Long-term outcomes in acute kidney injury patients who underwent continuous renal replacement therapy: a single-center experience.

INTRODUCTION: Acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is the most severe form of AKI associated with poor short- and long-term patient outcomes. The aim of this study was to evaluate the variables associated with long-term patient survival in our clinic. METHODS: This was a single-center retrospective study with AKI survivors who received CRRT from March 2011 to February 2015. During the study period, all consecutive AKI survivors who underwent CRRT were included. Patients on maintenance dialysis prior to CRRT were excluded. Data were collected by reviewing the patients' medical charts. Long-term follow-up data were gathered through February 2018. RESULTS: A total of 430 patients were included, and 62.8% of the patients were male. The mean age of the patients was 63.4 ± 14.6 years. The mean serum creatinine level at the time of CRRT initiation was 3.5 ± 2.5 mg/dL. At the time of discharge, the mean eGFR and serum creatinine levels were 58.4 ± 46.7 and 1.7 ± 1.6 mg/dL, respectively. After 3 years, 44.9% of the patients had survived. When we investigated the factors associated with long-term patient mortality, a longer stay in the ICU [OR 1.034 (1.016-1.053), p < 0.001], a history of cancer [OR 3.830 (1.037-3.308), p = 0.037], a prolonged prothrombin time [OR 1.852 (1.037-3.308), p = 0.037] and a lower eGFR at the time of discharge [OR 0.988 (0.982-0.995), p = 0.001] were independently associated with long-term patient mortality. CONCLUSION: Our study demonstrates that long-term mortality after CRRT is associated with longer ICU stays and lower eGFRs at the time of hospital discharge. Our data imply the importance of renal recovery for long-term survival of AKI patients treated with CRRT.

Effects of bioactive glass incorporation into glass ionomer cement on demineralized dentin.

The effects of the incorporation of sodium-free bioactive glass into glass ionomer cement (GIC) on the demineralized dentin are studied. Four experimental groups with various amounts of BAG in GIC were considered: BG0 group: 0 wt% (control); BG5 group: 5 wt%; BG10 group: 10 wt%; BG20 group: 20 wt%. The GIC surface and GIC-approximated demineralized dentin surfaces were evaluated using field emission scanning electron microscopy (FE-SEM). X-ray diffraction (XRD) analysis was performed to evaluate the chemical changes in the GIC-approximated dentin surface. In addition, a shear bond strength test was performed to evaluate the effects of BAG incorporation on the bond strength of GIC. FE-SEM analysis indicated that BAG-incorporated GICs formed distinct precipitates on their surface. Precipitates were also formed on the GIC-approximated demineralized dentin surface. It was more obvious when the amount of BAG increased. In the XRD analysis, fluorapatitie (FAP) peaks were detected in the BG5, BG10, and BG20 groups. There was no significant difference in the shear bond strength among all experimental groups. BAG-incorporated GIC precipitated FAP crystals underlying demineralized dentin surface without affecting bond strength. This study suggests the possibility of BAG as a beneficial additive in GIC.