PMID- 37800923
OWN - NLM
STAT- MEDLINE
DCOM- 20240216
LR  - 20240216
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 94
IP  - 3
DP  - 2024 Mar 1
TI  - Risk of Subdural Hematoma Expansion in Patients With End-Stage Renal Disease: 
      Continuous Venovenous Hemodialysis Versus Intermittent Hemodialysis.
PG  - 567-574
LID - 10.1227/neu.0000000000002708 [doi]
AB  - BACKGROUND AND OBJECTIVES: Subdural hematoma (SDH) patients with end-stage renal 
      disease (ESRD) require renal replacement therapy in addition to neurological 
      management. We sought to determine whether continuous venovenous hemodialysis 
      (CVVHD) or intermittent hemodialysis (iHD) is associated with higher rates of SDH 
      re-expansion as well as morbidity and mortality. METHODS: Hemodialysis-dependent 
      patients with ESRD who were discovered to have an SDH were retrospectively 
      identified from 2016 to 2022. Rates of SDH expansion during CVVHD vs iHD were 
      compared. Hemodialysis mode was included in a multivariate logistic regression 
      model to test for independent association with SDH expansion and mortality. 
      RESULTS: A total of 123 hemodialysis-dependent patients with ESRD were discovered 
      to have a concomitant SDH during the period of study. Patients who received CVVHD 
      were on average 10.2 years younger ( P < .001), more likely to have traumatic SDH 
      (47.7% vs 19.0%, P < .001), and more likely to have cirrhosis (25.0% vs 10.1%, P 
      = .029). SDH expansion affecting neurological function occurred more frequently 
      during iHD compared with CVVHD (29.7% vs 12.0%, P = .013). Multivariate logistic 
      regression analysis found that CVVHD was independently associated with decreased 
      risk of SDH affecting neurological function (odds ratio 0.25, 95% CI 0.08-0.65). 
      Among patients who experienced in-hospital mortality or were discharged to 
      hospice, 5% suffered a neurologically devastating SDH expansion while on CVVHD 
      compared with 35% on iHD. CONCLUSION: CVVHD was independently associated with 
      decreased risk of neurologically significant SDH expansion. Therefore, receiving 
      renal replacement therapy through a course of CVVHD may increase SDH stability in 
      patients with ESRD.
CI  - Copyright (c) Congress of Neurological Surgeons 2023. All rights reserved.
FAU - Ran, Kathleen R
AU  - Ran KR
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Ejimogu, Nna-Emeka
AU  - Ejimogu NE
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Yang, Wuyang
AU  - Yang W
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Kilgore, Collin B
AU  - Kilgore CB
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Nair, Sumil K
AU  - Nair SK
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Monroy Trujillo, Jose M
AU  - Monroy Trujillo JM
AD  - Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore , 
      Maryland , USA.
FAU - Jackson, Christopher M
AU  - Jackson CM
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Mukherjee, Debraj
AU  - Mukherjee D
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Anderson, William S
AU  - Anderson WS
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Gallia, Gary L
AU  - Gallia GL
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Weingart, Jon D
AU  - Weingart JD
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Robinson, Shenandoah
AU  - Robinson S
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Cohen, Alan R
AU  - Cohen AR
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Bettegowda, Chetan
AU  - Bettegowda C
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Huang, Judy
AU  - Huang J
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Tamargo, Rafael J
AU  - Tamargo RJ
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
FAU - Xu, Risheng
AU  - Xu R
AUID- ORCID: 0000-0003-4288-1232
AD  - Department of Neurosurgery, Johns Hopkins University School of Medicine, 
      Baltimore , Maryland , USA.
LA  - eng
PT  - Journal Article
DEP - 20231006
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Humans
MH  - *Continuous Renal Replacement Therapy
MH  - Retrospective Studies
MH  - Renal Dialysis/adverse effects
MH  - *Kidney Failure, Chronic/complications/therapy
MH  - Hematoma, Subdural/epidemiology/etiology
EDAT- 2023/10/06 12:44
MHDA- 2024/02/16 06:43
CRDT- 2023/10/06 09:04
PHST- 2023/06/20 00:00 [received]
PHST- 2023/08/10 00:00 [accepted]
PHST- 2024/02/16 06:43 [medline]
PHST- 2023/10/06 12:44 [pubmed]
PHST- 2023/10/06 09:04 [entrez]
AID - 00006123-202403000-00017 [pii]
AID - 10.1227/neu.0000000000002708 [doi]
PST - ppublish
SO  - Neurosurgery. 2024 Mar 1;94(3):567-574. doi: 10.1227/neu.0000000000002708. Epub 
      2023 Oct 6.