Long term end-stage renal disease and death following acute renal replacement therapy in the ICU
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Long term end-stage renal disease and death following acute renal replacement therapy in the ICU. / Lohse, R.; Damholt, M. B.; Wiis, J.; Perner, A.; Lange, T.; Ibsen, M.
I: Acta Anaesthesiologica Scandinavica, Bind 60, Nr. 8, 09.2016, s. 1092-1101.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Long term end-stage renal disease and death following acute renal replacement therapy in the ICU
AU - Lohse, R.
AU - Damholt, M. B.
AU - Wiis, J.
AU - Perner, A.
AU - Lange, T.
AU - Ibsen, M
N1 - © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
PY - 2016/9
Y1 - 2016/9
N2 - INTRODUCTION: In ICU the need for acute renal replacement therapy (RRT) associates with high mortality and risk of end-stage renal disease (ESRD), but there are limited long-term data. We investigated these outcomes and their risk factors.METHODS: Retrospective analysis of all adult patients admitted to a general, university hospital ICU 2005-2012, excluding chronic dialysis patients. ESRD was defined as need of RRT > 90 days or kidney transplant.RESULTS: Of 5766 patients included, 1004 (16%) received acute RRT; their 30-day mortality was 42% vs. 16% for those not requiring acute RRT (adjusted hazard ratio (HR) 1.13 (0.96-1.32)). The 90-day mortality was 55% for patients receiving acute RRT vs. 22% for those who did not (adjusted HR 1.32 (1.15-1.51)) and 1-year mortality was 63% vs. 30%, respectively, (adjusted HR 1.31 (1.16-1.48)). The 7-year risk of ESRD for ICU patients surviving 90 days was 10% for patients who received acute RRT vs. 0.5% among those who did not (adjusted HR 5.9 (2.9-12.4)). Independent risk factors for ESRD included pre-existing kidney disease, pre-existing peripheral vascular disease and use of acute RRT in ICU.CONCLUSIONS: The need of acute RRT was associated with markedly increased long term risk of death and ESRD; in contrast its use was not associated with 30-day mortality. In addition to acute RRT, decreased kidney function and peripheral vascular disease before ICU admission were risk factors for ESRD. It seems warranted offering medical follow-up to patients after acute RRT in ICU.
AB - INTRODUCTION: In ICU the need for acute renal replacement therapy (RRT) associates with high mortality and risk of end-stage renal disease (ESRD), but there are limited long-term data. We investigated these outcomes and their risk factors.METHODS: Retrospective analysis of all adult patients admitted to a general, university hospital ICU 2005-2012, excluding chronic dialysis patients. ESRD was defined as need of RRT > 90 days or kidney transplant.RESULTS: Of 5766 patients included, 1004 (16%) received acute RRT; their 30-day mortality was 42% vs. 16% for those not requiring acute RRT (adjusted hazard ratio (HR) 1.13 (0.96-1.32)). The 90-day mortality was 55% for patients receiving acute RRT vs. 22% for those who did not (adjusted HR 1.32 (1.15-1.51)) and 1-year mortality was 63% vs. 30%, respectively, (adjusted HR 1.31 (1.16-1.48)). The 7-year risk of ESRD for ICU patients surviving 90 days was 10% for patients who received acute RRT vs. 0.5% among those who did not (adjusted HR 5.9 (2.9-12.4)). Independent risk factors for ESRD included pre-existing kidney disease, pre-existing peripheral vascular disease and use of acute RRT in ICU.CONCLUSIONS: The need of acute RRT was associated with markedly increased long term risk of death and ESRD; in contrast its use was not associated with 30-day mortality. In addition to acute RRT, decreased kidney function and peripheral vascular disease before ICU admission were risk factors for ESRD. It seems warranted offering medical follow-up to patients after acute RRT in ICU.
KW - Journal Article
U2 - 10.1111/aas.12744
DO - 10.1111/aas.12744
M3 - Journal article
C2 - 27219737
VL - 60
SP - 1092
EP - 1101
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 8
ER -
ID: 165920909