NDLI: Renal replacement therapy is an independent risk factor for mortality in critically ill patients with acute kidney injury

Content Provider	Springer Nature : BioMed Central
Author	Elseviers, Monique M Lins, Robert L Van der Niepen, Patricia Hoste, Eric Malbrain, Manu L Damas, Pierre Devriendt, Jacques
Abstract	Introduction Outcome studies in patients with acute kidney injury (AKI) have focused on differences between modalities of renal replacement therapy (RRT). The outcome of conservative treatment, however, has never been compared with RRT. Methods Nine Belgian intensive care units (ICUs) included all adult patients consecutively admitted with serum creatinine >2 mg/dl. Included treatment options were conservative treatment and intermittent or continuous RRT. Disease severity was determined using the Stuivenberg Hospital Acute Renal Failure (SHARF) score. Outcome parameters studied were mortality, hospital length of stay and renal recovery at hospital discharge. Results Out of 1,303 included patients, 650 required RRT (58% intermittent, 42% continuous RRT). Overall results showed a higher mortality (43% versus 58%) as well as a longer ICU and hospital stay in RRT patients compared to conservative treatment. Using the SHARF score for adjustment of disease severity, an increased risk of death for RRT compared to conservative treatment of RR = 1.75 (95% CI: 1.4 to 2.3) was found. Additional correction for other severity parameters (Acute Physiology And Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA)), age, type of AKI and clinical conditions confirmed the higher mortality in the RRT group. Conclusions The SHARF study showed that the higher mortality expected in AKI patients receiving RRT versus conservative treatment can not only be explained by a higher disease severity in the RRT group, even after multiple corrections. A more critical approach to the need for RRT in AKI patients seems to be warranted.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc9355.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc9355
Journal	Critical Care
Issue Number	6
Volume Number	14
Language	English
Publisher	BioMed Central
Publisher Date	2010-12-01
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Renal Replacement Therapy Acute Kidney Injury Sequential Organ Failure Assessment Continuous Renal Replacement Therapy Sequential Organ Failure Assessment Score
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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