Effect of acute kidney injury requiring extended dialysis on 28 day and 1 year survival of patients undergoing interventional lung assist membrane ventilator treatment

In a retrospective analysis of a tertiary care hospital we evaluated all patients undergoing interventional lung assist (iLA) treatment between January 1st 2005 and December 31st 2009. Data from all 61 patients (31 F/30 M), median age 40 (28 to 52) years were obtained by chart review. Follow up data up to one year were obtained.Of the 61 patients undergoing iLA membrane ventilator treatment 21 patients had acute kidney injury network (AKIN) stage 3 and were treated by extended dialysis (ED). Twenty-eight day survival of all patients was 33%. While patients without ED showed a 28 day survival of 40%, the survival of patients with ED was only 19%. Patients on ED were not different in respect to age, weight, Horowitz index and underlying disease.AKI requiring ED therapy in patients undergoing iLA treatment increases mortality in ICU patients. Patients in whom iLA was placed as a bridge to lung transplantation and that were successfully transplanted showed the best outcome. Future studies have to clarify whether it is possible to identify patients that truly benefit from the combination of these two extracorporeal treatment methods.The most frequent contributing factor to acute kidney injury (AKI) is sepsis and multi-organ dysfunction syndrome (MODS) [1]. The high mortality rate of patients with AKI reaches 60% despite considerable improvement of renal replacement therapy (RRT). This fostered the interest on the impact of AKI on distant organ function. One interesting interaction is the one between lung and kidney. AKI induces increased lung vascular permeability, cellular inflammation, and dysregulated salt and water channels resulting in respiratory failure [2]. Also in patients with non-severe pneumonia AKI is associated with higher immune response and an increased risk of death [3]. In contrast to several studies investigating the effect of AKI on survival of patients undergoing extracorporeal membrane oxygenation [4,5], there is only scarce data on the effect of AK