Long term end-stage renal disease and death following acute renal replacement therapy in the ICU

Autor:	Jørgen Wiis, Anders Perner, Theis Lange, Robin Lohse, Michael Ibsen, Mette Brimnes Damholt
Rok vydání:	2016
Předmět:	Male medicine.medical_specialty medicine.medical_treatment Disease urologic and male genital diseases End stage renal disease 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Humans Medicine 030212 general & internal medicine Renal replacement therapy Intensive care medicine Aged Retrospective Studies business.industry Vascular disease Hazard ratio 030208 emergency & critical care medicine General Medicine Middle Aged University hospital medicine.disease female genital diseases and pregnancy complications Renal Replacement Therapy Intensive Care Units Anesthesiology and Pain Medicine Chronic dialysis Kidney Failure Chronic Female business Kidney disease
Zdroj:	Acta Anaesthesiologica Scandinavica. 60:1092-1101
ISSN:	0001-5172
Popis:	Introduction In ICU the need for acute renal replacement therapy (RRT) associates with high mortality and risk of end-stage renal disease (ESRD), but there are limited long-term data. We investigated these outcomes and their risk factors. Methods Retrospective analysis of all adult patients admitted to a general, university hospital ICU 2005–2012, excluding chronic dialysis patients. ESRD was defined as need of RRT > 90 days or kidney transplant. Results Of 5766 patients included, 1004 (16%) received acute RRT; their 30-day mortality was 42% vs. 16% for those not requiring acute RRT (adjusted hazard ratio (HR) 1.13 (0.96–1.32)). The 90-day mortality was 55% for patients receiving acute RRT vs. 22% for those who did not (adjusted HR 1.32 (1.15–1.51)) and 1-year mortality was 63% vs. 30%, respectively, (adjusted HR 1.31 (1.16–1.48)). The 7-year risk of ESRD for ICU patients surviving 90 days was 10% for patients who received acute RRT vs. 0.5% among those who did not (adjusted HR 5.9 (2.9–12.4)). Independent risk factors for ESRD included pre-existing kidney disease, pre-existing peripheral vascular disease and use of acute RRT in ICU. Conclusions The need of acute RRT was associated with markedly increased long term risk of death and ESRD; in contrast its use was not associated with 30-day mortality. In addition to acute RRT, decreased kidney function and peripheral vascular disease before ICU admission were risk factors for ESRD. It seems warranted offering medical follow-up to patients after acute RRT in ICU.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c168d3dee80f0d7a9a3457205ee03bb6 https://doi.org/10.1111/aas.12744 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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