Determinants of renal function at hospital discharge of patients treated with renal replacement therapy in the intensive care unit
Purpose: Identification of risk factors for impaired renal function at hospital discharge in critically ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT). Methods: A single-center retrospective cohort study was performed evaluating demographic and clinical parameters as potential risk factors for a modest to severely impaired renal function at hospital discharge in patients with AKI requiring RRT in the intensive care unit. Results: Of the 353 patients in our cohort, 90 (25.5%) patients had pre-existing chronic kidney disease (CKD). An estimated glomerular filtration rate (eGFR) ≤60 mL min-1 1.73 m-2 at hospital discharge occurred in 64.0% of which 63.7% without known renal impairment before hospital admission and 8.2% of all cases left the hospital dialysis-dependent. Multivariable logistic regression showed that age (OR = 1.051, P < .001), serum creatinine concentration at start of RRT (OR = 1.004, P < .001) and administration of iodine-containing contrast fluid (OR = 0.830, P = .045) were associated with an eGFR ≤60 mL min-1 1.73 m-2. Furthermore, a medical history of CKD (OR = 5.865, P < .001) was associated with dialysis dependence. Conclusions: Elderly and patients with pre-existing CKD are at a high risk for modest to severely impaired renal function at hospital discharge after AKI requiring RRT.
|Keywords||Acute kidney injury, Acute renal failure, Chronic kidney disease, Critical ill, Dialysis, Renal recovery, Renal replacement therapy|
|Persistent URL||dx.doi.org/10.1016/j.jcrc.2012.10.013, hdl.handle.net/1765/60601|
|Journal||Journal of Critical Care: improving patient care by integrating critical care systems knowledge into practice behavior|
Fortrie, G, Stads, S, de Geus, H.R.H, Groeneveld, A.B.J, Zietse, R, & Betjes, M.G.H. (2013). Determinants of renal function at hospital discharge of patients treated with renal replacement therapy in the intensive care unit. Journal of Critical Care: improving patient care by integrating critical care systems knowledge into practice behavior, 28(2), 126–132. doi:10.1016/j.jcrc.2012.10.013