Association of hypochloremia with mortality among patients requiring continuous renal replacement therapy

Radhakrishnan, Yeshwanter; Cheungpasitporn, Wisit; Petnak, Tananchai; Genovez, Jose Zabala; Chewcharat, Api; Qureshi, Fawad; Mao, Michael A; Kashani, Kianoush

doi:10.1007/s40620-022-01305-0

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…[12][13][14] Among these factors is the derangement of various electrolytes reported to be associated with higher mortality in CRRT patients. [15][16][17][18] Although serum phosphate derangement has been associated with increased mortality risk in various study populations such as hospitalized individuals, particularly critically ill and septic patients, 5,7,[19][20][21][22][23][24] there is limited evidence on whether serum phosphate is associated with mortality or has any predictive value in critically ill AKI patients receiving CRRT. Therefore, this study aimed to determine the mortality risk based on serum phosphate levels before CRRT and during CRRT among AKI patients requiring CRRT.…”

Section: Introductionmentioning

confidence: 99%

Association of Serum Phosphate Derangement With Mortality in Patients on Continuous Renal Replacement Therapy

Radhakrishnan

Cheungpasitporn

Petnak

et al. 2022

Can J Kidney Health Dis

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Background: There is limited evidence on the association of serum phosphate with mortality in patients receiving continuous renal replacement therapy (CRRT). Objective: To assess the association of serum phosphate with mortality in critically ill patients requiring CRRT for acute kidney injury (AKI). Design: A cohort study. Setting: A tertiary referral hospital in the United States. Patients: Acute kidney injury patients receiving CRRT from 2006 through 2015 in intensive care units. Measurements: (1) Serum phosphate before CRRT and (2) mean serum phosphate during CRRT were categorized into 3 groups; ≤2.4 (hypophosphatemia), 2.5 to 4.5 (normal serum phosphate group), and ≥4.6 (hyperphosphatemia) mg/dL. Methods: Multivariable logistic regression was used to assess the association between serum phosphate and 90-day mortality. Results: A total of 1108 patients were included in this study. Of these, 55% died within 90 days after CRRT initiation. Before CRRT, 3%, 30%, and 66% had hypophosphatemia, normophosphatemia, and hyperphosphatemia, respectively. Before CRRT, both hypophosphatemia and hyperphosphatemia were significantly associated with higher 90-day mortality with the adjusted odds ratio (OR) of 2.22 (95% confidence interval [CI]: [1.03, 4.78]) and 1.62 (95% CI: [1.21, 2.18]), respectively. During CRRT, 3%, 85%, and 12% had mean serum phosphate in hypophosphatemia, normophosphatemia, and hyperphosphatemia range. During CRRT, hyperphosphatemia was significantly associated with higher 90-day mortality with adjusted OR of 2.22 (95% CI: [1.45, 3.38]). Limitations: Single center, observational design, lack of information regarding causes of serum phosphate derangement. Conclusion: Most CRRT patients had hyperphosphatemia before CRRT initiation but maintain normal serum phosphate during CRRT. Before CRRT, hypo- and hyperphosphatemia, and during CRRT, hyperphosphatemia predicted higher mortality. Trial registration: Not registered.

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Section: Introductionmentioning

confidence: 99%

Association of Serum Phosphate Derangement With Mortality in Patients on Continuous Renal Replacement Therapy

Radhakrishnan

Cheungpasitporn

Petnak

et al. 2022

Can J Kidney Health Dis

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“…Las manifestaciones clínicas son irritabilidad, agitación, hiperreflexia, tetania, hipertonicidad, calambres, mareos, arritmias cardiacas, bradipnea, coma y parada respiratoria. 21 Por otra parte, la hipercloremia registra valores > 107 mEq/L y es frecuente en pacientes con choque séptico y se asocia a la fluidoterapia con solución NaCl 0.9%. Asimismo, se ha relacionado con mayor mortalidad de pacientes en choque séptico.…”

Section: Cloro (Cl -)unclassified

Diferencia sodio (Na+)-cloro (Cl-) e índice de cloro/sodio (Cl-/Na+) como marcadores pronósticos de mortalidad en pacientes con choque séptico

Abasolo Chavero,

Mendoza Rodríguez,

Cortés Munguía

et al. 2023

Medicina Crítica

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Diferencia sodio (Na + )-cloro (Cl -) e índice de cloro/ sodio (Cl -/Na + ) como marcadores pronósticos de mortalidad en pacientes con choque séptico Sodium (Na + )-chlorine (Cl -) difference and chlorine/sodium index (Cl -/Na + ) as prognostic markers of mortality in patients with septic shock Diferença sódio (Na + )-cloro (Cl -) e índice cloro/sódio (Cl -/Na + ) como marcadores prognósticos de mortalidade em pacientes com choque séptico

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Association of serum chloride levels with all-cause mortality among patients in surgical intensive care units: a retrospective analysis of the MIMIC-IV database

Ma,

Tian,

Wang

et al. 2025

BMC Anesthesiol

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Association of hypochloremia with mortality among patients requiring continuous renal replacement therapy

Cited by 3 publications

References 26 publications

Association of Serum Phosphate Derangement With Mortality in Patients on Continuous Renal Replacement Therapy

Association of Serum Phosphate Derangement With Mortality in Patients on Continuous Renal Replacement Therapy

Diferencia sodio (Na+)-cloro (Cl-) e índice de cloro/sodio (Cl-/Na+) como marcadores pronósticos de mortalidad en pacientes con choque séptico

Association of serum chloride levels with all-cause mortality among patients in surgical intensive care units: a retrospective analysis of the MIMIC-IV database

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