- Poster presentation
- Published:
ICU patients treated with RRT for AKI who have chronic kidney disease have better 1-year outcome compared with patients with better kidney function
Critical Care volume 18, Article number: P405 (2014)
Introduction
Chronic kidney disease (CKD) is a risk factor for developing acute kidney injury (AKI) with need for renal replacement therapy (RRT). AKI-RRT is associated with important short-term mortality, and recent data showed there is also important increased risk for 1-year mortality. The aim of this study is to evaluate variables associated with 1-year survival, and in particular the impact of baseline CKD in a cohort of AKI-RRT patients.
Methods
A single-center observational study in a 50-bed ICU tertiary care hospital. During the study period August 2004 to December 2012 all consecutive adult AKI-RrT patients were included. Data were retrieved from the electronic ICU patient file, the electronic hospital patient file and the electronic ICU-RRT database. Long-term outcome data were collected by a telephone survey.
Results
During the 9-year study period, a total of 1,291 AKI-RRT patients were included. Short-term mortality at day 30 was 47.2%; mortality at 1 year was 64.3%. Compared with nonsurvivors, 1-year survivors had similar age (65 vs. 67 years, P = 0.077), worse kidney function at baseline (eGFR 46 vs. 52 ml/minute/1.73 m2, P = 0.001; CKD stage ≥3 65% vs. 58%, P = 0.019), a greater proportion was male (69.0% vs. 63.2%, P = 0.048), and more were admitted to the cardiac surgery ICU (39% vs. 46%, P = 0.012). They were less severely ill as illustrated by lower SAPS 2 score at ICU admission (52 vs. 69, P < 0.001), and at the time of initiation of RRT, and a lower SOFA score (9 vs. 11; P < 0.001). A smaller proportion was on mechanical ventilation (85.1% vs. 89.7%, P = 0.042) and on vasoactive drugs (45.7% vs. 63.9%, P < 0.001). Survivors had earlier initiation of RRT (2 vs. 3 days, P = 0.034), and more frequently intermittent RRT was used (84.8% vs. 63.2%; P < 0.001). When corrected for gender, age, severity of illness, and modality and timing of RRT, worse baseline kidney function, defined as CKD stage ≥3, remained associated with better 1-year survival (odds ratio 1.6, 95% CI: 1.1 to 2.2, P = 0.011).
Conclusion
In ICU patients who had AKI-RRT, 1-year survival was associated with lower severity of illness. Surprisingly, worse kidney function or CKD stage ≥3 was also associated with long-term survival. This effect remained present after adjudication for relevant covariates.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
De Corte, W., Sergoyne, V., Vanhalst, J. et al. ICU patients treated with RRT for AKI who have chronic kidney disease have better 1-year outcome compared with patients with better kidney function. Crit Care 18 (Suppl 1), P405 (2014). https://doi.org/10.1186/cc13595
Published:
DOI: https://doi.org/10.1186/cc13595