Outcomes following dialysis for acute kidney injury among different stages of chronic kidney disease.

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Among patients investigated, 21 (16%) were successfully withdrawn from acute hemodialysis after an average of 8 sessions of dialysis therapy (range: 1-44).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.

• Authors: Po-Hung Lee, Vin-Cent Wu, Fu-Chang Hu, Chun-Fu Lai, Yung-Ming Chen, Tun-Jun Tsai, Kwan-Dun Wu, National Taiwan University Study Group on Acute Renal Failure
• Journal: American journal of nephrology (Am J Nephrol) Vol. 34 Issue 2 Pg. 95-103 ( 2011) ISSN: 1421-9670 [Electronic] Switzerland
• PMID: 21691057 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Topics

• Acute Kidney Injury (mortality, pathology)
• Aged
• Aged, 80 and over
• Disease Progression
• Female
• Humans
• Kidney Failure, Chronic (mortality, pathology)
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Outcome Assessment, Health Care
• Proportional Hazards Models
• Renal Dialysis (methods)
• Renal Insufficiency, Chronic (mortality, pathology)
• Retrospective Studies
• Treatment Outcome