Hyperoncotic Albumin Solution in Continuous Renal Replacement Therapy Patients

Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia, zach.obrien01@gmail.com. Department of Anaesthesia, Austin Hospital, Melbourne, Victoria, Australia, zach.obrien01@gmail.com. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, zach.obrien01@gmail.com. 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. Department of Critical Care, School of Medicine, The University of Melbourne, Melbourne, Victoria, Australia. The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia. Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia. Data Analytics Research and Evaluation (DARE) Centre, The University of Melbourne and Austin Hospital, Melbourne, Victoria, Australia.

Blood purification. 2021;:1-10

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Abstract
AIM: The aim of this study was to investigate the association of hyperoncotic (20%) human albumin solution (HAS) with outcomes among critically ill patients receiving continuous renal replacement therapy (RRT). METHODS Analysis of the Randomized Evaluation of Normal versus Augmented Level (RENAL) RRT trial data. RESULTS Of 1,508 patients, 771 (51%) received albumin. Of these, 345 (45%) received 4% HAS only, 155 (20%) received 20% HAS only, and 271 (35%) received both. Patients who received combined 4% and 20% HAS were more severely ill, received more days of RENAL trial therapy and required mechanical ventilation for longer. Mean daily fluid balance was -288 mL (-904 to 261) with 20% HAS only versus 245 mL (-248 to 1,050) with 4% HAS only (p < 0.001). On Cox proportional hazards regression, 20% HAS exposure was not associated with greater 90-day mortality (odds ratio 1.12, 95% confidence interval [CI]: 0.77-1.62; p = 0.55) or longer recovery to RRT independence (sub-hazard ratio 1.04, 95% CI: 0.84-1.30; p = 0.70) compared to those who received 4% HAS only. CONCLUSIONS RENAL trial patients commonly received albumin in varying concentrations. The administration of 20% HAS was associated with a more negative fluid balance but was not independently associated with increased mortality or RRT dependence when compared to 4% HAS only.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine