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Prognostics factors for mortality and renal recovery in critically ill patients
with acute kidney injury and renal replacement therapy
#MMPMID27096679
Gaião SM
; Gomes AA
; Paiva JA
Rev Bras Ter Intensiva
2016[Jan]; 28
(1
): 70-7
PMID27096679
show ga
OBJECTIVE: Identify prognostic factors related to mortality and non-recovery of
renal function. METHODS: A prospective single-center study was conducted at the
intensive care medicine department of a university hospital between 2012 and
2015. Patients with acute kidney injury receiving continuous renal replacement
therapy were included in the study. Clinical and analytical parameters were
collected, and the reasons for initiation and discontinuation of renal
replacement therapy were examined. RESULTS: A total of 41 patients were included
in the study, of whom 43.9% had sepsis. The median Simplified Acute Physiology
Score II (SAPSII) was 56 and the mortality was 53.7%, with a predicted mortality
of 59.8%. The etiology of acute kidney injury was often multifactorial (56.1%).
Survivors had lower cumulative fluid balance (median = 3,600mL, interquartile
range [IQR] = 1,175 - 8,025) than non-survivors (median = 12,000mL, IQR = 6,625 -
17,875; p = 0.004). Patients who recovered renal function (median = 51.0, IQR =
45.8 - 56.2) had lower SAPS II than those who do not recover renal function
(median = 73, IQR = 54 - 85; p = 0.005) as well as lower fluid balance (median =
3,850, IQR = 1,425 - 8,025 versus median = 11,500, IQR = 6,625 - 16,275; p =
0.004). CONCLUSIONS: SAPS II at admission and cumulative fluid balance during
renal support therapy were risk factors for mortality and non-recovery of renal
function among critically ill patients with acute kidney injury needing renal
replacement therapy.
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