Surgical procedures were considered major if the length of hospital stay for patients in a given diagnosis-related group exceeded two days [15-18]. Informed consent was waived because there was www.selleckchem.com/products/Bosutinib.html no breach of privacy and it did not interfere with clinical decisions related to patient care. Approval for this study was obtained from the Institutional Review Board of National Taiwan University Hospital (No. 31MD03).Patient information and data collectionThe demographic data, comorbid diseases, types of surgery and RRT, as well as the indications for RRT were documented. The biochemistry data such as complete blood cell count, blood urea nitrogen (BUN), serum creatinine (sCr), glomerular filtration rate (GFR), serum albumin, and serum potassium (sK+) were recorded upon ICU admission and RRT initiation.

Severity scores including Glascow Coma Scale (GCS) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) [19] score, and Sequential Organ Failure Assessment (SOFA) [20] score were also measured at the two time points. Also, the need for mechanical ventilation was recorded and the usage of inotropic equivalent was calculated to evaluate the vasopressor dose [21]. Then we measured and recorded patients’ outcome including in-hospital mortality and RRT wean-off.Definitions were made as following: diabetes, previous usage of insulin or oral hypoglycemic agents; hypertension, blood pressure above 140/90 mmHg or usage of anti-hypertension agents; cardiac failure, low cardiac output with a central venous pressure (CVP) above 12 mmHg and an dopamine equivalent above 5 ��g/kg/min [21]; chronic kidney disease (CKD), sCr of 1.

5 mg/dl or greater documented prior to this admission [22]; sepsis, persisted or progressive signs and symptoms of the systemic inflammatory response syndrome with a documented or presumed persistence of infection [23]; RRT wean-off, cessation from RRT for at least 30 days [15].The types of major abdominal surgery were further divided into five categories depending on the involvement of abdominal organs: (1) hepatobiliary organ, (2) upper gastrointestinal (GI) tract, (3) lower GI tract, (4) urological organs, and (5) other sites. ‘Upper GI tract’ was defined as the duodenum and above, while ‘lower GI tract’ included the area from the jejunum to rectum. If the surgery didn’t involve the one of the four major organs (1 to 4), it would be categorized as ‘other sites’ (5).

The modality of RRT was chosen according to the hemodynamics of the patients. Continuous Drug_discovery venovenous hemofiltration was performed, if more than 15 points of inotropic equivalent [15] was required to maintain systemic blood pressure up to 120 mmHg, using high-flux filters (Hemofilter, PAN-10, Asahi Kasei, Japan) and HF 400 (Informed, Geneva, Switzerland). The hemofiltration flow and blood flow blood flow were 35 ml/kg/hour and 200 ml/min, respectively.