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Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre
Background At least a quarter of patients admitted to the Cardiac Intensive Care Unit (CICU) will develop Acute Kidney Injury (AKI) and some of these patients receive Renal Replacement Therapy (RRT). The clinical profiles and outcomes of CICU patients receiving RRT in resource constraint settings li...
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| Format: | Thesis |
| Language: | English |
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Department of Medicine
2022
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| _version_ | 1867613258352951296 |
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| access_status_str | Open Access |
| author | Mbanga, Luyanda C |
| author2 | Ntsekhe, Mpiko |
| author_browse | Mbanga, Luyanda C Ntsekhe, Mpiko |
| author_facet | Ntsekhe, Mpiko Mbanga, Luyanda C |
| author_sort | Mbanga, Luyanda C |
| collection | Thesis |
| description | Background At least a quarter of patients admitted to the Cardiac Intensive Care Unit (CICU) will develop Acute Kidney Injury (AKI) and some of these patients receive Renal Replacement Therapy (RRT). The clinical profiles and outcomes of CICU patients receiving RRT in resource constraint settings like South Africa is unknown. Objectives The objectives of this study were to determine the clinical profiles and outcomes of patients receiving RRT in the CICU in a South African Tertiary Centre. Methods In this retrospective study we included consecutive patients admitted and receiving RRT at the Groote Schuur Hospital CICU from 01/01/2012 to 31/12/2016. Results During the study period 3247 patients were admitted to the CICU and 46 received RRT. The RRT patients had a mean (SD) age of 52 (17) years, 56% were males, and 65% had a background history of systemic hypertension. Heart failure syndromes accounted for 60.9% of CICU admission in the RRT patient group, followed by acute coronary syndromes and arrhythmias, which accounted for 26.1% and 13.0% respectively. The RRT patient population had an in-hospital and 30-day mortality of 58.7% and 60.9% respectively. Baseline use of Angiotensin Converting Enzyme (ACE) inhibitor or Angiotensin Receptor Blocker (ARB) was associated with a reduced 30 day mortality, Hazards Ratio (HR) 0.43; 95% Confidence interval (95%CI) 0.20 – 0.93; p = 0.031. In addition, heart failure was associated with an increased 30 day mortality, HR 2.52; 95% CI 1.10 – 5.78; p = 0.029. Conclusion Heart failure syndrome accounts for a majority of RRT patients admitted to the our CICU. Patients receiving RRT in CICU have a high in-hospital and 30-day mortality. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/36486 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:17.409Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/36486 Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre Mbanga, Luyanda C Ntsekhe, Mpiko medicine Background At least a quarter of patients admitted to the Cardiac Intensive Care Unit (CICU) will develop Acute Kidney Injury (AKI) and some of these patients receive Renal Replacement Therapy (RRT). The clinical profiles and outcomes of CICU patients receiving RRT in resource constraint settings like South Africa is unknown. Objectives The objectives of this study were to determine the clinical profiles and outcomes of patients receiving RRT in the CICU in a South African Tertiary Centre. Methods In this retrospective study we included consecutive patients admitted and receiving RRT at the Groote Schuur Hospital CICU from 01/01/2012 to 31/12/2016. Results During the study period 3247 patients were admitted to the CICU and 46 received RRT. The RRT patients had a mean (SD) age of 52 (17) years, 56% were males, and 65% had a background history of systemic hypertension. Heart failure syndromes accounted for 60.9% of CICU admission in the RRT patient group, followed by acute coronary syndromes and arrhythmias, which accounted for 26.1% and 13.0% respectively. The RRT patient population had an in-hospital and 30-day mortality of 58.7% and 60.9% respectively. Baseline use of Angiotensin Converting Enzyme (ACE) inhibitor or Angiotensin Receptor Blocker (ARB) was associated with a reduced 30 day mortality, Hazards Ratio (HR) 0.43; 95% Confidence interval (95%CI) 0.20 – 0.93; p = 0.031. In addition, heart failure was associated with an increased 30 day mortality, HR 2.52; 95% CI 1.10 – 5.78; p = 0.029. Conclusion Heart failure syndrome accounts for a majority of RRT patients admitted to the our CICU. Patients receiving RRT in CICU have a high in-hospital and 30-day mortality. 2022-06-21T09:23:55Z 2022-06-21T09:23:55Z 2022 2022-06-21T09:23:23Z Master Thesis Masters MMed http://hdl.handle.net/11427/36486 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | medicine Mbanga, Luyanda C Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre |
| thesis_degree_str | Master's |
| title | Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre |
| title_full | Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre |
| title_fullStr | Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre |
| title_full_unstemmed | Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre |
| title_short | Clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a South African tertiary centre |
| title_sort | clinical profiles and outcomes of patients receiving acute renal replacement therapy in the cardiac intensive care unit at a south african tertiary centre |
| topic | medicine |
| url | http://hdl.handle.net/11427/36486 |
| work_keys_str_mv | AT mbangaluyandac clinicalprofilesandoutcomesofpatientsreceivingacuterenalreplacementtherapyinthecardiacintensivecareunitatasouthafricantertiarycentre |