Mortality in hospitalized chronic kidney disease patients starting unplanned urgent haemodialysis. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Panocchia, Nicola; Tazza, Luigi; Di Stasio, Enrico; Liberatori, Massimo; Vulpio, Carlo; Giungi, Stefania; Lucani, Giovanna; Antocicco, Manuela; Bossola, Maurizio
• Is Part Of: Nephrology. Volume 21:Issue 1(2016)
• Page Start: 62
• Page End: 67
• Publication Date: 2016-01
• Subjects: aging -- chronic kidney diseases -- end‐stage renal disease -- haemodialysis -- hospitalization -- mortality -- unplanned -- urgent; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.12561
• Languages: English
• ISSNs: 1320-5358

Abstract

Abstract: Aim: Data on the outcome of chronic kidney disease (CKD) patients who are hospitalized and start unplanned urgent haemodialysis (HD) are lacking. This prospective, longitudinal, observational study aimed to define the hospital mortality rate and associated factors in CKD patients who start unplanned urgent HD. Methods: Between January 2003 and December 2009, all patients with CKD who were hospitalized, diagnosed with ESRD and started unplanned urgent haemodialysis at Haemodialysis Service of the Catholic University of Rome, Italy were recruited. Exclusion criteria were: acute renal failure, prior history of dialysis, multiple organ failure, coma, and dementia. Hospital mortality rate was the primary outcome. Results: Three and hundred sixteen patients were studied: 99 died after 19.5 ± 27.3 days and 217 survived until discharge. Of these, 154 were prescribed chronic HD and 63 restored renal function. Patients who died were significantly older and had a higher Charlson Comorbidity Index score. The mortality rates were 51.1% in patients with 81–90 years, 37.8% with 71–80 years, 34.1% with 61–70 years and 13.9% with age ≤60 years. Logistic regression analysis showed that age only was an independent risk factor for all‐cause mortality. Conclusions: In CKD patients who need hospitalization and start unplanned urgent haemodialysis the mortality is very high and significantly related to age. Summary at a Glance: In this manuscript, the authors examine outcomes in patients who are hospitalized and urgently commence haemodialysis. Their findings reveal that the mortality is very high and that this is significantly associated with patient age.