Universität zu Köln

Schmitz, Michael, Tillmann, Frank P., Paluckaite, Ausra, Laufer, Erich A., Rayner, Brian, Rump, Lars C. and Heering, Peter J. (2017). Mortality risk factors in intensive care unit patients with acute kidney injury requiring renal replacement therapy: a retrospective cohort study. Clin. Nephrol., 88 (1). S. 27 - 33. DEISENHOFEN-MUENCHEN: DUSTRI-VERLAG DR KARL FEISTLE. ISSN 0301-0430

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Abstract

Background: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. Methods: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved. Multi-and univariate analyses were performed to determine the impact of different risk factors on mortality. Results: The most common causes of AKI were sepsis (39.3%) and cardiac events (32%). The majority of patients were treated by continuous (67.3%), the others by intermittent RRT. After 30 days, 51.0% of patients survived. Nonsurvivors were older (73 vs. 69 years), had a higher APACHEE II score (30.1 +/- 5.6 vs. 26.5 +/- 7.1), and were more likely to be vasopressor dependent, mechanically ventilated, or treated by continuous RRT. Multivariate analysis revealed that higher age, higher APACHEE II score, and lower serum creatinine at baseline were independent predictors for mortality, whereas histories of diabetes mellitus, arterial hypertension, coronary heart disease, or stroke were not. Conclusion: Critically-ill patients with AKI requiring RRT continue to have a high mortality. Age and APACHE II score showed an impact on mortality whereas traditional cardiovascular risk factors did not. Higher BUN and creatinine levels do not have a negative impact on mortality. Our findings support the current practice that RRT initiation should primarily be guided by clinical decision.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schmitz, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Tillmann, Frank P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Paluckaite, Ausra UNSPECIFIED UNSPECIFIED UNSPECIFIED Laufer, Erich A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rayner, Brian UNSPECIFIED UNSPECIFIED UNSPECIFIED Rump, Lars C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heering, Peter J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-225835
DOI:	10.5414/CN109078
Journal or Publication Title:	Clin. Nephrol.
Volume:	88
Number:	1
Page Range:	S. 27 - 33
Date:	2017
Publisher:	DUSTRI-VERLAG DR KARL FEISTLE
Place of Publication:	DEISENHOFEN-MUENCHEN
ISSN:	0301-0430
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CRITICALLY-ILL PATIENTS; LATE INITIATION; FAILURE; DIALYSIS; SURVIVAL Multiple languages Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22583