Clinical characteristics and short-term outcome of dialysis-requiring acute kidney injury in critically ill patients
Keywords:Critically ill patients, Acute kidney injury, Dialysis, Continuous renal replacement therapy, Intermittent hemodialysis
Aim: Dialysis-requiring acute kidney injury (D-AKI) in intensive care unit (ICU) continues to be associated with adverse outcomes of high mortality and dialysis-dependent chronic kidney disease (CKD). This retrospective study aimed to identify clinical characteristics of dialysis-requiring AKI and renal replacement therapy (RRT) which replaces the normal blood-filtering function of the kidneys in current ICU practice.
Methods: This retrospective cohort study was conducted in a 20-bed, third level ICU of a University Hospital between 2011 and 2017. In total, 145 D-AKI patients who underwent RRT were identified. Hospital records of patients with D-AKI were retrospectively analyzed for demographics, medical history, clinical characteristics, details of RRT modality, and short-term outcome.
Results: Of the 1689 patients investigated, 145 had D-AKI. The median age of the patients included in the study was 73 years. Septic etiology was the most common suspected cause for D-AKI development. Fifty-two patients (35.9%) underwent continuous RRT (CRRT) while intermittent hemodialysis was used in 93 patients (64.1%). Mechanical ventilation and inotropic support were more commonly used in CRRT patients than IHD patients (P=0.03). In total, in-hospital mortality rate was 73.1% while rate of dialysis-dependent CKD on discharge was 6.2%. Mortality rate was significantly higher in CRRT (84.6%) patients than in IHD patients (66.7%, P=0.019).
Conclusion: Our study results reveal that sepsis appears to be the most important cause of D-AKI in intensive care patients. D-AKI was observed more frequently in elderly patients and associated with an increased risk of short-term mortality.
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Copyright (c) 2020 Firdevs Tugba Bozkurt, Melek Doganci, Duygu Kayar Calili, Ahmet Akdag, Seval İzdes
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