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- Title
Kidney Increase Natriuresis but Not Glomerular Filtration Under Veno-venous ECMO, a Retrospective Study.
- Authors
Penaud, Victor; Duburcq, Thibault; Bureau, Côme; Salmon Gandonnière, Charlotte; Arrestier, Romain; Henri, Samuel; Dres, Martin; Jacquier, Sophie; Prost, Nicolas De; Giraud, Raphael; Ricard, Jean-Damien; Roux, Damien; Uhel, Fabrice; Legouis, David; Verney, Charles
- Abstract
Purpose: Acute kidney injury is a frequent complication of acute respiratory distress syndrome (ARDS). We aim to study the evolution of kidney function in patients presenting severe ARDS and requiring veno-venous extracorporeal membrane oxygenation (VV ECMO). Methods: We conducted a multicenter retrospective study, including adult patients requiring VV ECMO for ARDS. The primary outcome was the evolution of the serum creatinine level after VV ECMO initiation. Secondary outcomes were change in urine output, and urine biochemical parameters after VV ECMO initiation. Results: One hundred and two patients were included. VV ECMO was initiated after a median of 6 days of mechanical ventilation, mainly for ARDS caused by COVID-19 (73%). Serum creatinine level did not significantly differ after VV ECMO initiation (P =.20). VV ECMO was associated with a significant increase in daily urine output (+6.6 mL/kg/day, [3.8;9.3] P <.001), even after adjustment for potential confounding factors; with an increase in natriuresis. The increase in urine output under VV ECMO was associated with a reduced risk of receiving kidney replacement therapy (OR 0.4 [0.2;0.8], P =.026). Conclusions: VV ECMO initiation in severe ARDS is associated with an increase in daily urine output and natriuresis, without change in glomerular filtration rate.
- Subjects
NATRIURESIS; ACUTE kidney failure; GLOMERULAR filtration rate; ADULT respiratory distress syndrome; KIDNEY physiology
- Publication
Journal of Intensive Care Medicine, 2024, Vol 39, Issue 2, p146
- ISSN
0885-0666
- Publication type
Article
- DOI
10.1177/08850666231195755