Skip to main content

Degree of impaired kidney function at hospital discharge has a major impact on long-term survival of critically ill patients recovered from renal failure


Renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI) is associated with high mortality. However, little is known about the prognosis of renal function after ICU discharge and the effect of persisting impaired kidney function on long-term survival. The objective of this study was to evaluate the overall long-term mortality in a cohort of ICU patients with AKI necessitating RRT. We hypothesized that both patient characteristics and the degree of renal insufficiency at hospital discharge will influence long-term mortality.


A retrospective cohort study was performed including all patients older than 18 years admitted to the ICU of a tertiary-care center between 1994 and 2010, who underwent continuous RRT during their ICU stay (n = 1,220).


In-hospital mortality was 54.9%. After hospital discharge, the overall mortality was 75.3% after a median follow-up of 8.5 years (range 1 to 17 years). Univariate analysis showed that age, surgical or nonsurgical reason for ICU admission and kidney function at discharge were associated with overall survival. Multivariate Cox regression analysis of the association of kidney function at hospital discharge with patient survival was performed, adjusting for age, sex and surgical or nonsurgical admission type. The eGFR at hospital discharge remained independently associated with long-term survival (P < 0.001). Only 87 (15.8%) patients were discharged with an eGFR >90 ml/minute (using the MDRD formula). In this group 5-year and 10-year survival were respectively 77.6% and 66.7%. The mortality risk increased for every increase in stage of chronic kidney disease (hazard ratio 1.25, P < 0.001). Patients discharged with an eGFR <30 ml/minute (CKD 4 to 5, 37.3% of patients at hospital discharge) had a 5-year and 10-year survival of only 42.5% and 28.5%.


ICU patients with AKI who received CRRT have a high mortality risk. This is more outspoken for patients who experience incomplete recovery of renal function at hospital discharge. Impaired kidney function at discharge has a major negative impact on their long-term survival. These results stress the importance of preserving kidney function in ICU patients and the need for long-term nephrological follow-up. Future research will have to identify possible determinants in the period following hospital discharge that can be used to prolong survival in these patients.

Author information



Corresponding author

Correspondence to S Stads.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Stads, S., Fortrie, G., Van Bommel, J. et al. Degree of impaired kidney function at hospital discharge has a major impact on long-term survival of critically ill patients recovered from renal failure. Crit Care 16, P375 (2012).

Download citation

  • Published:

  • DOI:


  • Chronic Kidney Disease
  • Hospital Discharge
  • Renal Replacement Therapy
  • Kidney Function
  • Acute Kidney Injury