Long-term renal and overall survival of critically ill patients with acute renal injury who received continuous renal replacement therapy. (1st January 2017)

• Record Type: Journal Article
• Authors: Wu, Lingping; Zhang, Ping; Yang, Yi; Jiang, Hua; He, Yongchun; Xu, Chunping; Yan, Huijuan; Guo, Qi; Luo, Qun; Chen, Jianghua
• Is Part Of: Renal failure. Volume 39:Number 1(2017)
• Page Start: 736
• Page End: 744
• Publication Date: 2017-01-01
• Subjects: Acute kidney injury -- continuous renal replacement therapy -- critically ill -- long-term survival; Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.1080/0886022X.2017.1398667
• Languages: English
• ISSNs: 0886-022X

Abstract

Abstract: Background: Acute kidney injury (AKI) is associated with the increased short-term mortality of critically ill patients on continuous renal replacement therapy (CRRT). The aim of this research was to evaluate the association of kidney function at discharge with the long-term renal and overall survival of critically ill patients with AKI who were on CRRT in an intensive care unit (ICU). Methods: We retrospectively collected data for critically ill patients with AKI who were admitted to ICU on CRRT at a tertiary metropolitan hospital in China between 2008 and 2013. The patients were followed up to their death or to 30 September 2016 by telephone. Results: A total of 403 patients were enrolled in this study. The 1-, 3- and 5-year patient survival rates were 64.3 ± 2.4, 55.8 ± 2.5 and 46.3 ± 2.7%, respectively. In multivariate analysis, age, sepsis, decreased renal perfusion (including volume contraction, congestive heart failure, hypotension and cardiac arrest), preexisting kidney disease, Apache II score, Saps II score, vasopressors and eGFR <45 mL/min/1.73 m 2 at discharge were independent factors for worse long-term patient survival. And age, preexisting kidney disease, Apache II score, mechanical ventilation (MV) and eGFR <45 mL/min/1.73 m 2 at discharge were also associated with worse renal survival. Conclusions: This study showed that impaired kidney function at discharge was shown to be an important risk factor affecting the long-term renal survival rates of critically ill patients with AKI. An eGFR <45 mL/min/1.73 m 2 was an independent risk factor for decreased overall survival and renal survival.