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Clin Exp Nephrol. 2018 Dec;22(6):1411-1419. doi: 10.1007/s10157-018-1595-x. Epub 2018 Jun 11.

Long-term outcomes in acute kidney injury patients who underwent continuous renal replacement therapy: a single-center experience.

Author information

1
Department of Internal Medicine, Pusan National University School of Medicine, Pusan, Republic of Korea.
2
Division of Nephrology, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro179, Seo-gu, Pusan, 602-739, Republic of Korea.
3
Department of Nursing, Pusan National University Hospital, Pusan, Republic of Korea.
4
Department of Internal Medicine, Pusan National University School of Medicine, Pusan, Republic of Korea. shsong0209@pusan.ac.kr.
5
Division of Nephrology, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro179, Seo-gu, Pusan, 602-739, Republic of Korea. shsong0209@pusan.ac.kr.

Abstract

INTRODUCTION:

Acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is the most severe form of AKI associated with poor short- and long-term patient outcomes. The aim of this study was to evaluate the variables associated with long-term patient survival in our clinic.

METHODS:

This was a single-center retrospective study with AKI survivors who received CRRT from March 2011 to February 2015. During the study period, all consecutive AKI survivors who underwent CRRT were included. Patients on maintenance dialysis prior to CRRT were excluded. Data were collected by reviewing the patients' medical charts. Long-term follow-up data were gathered through February 2018.

RESULTS:

A total of 430 patients were included, and 62.8% of the patients were male. The mean age of the patients was 63.4 ± 14.6 years. The mean serum creatinine level at the time of CRRT initiation was 3.5 ± 2.5 mg/dL. At the time of discharge, the mean eGFR and serum creatinine levels were 58.4 ± 46.7 and 1.7 ± 1.6 mg/dL, respectively. After 3 years, 44.9% of the patients had survived. When we investigated the factors associated with long-term patient mortality, a longer stay in the ICU [OR 1.034 (1.016-1.053), p < 0.001], a history of cancer [OR 3.830 (1.037-3.308), p = 0.037], a prolonged prothrombin time [OR 1.852 (1.037-3.308), p = 0.037] and a lower eGFR at the time of discharge [OR 0.988 (0.982-0.995), p = 0.001] were independently associated with long-term patient mortality.

CONCLUSION:

Our study demonstrates that long-term mortality after CRRT is associated with longer ICU stays and lower eGFRs at the time of hospital discharge. Our data imply the importance of renal recovery for long-term survival of AKI patients treated with CRRT.

KEYWORDS:

Acute kidney injury; Continuous renal replacement therapy; Long-term outcome

PMID:
29948445
DOI:
10.1007/s10157-018-1595-x
[Indexed for MEDLINE]

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