title: Renal function and survival in 200 patients undergoing ECMO therapy.
abstract: BACKGROUND
  Extracorporeal membrane oxygenation (ECMO) is increasingly used in the intensive care unit (ICU) setting to improve gas exchange in patients with acute respiratory distress syndrome as well as in patients pre- and post-heart and lung transplantation. In this clinical setting, acute kidney injury (AKI) is frequently observed. So far, it is unknown how AKI affects the survival of critically ill patients receiving ECMO support and whether veno-veno and veno-arterial ECMO have different effects on kidney function.
  
  
  METHODS
  This is a retrospective analysis of patients undergoing ECMO treatment in medical and surgical ICUs in a tertiary care centre. We evaluated all patients undergoing ECMO treatment at our centre between 1 January 2005 and 31 December 2010. Data from all 200 patients (83F/117M), median age 45 (17-83) years, were obtained by chart review. Follow-up data were obtained for up to 3 months.
  
  
  RESULTS
  Three-month survival of all patients was 31%. Of the 200 patients undergoing ECMO treatment, 60% (120/200) required renal replacement therapy (RRT) for AKI. While patients without RRT showed a 3-month survival of 53%, the survival of patients with AKI requiring RRT was 17% (P = 0.001). Longer duration of RRT was associated with a higher mortality.
  
  
  CONCLUSIONS
  AKI requiring RRT therapy in patients undergoing ECMO treatment increases mortality in ICU patients. Future studies have to clarify whether it is possible to identify patients who benefit from the combination of ECMO and RRT.
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, Medical School Hannover, Germany. kielstein@yahoo.com
authors.forename: Jan T
authors.initials: JT
authors.lastname: Kielstein
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Heiden
authors.forename: Gernot
authors.initials: G
authors.lastname: Beutel
authors.forename: Jens
authors.initials: J
authors.lastname: Gottlieb
authors.forename: Olaf
authors.initials: O
authors.lastname: Wiesner
authors.forename: Carsten
authors.initials: C
authors.lastname: Hafer
authors.forename: Johannes
authors.initials: J
authors.lastname: Hadem
authors.forename: Ansgar
authors.initials: A
authors.lastname: Reising
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Christian
authors.initials: C
authors.lastname: Kühn
authors.forename: Stefan
authors.initials: S
authors.lastname: Fischer
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult