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  • Open Access

Long-term mortality of critically ill patients with acute renal failure requiring renal replacement therapy: a 5-year population-based cohort study

  • 1,
  • 1,
  • 2,
  • 2,
  • 1,
  • 2 and
  • 2
Critical Care200610 (Suppl 1) :P295

https://doi.org/10.1186/cc4642

  • Published:

Keywords

  • Acute Renal Failure
  • Renal Replacement Therapy
  • Civil Registration System
  • Main Study Variable
  • Danish Civil Registration System

Background

Despite evidence of a notoriously high short-term mortality of critically ill patients with acute renal failure (ARF), requiring renal replacement therapy (RRT), limited data exist on medium-term and long-term mortality of these patients.

Objective

To examine 90-day and 5-year mortality of critically ill patients with ARF, requiring RRT, compared with critically ill patients without ARF, requiring RRT.

Design

A population-based cohort study.

Methods

Aarhus University Intensive Care Study Cohort enabled us to identify all patients, aged 15 years or more, with first-time admission to three multidisciplinary ICUs within Aarhus University Hospital from 1999 to 2003. We obtained information on the presence of ARF requiring RRT through the study cohort. Complete follow-up on mortality was obtained from the Danish Civil Registration System. We constructed Kaplan-Meier survival curves, based on the date of ICU admission, for the main study variables (RRT: yes/no and age groups: 15–59, 60+ years) and computed contingency tables for 90-day and 5-year mortality. We computed 90-day mortality rate ratios (MRR) and 5-year MRR for patients surviving 90 days, stratified on age group.

Results

We identified 16,038 patients with a first-time ICU admission; 685 (4.3%) of those had ARF requiring RRT. The median age was 66.2 years (range 17.7–89.7) among patients with ARF requiring RRT, and 63.8 years (range 15.1–101.7) among those without ARF. Ninety-day and 5-year mortality among patients with ARF requiring RRT, aged 60+ years, was 60% and 79%, compared with 39% and 53% among those younger than 60 years (see Fig. 1). The 90-day MRR for patients with ARF requiring RRT aged 15–59 and 60+ years was 6.8 (95% CI: 5.5–8.5) and 6.2 (95% CI: 5.4–7.1) when compared with patients without ARF requiring RRT. In comparison, the corresponding 5-year MRR for patients surviving the first 90 days after ICU admission was 1.3 (95% CI: 0.8–2.0) and 1.6 (95% CI: 1.2–2.1), respectively.

Figure 1

Conclusion

ARF requiring RRT in critically ill patients is associated with a substantial increase in medium-term mortality, most markedly among elderly patients. However, among critically ill patients with ARF requiring RRT who survive the first 90 days after ICU admission, the 5-year mortality seems to be only slightly increased.

Authors’ Affiliations

(1)
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus C, Denmark
(2)
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark

Copyright

© BioMed Central Ltd 2006

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