NDLI: Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy: a matched cohort study

Content Provider	Springer Nature : BioMed Central
Author	Oeyen, Sandra De Corte, Wouter Benoit, Dominique Annemans, Lieven Dhondt, Annemieke Vanholder, Raymond Decruyenaere, Johan Hoste, Eric
Abstract	Introduction Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients and is associated with increased morbidity and mortality. We compared long-term outcome and quality of life (QOL) in ICU patients with AKI treated with renal replacement therapy (RRT) with matched non-AKI-RRT patients. Methods Over 1 year, consecutive adult ICU patients were included in a prospective cohort study. AKI-RRT patients alive at 1 year and 4 years were matched with non-AKI-RRT survivors from the same cohort in a 1:2 (1 year) and 1:1 (4 years) ratio based on gender, age, Acute Physiology and Chronic Health Evaluation II score, and admission category. QOL was assessed by the EuroQoL-5D and the Short Form-36 survey before ICU admission and at 3 months, 1 and 4 years after ICU discharge. Results Of 1953 patients, 121 (6.2 %) had AKI-RRT. AKI-RRT hospital survivors (44.6 %; N = 54) had a 1-year and 4-year survival rate of 87.0 % (N = 47) and 64.8 % (N = 35), respectively. Forty-seven 1-year AKI-RRT patients were matched with 94 1-year non-AKI-RRT patients. Of 35 4-year survivors, three refused further cooperation, three were lost to follow-up, and one had no control. Finally, 28 4-year AKI-RRT patients were matched with 28 non-AKI-RRT patients. During ICU stay, 1-year and 4-year AKI-RRT patients had more organ dysfunction compared to their respective matches (Sequential Organ Failure Assessment scores 7 versus 5, P < 0.001, and 7 versus 4, P < 0.001). Long-term QOL was, however, comparable between both groups but lower than in the general population. QOL decreased at 3 months, improved after 1 and 4 years but remained under baseline level. One and 4 years after ICU discharge, 19.1 % and 28.6 % of AKI-RRT survivors remained RRT-dependent, respectively, and 81.8 % and 71 % of them were willing to undergo ICU admission again if needed. Conclusion In long-term critically ill AKI-RRT survivors, QOL was comparable to matched long-term critically ill non-AKI-RRT survivors, but lower than in the general population. The majority of AKI-RRT patients wanted to be readmitted to the ICU when needed, despite a higher severity of illness compared to matched non-AKI-RRT patients, and despite the fact that one quarter had persistent dialysis dependency.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/s13054-015-1004-8.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/s13054-015-1004-8
Journal	Critical Care
Issue Number	1
Volume Number	19
Language	English
Publisher	BioMed Central
Publisher Date	2015-12-01
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Intensive Care Unit Renal Replacement Therapy Acute Kidney Injury Intensive Care Unit Admission Intensive Care Unit Stay
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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