Analysis of renal outcome in patients with acute on chronic renal failure requiring emergent hemodilysis
Journal
Journal of Internal Medicine of Taiwan
Journal Volume
15
Journal Issue
3
Pages
115-124
Date Issued
2004
Author(s)
Abstract
Emergent hemodialysis may be required for patients with acute on chronic renal failure who develop fluid overload, hyperkalemia, or uremic complications. However, information is limited regarding the renal outcome of these patients, for instance whether they can be withdrawn from acute dialysis therapy or require long-term replacement treatment. We investigated a retrospective cohort of patients with chronic kidney disease who required emergent hemodialysis at NTUH during a 6-month period to determine factors associated with renal recovery and dialysis withdrawal. All parameters and biochemical data were obtained by reviewing medical chart wherever possible. Among the 144 patients investigated, 22 (15.3%) were successfully withdrawn from hemodialysis after an average of 8 sessions of dialytic therapy (ranging from 1 to 44, group A). These patients could maintain dialysis-free for at least 3 months. Compared to patients who cannot be withdrawn from hemodialysis (group B, n = 122), group A patients had characteristics as follows: they were more likely to suffer from acute deteriorating factors, especially dehydration and urinary tract obstruction; the indication of hemodialysis was more likely to be fluid overload; the renal size was larger, the pre-dialysis hemoglobin level was higher, and the pre-dialysis serum creatinine level was lower. Besides, group A patients suffered from less frequent intra-dialytic hypotensive episodes, and the urine amount returned more quickly than group B patients. About 15% of patients with chronic kidney disease who receive emergent hemodialysis could be withdrawn from acute dialytic therapy for at least 3 months. These patients usually have reversible deteriorating factors, less severe chronic renal damage, and less frequent intra-dialytic hypotensive event.
SDGs
Other Subjects
creatinine; hemoglobin; potassium; acute kidney failure; adolescent; adult; aged; article; chronic kidney failure; cohort analysis; controlled study; dehydration; deterioration; female; hemodialysis; hemodialysis patient; human; hyperkalemia; hypervolemia; hypotension; kidney size; long term care; major clinical study; male; medical record; retrospective study; Taiwan; treatment indication; treatment outcome; treatment withdrawal; university hospital; uremia; urinary tract obstruction; urine volume
Type
journal article