Early Treatment with Human Albumin Solution in Continuous Renal Replacement Patients

Department of Intensive Care, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Department of Intensive Care, Royal Adelaide Hospital, Adelaide, South Australia, Australia. The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia. Department of Intensive Care, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia, rinaldo.bellomo@austin.org.au. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, rinaldo.bellomo@austin.org.au. Centre for Integrated Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia, rinaldo.bellomo@austin.org.au.

Blood purification. 2020;:1-9

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Abstract
AIMS: To study the impact of early human albumin solution (HAS) in continuous renal replacement therapy (RRT) patients. METHODS Analysis of Randomized Evaluation of Normal versus Augmented Level (RENAL) RRT trial data. RESULTS Of 1,464 patients, 500 (34%) received early albumin. These patients had higher illness severity scores, greater use of mechanical ventilation, and 90-day mortality (51 vs. 41%; p < 0.001). However, early albumin carried similar RRT dependence risk among survivors at day 90 (4.9 vs. 5.8%; p = 0.62). On Cox proportional hazards regression, with standardized inverse probability of treatment weighting, early albumin was not associated with increased mortality (hazard ratio [HR]: 1.23, 95% CI: 0.97-1.55; p = 0.09) or recovery to RRT independence (HR: 0.92, 95% CI: 0.78-1.10; p = 0.38). CONCLUSIONS Early albumin was administered to one-third of RENAL trial patients and in those with greater illness severity. Early albumin was not independently associated with mortality risk or rate of recovery to RRT independence.
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Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine