Outcomes following dialysis for acute kidney injury among different stages of chronic kidney disease
Journal
American Journal of Nephrology
Journal Volume
34
Journal Issue
2
Pages
95-103
Date Issued
2011
Author(s)
Abstract
Background: Information is limited regarding the outcomes of patients with preexisting chronic kidney disease (CKD) who develop dialysis-requiring acute kidney injury. Methods: 131 adult patients with advanced CKD who received emergent hemodialysis from January to June in 2002 were recruited and monitored for all-cause mortality and end-stage renal disease until the end of 2007. Results: Among patients investigated, 21 (16%) were successfully withdrawn from acute hemodialysis after an average of 8 sessions of dialysis therapy (range: 1-44). Multivariate analysis revealed that larger kidney size (odds ratio, OR = 1.755, p = 0.018), lower predialysis creatinine (OR = 0.722, p = 0.002), and non-diabetes (OR = 0.271, p = 0.037) were predictors for withdrawal. After 5 years, all patients in the non-withdrawal group remained on chronic dialysis, whereas only 8/21 (38%) patients in the withdrawal group developed end-stage renal disease. Cox's analysis showed that age (hazard ratio, HR = 1.043, p < 0.0001), prerenal azotemia (HR = 1.040, p = 0.002), and adjusted propensity score for assigning to dialysis withdrawal (HR = 6.819, p = 0.008) were associated with mortality. Withdrawal from acute dialysis was not related to long-term mortality (p = 0.34). Conclusions: Among the advanced CKD patients, predictors of the successful weaning from acute dialysis were non-diabetes, larger kidney size and lower serum creatinine levels. The strategy of removal from emergent dialysis was not related to long-term mortality. Copyright ? 2011 S. Karger AG, Basel.
SDGs
Other Subjects
creatinine; acute kidney failure; article; chronic kidney disease; controlled clinical trial; controlled study; diabetes mellitus; disease severity; emergency care; female; hemodialysis; hemodialysis patient; human; kidney failure; kidney size; major clinical study; male; mortality; outcome assessment; priority journal; risk factor; treatment outcome; uremia
Publisher
S. Karger AG
Type
journal article