD) were evaluated and compared to the values of 114 patients using an acetate-free bicarbonate dialysate (AFD). Acetate-free bicarbonate ...
journal_title:Artificial organs
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1594.1998.06205.x
更新日期:1998-07-01 00:00:00
abstract::From January 1980 through December 1990, implantation of a permanent pacemaker was performed in 34 patients following open heart surgery. The patients were divided into two groups according to the clinical indications for implantation of permanent pacemakers. Group 1 (9 patients) had surgical atrioventricular block, a...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1993.tb00591.x
更新日期:1993-05-01 00:00:00
abstract::An important present and emerging trend in biomaterials development is the synthesis of polymers which combine capabilities of biologic recognition ("biomimetic") with sensitivity to small environmental changes ("stimuli-responsive"). This short article highlights some of the many opportunities and challenges in this ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1988.tb02813.x
更新日期:1988-12-01 00:00:00
abstract::Microcapsules containing insulin crystals or islets of Langerhans were made by extruding a mixture of insulin crystals or islets and sodium alginate into a calcium chloride solution, and then coating it with poly-l-lysine. When these microcapsules were incubated at 37 degrees C, insulin could be detected readily in th...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1983.tb04187.x
更新日期:1983-05-01 00:00:00
abstract::There is increasing evidence showing that adult stem cells are useful for tissue regeneration. Bone marrow mesenchymal stem cells (MSCs) are self-renewing and are potent in differentiating into multiple cells and tissues. To investigate the practicability of repairing burn wounds with tissue-engineered (TE) skin combi...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2008.00654.x
更新日期:2008-12-01 00:00:00
abstract::Since the introduction of high-performance prosthetic heart valves, particularly bileaflet valves and monoleaflet valves with larger opening angles, we have observed in vivo complex leaflet motion which has not been experimentally confirmed yet. We developed a computer-controlled hydraulic mock circulator to study the...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1997.tb00373.x
更新日期:1997-04-01 00:00:00
abstract::A comparative assessment has been made regarding efficacy and safety of the double filtration plasmapheresis (DFPP), thermofiltration (TFPP), and low-density lipoprotein (LDL) adsorptive (PA) methods by making a crossover test on heterozygous familial hypercholesterolemia patients. Treatments by DFPP, TFPP (secondary ...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章
doi:10.1111/j.1525-1594.1996.tb04448.x
更新日期:1996-04-01 00:00:00
abstract::Artificial cells are prepared in the laboratory for medical and biotechnological applications. Encapsulated cells are being studied for the treatment of diabetes, liver failure, and other conditions. More recently, there have been extensive studies into the use of encapsulated genetically engineered cells for gene the...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.06243.x
更新日期:1998-11-01 00:00:00
abstract::Left dominant biventricular failure is a common type of heart failure after cardiac surgery. We developed a biventricular bypass (BVB) system for treatment of postcardiotomy ventricular failure, and we previously reported that the clinical results of the BVB system were superior to those obtained with venoarterial byp...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.06015.x
更新日期:1998-09-01 00:00:00
abstract::This article presents the first in vivo experiments with a new type of valveless ventricular assist device, a wave-generating pump. Our goal was to evaluate the hemodynamic performance of the pump by comparing it with the Biomedicus BP-80 centrifugal pump and by sustaining a 3 h long left ventricular assistance. We co...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2002.06973.x
更新日期:2002-12-01 00:00:00
abstract::A totally implantable centrifugal artificial heart has been developed in which a pivot bearing supported centrifugal pump is used as a blood pump. The following have been adopted as blood contacting materials in our pump: titanium alloy (Ti-6A1-4V) for the housing and impeller, alumina ceramic (Al2O3) for the male piv...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.6184r.x
更新日期:1998-09-01 00:00:00
abstract::The effect of age on the calcification of biomaterials was studied by the subcutaneous implantation of poly(hydroxyethyl methacrylate) hydrogel in rats. The hydrogel sheets were implanted in rats 6, 12, 24, and 52 weeks (1 year) of age. The retrieved implants were compared and the percentage weight increase by mineral...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1985.tb04388.x
更新日期:1985-08-01 00:00:00
abstract::The neutralization of bacterial endotoxins (ET) is still an unsolved problem in therapeutic medicine. The efficacy of anti-endotoxin antibodies or receptor antagonists and other substances interfering with the endotoxin-induced pathomechanisms is dependent on an intact cellular degradation system of the host. However,...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1993.tb00630.x
更新日期:1993-09-01 00:00:00
abstract::Protein adsorption and platelet adhesion are two important biological processes arising at the blood prosthetic interface. The effect of certain antibiotics, namely, neomycin, gentamicin, ampicillin, penicillin-G, and streptomycin to modulate the albumin polycarbonate surface interaction was investigated using 125I al...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1988.tb02747.x
更新日期:1988-04-01 00:00:00
abstract::Experiments have been successfully performed culminating in functional, vascularized, three-dimensional cardiac muscle tissue. Past experience in tissue engineering has led us to the understanding that cell seeding density plays a critical role in the formation and function of both in vitro and in vivo engineered tiss...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2008.00591.x
更新日期:2008-09-01 00:00:00
abstract::Bone marrow mesenchymal stem cells (MSCs) have demonstrated their pluripotency to differentiate into different cell lineages and may be an alternative cell source for vascular tissue engineering. The objective of this study is to create small diameter vessels by seeding and culture of genetically modified MSCs onto a ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2006.00322.x
更新日期:2006-12-01 00:00:00
abstract::A bypass flow rate estimation and control system (BECS) for an implantable centrifugal blood pump (ICBP) has been developed in our institute. The estimated flow rate (EF) of the ICBP was derived from the electric power consumption, the rotating speed of a motor, and the blood viscosity presumed by the hematocrit and b...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.06130.x
更新日期:1998-06-01 00:00:00