The 90-day mortality and the subsequent renal recovery in critically ill surgical patients requiring acute renal replacement therapy

Abstract

Background: Particular attention should be paid to postoperative patients that suffer from severe acute kidney injury (AKI) requiring renal replacement therapy (RRT). Methods: This multicenter prospective observational study included 342 patients with postoperative AKI requiring RRT from January 2002 to December 2006. Results: There were 137 (40%) survivors at 90 days after the commencement of RRT. Independent predictors of 90-day mortality were older age, presence of sepsis, status post-cardiopulmonary resuscitation, necessity of continuous renal replacement therapy (CRRT), requirement of total parenteral nutrition, lower body mass index, higher Sequential Organ Failure Assessment score, and higher serum lactate level at the commencement of RRT. Further analysis among the survivors showed that lower serum creatinine at intensive care unit admission, lower Simplified Acute Physiology Score II and inotropic equivalent score at the commencement of RRT, and using CRRT were independent predictors for subsequent renal recovery. Conclusions: The development of AKI requiring RRT in postoperative critical patients represents a substantial risk for mortality and morbidity. ? 2009.