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

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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.

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Acknowledgements

This study was supported by the Biomedical Institute of Pusan National University Hospital. We sincerely thank Dr. Keun Hyeun Lee at the Hemin Korean Traditional Medical Clinic for analyzing the data.

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Authors and Affiliations

  1. Department of Internal Medicine, Pusan National University School of Medicine, Pusan, Republic of Korea

    Harin Rhee, Miyeun Han, Inseong Park, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak & Sang Heon Song

  2. Division of Nephrology, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro179, Seo-gu, Pusan, 602-739, Republic of Korea

    Harin Rhee, Miyeun Han, Inseong Park, Eun Young Seong, Ihm Soo Kwak & Sang Heon Song

  3. Department of Nursing, Pusan National University Hospital, Pusan, Republic of Korea

    Gum Sook Jang & Yeo Jin An

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  1. Harin Rhee
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Corresponding author

Correspondence to Sang Heon Song.

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Conflict of interest

None of the authors have declared any competing interest.

Human and animal rights

All procedures in studies involving human participants were performed in accordance with the ethical standards of the appropriate institutional and/or national review board (Pusan National University IRB Committee [1801-010-063]) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived by the IRB due to the retrospective nature of the analysis that used information contained in medical charts and records, which were anonymized.

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Rhee, H., Jang, G.S., An, Y.J. et al. Long-term outcomes in acute kidney injury patients who underwent continuous renal replacement therapy: a single-center experience. Clin Exp Nephrol 22, 1411–1419 (2018). https://doi.org/10.1007/s10157-018-1595-x

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  • DOI: https://doi.org/10.1007/s10157-018-1595-x

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