ABSTRACT
Continuous renal replacement therapy (CRRT) has became a modality of choice in chidren with acute renal failure (ARF), especially in cases of multiorgan failure (MOF) and in hemodynamically unstable patients in whom regular hemodialysis is difficult to reform. Newborns and infants with contraindications to peritoneal dialysis are another group of patients treated with CRRT. Retrospective analysis of CRRT therapy in 112 patients treated with (CVVHD, CVVH, CVVHDF, SCUF-continuous veno-venous hemodialysis/hemofiltration/ hemodiafiltration/ultrafiltration) between 2000-2005 is presented. Indication to CRRT was MOF (n=23, 20%), complications post-liver transplant (n=33, 29%), congenital metabolic defects (n=5, 4.5%), complications of cancer or chemotherapy (n=11, 9.8%) and other causes of ARF (n=40, 36.7%). Overall mortality was 36.6%. The highest rate was seen in children between 0-2 years of age (52,3%) and in patients with congenital metabolic diseases (80%). When adjusted to specific modality--the highest mortality was seen in patients treated with CVVHF (55.4%), while lower was in cases treated with CVVHD (37.8%) and CVVHDF (35.4%). Among older children higher mortality was seen in patients with mean arterial pressure (MAP) <70 mmHg (68.4%), compared to patients with MAP >70 mmHg (23.1%).
Subject(s)
Acute Kidney Injury/mortality , Acute Kidney Injury/therapy , Renal Replacement Therapy/mortality , Adolescent , Adult , Child , Child, Preschool , Dialysis Solutions/chemistry , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Multiple Organ Failure/mortality , Multiple Organ Failure/therapy , Retrospective StudiesABSTRACT
AIM: The aim of the study was to identify risk factors of relapse by investigating relationships among suicidality, impulsivity, genetic markers of serotonin activity, and relapse in alcohol-dependent patients. METHODS: 90 alcohol dependent patients were followed for 12 months after the baseline assessment, which entailed evaluation of suicidality and impulsivity as well as collection of DNA samples. Polymorphisms of genes involved in the synthesis and activity of the serotonin system were analyzed. After 12 months from the first visit, the patients were re-contacted and interviewed for relapse. RESULTS: Relapse rates were significantly higher among patients with the history of suicidal attempts recorded at the baseline assessment. The genetic analysis showed that patients with the G/G genotype in the 5HTR1A gene were more likely to relapse, whereas patients with the C/C genotype were more likely to abstain. Moreover, there was a strong trend for an association between the G/G genotype and a history of suicide attempts. CONCLUSIONS: High level of suicidality may predict relapse in alcoholic patients. Altered serotonergic function increases the risk of a suicide attempt and may contribute to higher risk of relapse in alcohol dependent patients.
