Table 1.
Characteristics of patients with acute liver failure (ALF) treated with continuous renal replacement therapy (CRRT)
| Variable | All ALF patients (n = 62) | Non-CRRT patients (n = 19) | CRRT patients (n = 43) | P* |
|---|---|---|---|---|
| Baseline characteristics at time of admission to ICU | ||||
| Age (years), mean (SD) | 38 ± 12 | 38 ± 13 | 38 ± 12 | 0.79 |
| Female | 36 (58%) | 11 (58%) | 25 (58%) | 0.99 |
| Contraindications to ELT | 17 (27%) | 6 (32%) | 11 (26%) | 0.63 |
| Paracetamol overdose aetiology | 33 (53%) | 10 (53%) | 23 (53%) | 0.95 |
| Non-paracetamol overdose aetiology | 29 (47%) | 9 (47%) | 20 (47%) | 0.95 |
| Time from first presentation to ICU at ELT hospital (hours), median (IQR) | 25 (8–49) | 22 (9–47) | 25 (6–57) | 0.89 |
| APACHE III score, mean (SD) | 82 ± 36 | 54 ± 22 | 95 ± 35 | < 0.001 |
| KCC fulfilment | 37 (60%) | 6 (32%) | 31 (72%) | 0.003 |
| KDIGO stage at time of commencing CRRT (creatinine criteria) | ||||
| No AKI | 19 (31%) | 9 (47%) | 10 (23%) | 0.06 |
| Stage 1 | 17 (27%) | 5 (26%) | 12 (28%) | |
| Stage 2 | 12 (19%) | 2 (11%) | 10 (23%) | |
| Stage 3 | 14 (23%) | 3 (16%) | 11 (26%) | |
| Biochemical and clinical data over the first 24 hours in ICU | ||||
| Maximal temperature (degrees Celsius), mean (SD) | 36.9 ± 0.7 | 36.9 ± 0.45 | 36.9 ± 0.8 | 0.73 |
| Nadir pH, mean (SD) | 7.29 ± 0.16 | 7.39 ± 0.07 | 7.25 ± 0.16 | 0.001 |
| Peak arterial CO2 (mmHg), mean (SD) | 37 ± 8 | 36 ± 5 | 37 ± 9 | 0.77 |
| Peak sodium (mmol/L), mean (SD) | 142 ± 6 | 143 ± 4 | 141 ± 7 | 0.43 |
| Peak lactate (mmol/L), median (IQR) | 7.1 (4.1–11.6) | 3.9 (2.7–8.8) | 8.3 (4.2–12.5) | 0.02 |
| Peak ALT (IU), mean (SD) | 5210 ± 3206 | 6246 ± 4054 | 4745 ± 2676 | 0.09 |
| Peak GGT (IU), median (IQR) | 106 (68–205) | 136 (82–211) | 97 (67–180) | 0.39 |
| Peak ALP (IU), median (IQR) | 139 (108–184) | 121 (98–148) | 148 (108–200) | 0.04 |
| Peak bilirubin (μmol/L), median (IQR) | 95 (67–187) | 80 (60–148) | 108 (67–223) | 0.40 |
| Peak creatinine (μmol/L), median (IQR) | 165 (92–263) | 75 (65–148) | 208 (133–311) | 0.001 |
| Peak urea (mmol/L), median (IQR) | 6.9 (3.1–12.0) | 7.0 (3.1–10.8) | 6.8 (3.0–13.5) | 0.50 |
| Peak INR, mean (SD) | 6.3 ± 3.1 | 5.4 ± 2.3 | 6.7 ± 3.4 | 0.13 |
| Peak aPTT (seconds), median (IQR) | 63 (44–77) | 46 (38–57) | 72 (51–86) | < 0.001 |
| Nadir fibrinogen (g/L), median (IQR) | 1.1 (0.8–1.6) | 1.5 (1.1–2.0) | 1.0 (0.8–1.3) | 0.01 |
| Nadir platelets (× 109/L), median (IQR) | 83 (41–122) | 106 (73–159) | 77 (38–120) | 0.07 |
| Nadir haemoglobin (g/L), median (IQR) | 102 (80–118) | 111 (96–124) | 87 (78–111) | 0.01 |
| Peak ammonia (μmol/L), median (IQR) | 132 (91–172) | 91 (54–115) | 141 (102–198) | 0.02 |
| 24-Hour net fluid balance from ICU admission (mL), median (IQR) | 4178 (1755–7130) | 3867 (222–5079) | 4993 (2416–7737) | 0.06 |
AKI = acute kidney injury; ALP = alkaline phosphatase; ALT = alanine aminotransferase; APACHE = Acute Physiology and Chronic Health Evaluation; aPTT = activated partial thromboplastin time; CO2 = carbon dioxide; ELT = emergency liver transplant; GGT = γ-glutamyl transferase; ICU = intensive care unit; INR = international normalised ratio; IQR = interquartile range; KCC = King’s College Criteria; KDIGO = Kidney Disease: Improving Global Outcomes; SD = standard deviation.
⁎
Differences between CRRT and non-CRRT groups.