ABSTRACT Introduction Comparative postoperative outcomes after cardiac surgery in Japanese patients receiving peritoneal dialysis (PD) and hemodialysis (HD) remain unclear. Methods We retrospectively evaluated 26 dialysis patients who underwent cardiac surgery from 2016 to 2022. The primary endpoint was a composite of all‐cause death, ischemic stroke, bleeding complications, and infections during hospitalization. The secondary endpoints included intubation duration, intensive care unit (ICU) stay, and postoperative stay in the cardiovascular surgery department. Results Seven patients received PD and nineteen received HD. The composite outcome occurred in 14% in PD and 42% in HD patients ( p = 0.36). Median intubation duration and ICU stay were 1 vs. 2 days ( p = 0.18) and 4 vs. 4 days ( p = 0.91), respectively. Median postoperative stay was shorter in PD than HD patients (14 vs. 17 days, p = 0.03). Conclusion No statistically significant difference in the composite in‐hospital outcome was observed between groups, although estimates were imprecise because of the small sample size.
ABSTRACT Introduction To develop and validate a 2‐h early‐warning nomogram for the risk of unplanned discontinuation of continuous renal replacement therapy (CRRT) in elderly intensive care unit (ICU) patients. Methods This study retrospectively enrolled elderly CRRT patients from two tertiary hospitals (2022–2024) via convenience sampling for model development. Predictive performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration plots, and internal validation using 1000 bootstrap resamples, with goodness of fit assessed by the Hosmer–Lemeshow test; an external cohort (Jan–Aug 2025) was used for clinical applicability. Results The unplanned CRRT discontinuation rate reached 27.4% in the modeling cohort and 32.8% in an external temporal validation cohort ( n = 247 sessions). Independent predictors included hypotension, therapeutic intervention scoring system (TISS) score, transmembrane pressure (TMP) at 2 h > 86 mmHg, and diagnosis. The model demonstrated robust predictive performance, with an AUC of 0.860 (training) and 0.865 (validation), good calibration (Brier scores: 0.107 internal, 0.127 external), and clinical net benefit across thresholds per decision curve analysis. Conclusions The model demonstrates robust discrimination, calibration, and clinical net benefit, with readily available variables indicating substantial potential for valuable clinical applications.
ABSTRACT Introduction Therapeutic apheresis procedures are inadvertently associated with adverse events, either related to the underlying disease or to the procedure itself. This study aims to analyze the various adverse events encountered during therapeutic apheresis procedures. Method This retrospective study analyses adverse events in therapeutic apheresis procedures with reference to the type of procedure, replacement fluid used, patients' age and gender, disease type, and the adverse events encountered. The data were collected and analyzed using the software R. A p ‐value of less than 0.05 was taken as significant. Result A total of 348 therapeutic apheresis procedures were performed on 127 patients. Adverse events were reported in 54 procedures in 45 patients. Adverse events were significantly higher in the pediatric age group patients and those with neurological diseases, with a strong association between the number of procedures and adverse events. Conclusion This study identified the number of apheresis procedures and patients in the neurology and pediatric age groups as key risk factors for adverse events in therapeutic apheresis. Optimizing preventive strategies and close monitoring will help reduce adverse events in therapeutic apheresis.
