Higher Prevalence of Concurrent Thrombocytopenia in Patients Receiving Continuous Renal Replacement Therapy in the Cardiac Intensive Care Unit

Jan M Griffin; Anam Tariq; Steven Menez; Yousuf Kyeso; Alice Chedid; Viswanathan Ramakrishnan; Steve P Schulman; C John Sperati; Michael J Choi; J William McEvoy; Blaithin A McMahon

doi:10.1159/000513366

Higher Prevalence of Concurrent Thrombocytopenia in Patients Receiving Continuous Renal Replacement Therapy in the Cardiac Intensive Care Unit

Blood Purif. 2021;50(6):891-898. doi: 10.1159/000513366. Epub 2021 Feb 25.

Authors

Affiliations

¹ Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
² Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
³ Department of Medicine, University of Tennessee, Memphis, Tennessee, USA.
⁴ Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
⁵ Department of Medicine, MedStar Georgetown University Hospital, Washington D.C., District of Columbia, USA.
⁶ Department of Cardiology, University College Hospital Galway, Discipline of Medicine, National University of Ireland Galway, Galway, Ireland.
⁷ Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA, blaithinmcmahon3@gmail.com.
⁸ Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA, blaithinmcmahon3@gmail.com.

PMID: 33631762
DOI: 10.1159/000513366

Abstract

Introduction: Thrombocytopenia (TCP) is a common finding in patients receiving continuous renal replacement therapy (CRRT).

Objective: The purpose of this study was to assess the nature of TCP in patients receiving CRRT.

Methods: This is a single-center case-control observational study of 795 patients involving over 166,950 h of delivered CRRT at Johns Hopkins Hospital. Concurrent TCP in patients receiving CRRT was defined as a decrease in platelet count of ≥50% any time within 72 h of initiation of CRRT with strict exclusion criteria.

Results: There was a higher incidence of TCP in the cardiac intensive care unit (CICU) (22.5%) compared to medical ICU (MICU) (13.1%). Using logistic regression, the odds of developing concurrent TCP in patients receiving CRRT was 2.46 (95% CI 1.32-3.57, p < 0.05) times higher in the CICU compared with the MICU. There was no difference in the incidence of severe or profound TCP or timing of acute TCP between the CICU and MICU.

Conclusion: Safe delivery of dialysis care in the ICU is paramount and creating awareness of potential risks such as concurrent TCP in patients receiving CRRT should be part of this care.

Keywords: Cardiac intensive care unit; Dialysis; Hemodialysis; Risk factors; Thrombocytopenia.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Case-Control Studies
Continuous Renal Replacement Therapy* / adverse effects
Female
Humans
Intensive Care Units
Male
Middle Aged
Platelet Count
Prevalence
Risk Factors
Thrombocytopenia / diagnosis
Thrombocytopenia / epidemiology*