Long-Term Clinical Outcomes of Acute Kidney Disease in Patients Receiving Extracorporeal Membrane Oxygenation

Introduction:Extracorporeal membrane oxygenation(ECMO) is widely used; however, studies on the long-termoutcomes of ECMO are scarce. We investigated the long-term clinical outcomes of acute kidney disease (AKD) inpatients receiving ECMO.Methods:Electronic data(2009-2018) were retrospectively collected from a multi-center database. Patients were divided into two groups (AKDand non-AKD) according to their AKD status 8-90 days afterthe initiation of ECMO. Inverse probability of treatmentweighting was used to balance baseline covariates betweenthe two groups. The primary outcomes were major adversekidney events (MAKEs) and major adverse cardiovascularevents (MACEs), and the secondary outcomes were all-causereadmission, sepsis-related readmission, infection-relatedreadmission, and dementia.Results:Totally, 395 patientswere eligible for analysis; of them, 160 patients (40.5%)developed AKD. The AKD group had a higher risk of MAKEs(hazard ratio [HR]: 2.06; 95% confidence interval [CI]:1.68-2.53) than did the non-AKD group. Subgroup analysisrevealed that the observed unfavorable effect of AKD on therisk of MAKEs was more pronounced in patients receivingvenovenous ECMO than in those receiving venoarterialECMO (HR: 5.69 vs. 1.85, respectively;pfor interaction =0.004). AKD group had a higher risk of MACE during theinitial 3-year post-ECMO in comparison to those without (HR:1.68; 95% CI: 1.22-2.30). Moreover, the risks of all-cause,sepsis-related, and infection-related readmissions were highin AKD survivors.Conclusions:AKD is associated with anincreased risk of long-term MAKEs and initial 3-year MACE inECMO recipients. In addition, AKD is associated with in-creased risks of all-cause, infection-related, and sepsis-related readmissions.(c) 2024 The Author(s).Published by S. Karger AG, Basel