BACKGROUND: Data on the long-term survival and renal function of patients with acute kidney injury (AKI) treated with continuous renal replacement therapy are scarce. METHODS: We investigated the 3-year survival and need for chronic dialysis in critically ill patients, who had survived an episode of AKI requiring continuous renal replacement therapy. RESULTS: A total of 206 ICU patients with AKI were randomized in a trial comparing haemofiltration versus haemodiafiltration. Of these, 95 (46%) survived at 90 days. Post-discharge information relating to 3-year survival and renal function was successfully obtained in 89 (94%) of the patients. Of the 89 patients studied, chronic kidney disease (CKD) was present in 32 subjects from the onset, and CKD developed de novo in 25 patients following AKI. End-stage renal disease (ESRD) developed in 9 patients (of whom 8 had pre-existing CKD) and 29 patients died. Three-year survival was 67% overall; the mortality at 3 years was 50% for those with pre-existing kidney disease, and 71 and 82% for those with de novo and without CKD, respectively. CONCLUSION: After an episode of AKI necessitating a continuous renal replacement therapy, rapid progression to ESKD is commonly observed in patients with pre-existing chronic renal impairment. Medical care with an emphasis on nephroprotection is necessary in these patients.
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BACKGROUND: Data on the long-term survival and renal function of patients with acute kidney injury (AKI) treated with continuous renal replacement therapy are scarce. METHODS: We investigated the 3-year survival and need for chronic dialysis in critically illpatients, who had survived an episode of AKI requiring continuous renal replacement therapy. RESULTS: A total of 206 ICU patients with AKI were randomized in a trial comparing haemofiltration versus haemodiafiltration. Of these, 95 (46%) survived at 90 days. Post-discharge information relating to 3-year survival and renal function was successfully obtained in 89 (94%) of the patients. Of the 89 patients studied, chronic kidney disease (CKD) was present in 32 subjects from the onset, and CKD developed de novo in 25 patients following AKI. End-stage renal disease (ESRD) developed in 9 patients (of whom 8 had pre-existing CKD) and 29 patients died. Three-year survival was 67% overall; the mortality at 3 years was 50% for those with pre-existing kidney disease, and 71 and 82% for those with de novo and without CKD, respectively. CONCLUSION: After an episode of AKI necessitating a continuous renal replacement therapy, rapid progression to ESKD is commonly observed in patients with pre-existing chronic renal impairment. Medical care with an emphasis on nephroprotection is necessary in these patients.
Authors: T M Muniraju; M H Lillicrap; J L Horrocks; J M Fisher; R M W Clark; N S Kanagasundaram Journal: Clin Med (Lond) Date: 2012-06 Impact factor: 2.659
Authors: Sarah M White; Lauren M North; Emily Haines; Megan Goldberg; Lydia M Sullivan; Jeffrey D Pressly; David S Weber; Frank Park; Kevin R Regner Journal: Mol Pharmacol Date: 2014-07-15 Impact factor: 4.436
Authors: Jorge Cerdá; Kathleen D Liu; Dinna N Cruz; Bertrand L Jaber; Jay L Koyner; Michael Heung; Mark D Okusa; Sarah Faubel Journal: Clin J Am Soc Nephrol Date: 2015-07-02 Impact factor: 8.237
Authors: Susanne Stads; Gijs Fortrie; Jasper van Bommel; Robert Zietse; Michiel G H Betjes Journal: Clin J Am Soc Nephrol Date: 2013-04-18 Impact factor: 8.237