Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy
<i>Background and Objective</i>: Acute kidney injury (AKI) remains a serious health condition around the world, and is related to high morbidity, mortality, longer hospitalization duration and worse long-term outcomes. The aim of our study was to estimate the significant related factors...
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MDPI AG
2021-10-01
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| Online Access: | https://www.mdpi.com/1648-9144/57/10/1076 |
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| author | Žilvinas Paškevičius Inga Skarupskienė Vilma Balčiuvienė Eglė Dalinkevičienė Neda Kušleikaitė-Pere Kristina Petrulienė Edita Žiginskienė |
| author_facet | Žilvinas Paškevičius Inga Skarupskienė Vilma Balčiuvienė Eglė Dalinkevičienė Neda Kušleikaitė-Pere Kristina Petrulienė Edita Žiginskienė |
| author_sort | Žilvinas Paškevičius |
| collection | DOAJ |
| description | <i>Background and Objective</i>: Acute kidney injury (AKI) remains a serious health condition around the world, and is related to high morbidity, mortality, longer hospitalization duration and worse long-term outcomes. The aim of our study was to estimate the significant related factors for poor outcomes of patients with severe AKI requiring renal replacement therapy (RRT). <i>Materials and Methods</i>: We retrospectively analyzed data from patients (<i>n</i> = 573) with severe AKI requiring RRT within a 5-year period and analyzed the outcomes on discharge from the hospital. We also compared the clinical data of the surviving and non-surviving patients and examined possible related factors for poor patient outcomes. Logistic regression was used to analyze the odds ratio for patient mortality and its related factors. <i>Results:</i> In 32.5% (<i>n</i> = 186) of the patients, the renal function improved and RRT was stopped, 51.7% (<i>n</i> = 296) of the patients died, and 15.9% (<i>n</i> = 91) of the patients remained dialysis-dependent on the day of discharge from the hospital. During the period of 5 years, the outcomes of the investigated patients did not change statistically significantly. Administration of vasopressors, aminoglycosides, sepsis, pulmonary edema, oliguria, artificial pulmonary ventilation (APV), patient age ≥ 65 y, renal cause of AKI, AKI after cardiac surgery, a combination of two or more RRT methods, dysfunction of three or more organs, systolic blood pressure (BP) ≤ 120 mmHg, diastolic BP ≤ 65 mmHg, and Sequential Organ Failure Assessment (SOFA) score on the day of the first RRT procedure ≥ 7.5 were related factors for lethal patient outcome. <i>Conclusions:</i> The mortality rate among patients with severe AKI requiring RRT is very high—52%. Patient death was significantly predicted by the causes of AKI (sepsis, cardiac surgery), clinical course (oliguria, pulmonary edema, hypotension, acidosis, lesion of other organs) and the need for a continuous renal replacement therapy. |
| first_indexed | 2024-03-10T06:24:20Z |
| format | Article |
| id | doaj.art-bdd2bf058be54929ae390791c67a31f4 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T06:24:20Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-bdd2bf058be54929ae390791c67a31f42023-11-22T19:04:31ZengMDPI AGMedicina1010-660X1648-91442021-10-015710107610.3390/medicina57101076Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement TherapyŽilvinas Paškevičius0Inga Skarupskienė1Vilma Balčiuvienė2Eglė Dalinkevičienė3Neda Kušleikaitė-Pere4Kristina Petrulienė5Edita Žiginskienė6Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, LT-50161 Kaunas, LithuaniaDepartment of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, LT-50161 Kaunas, LithuaniaHospital of Lithuanian University of Health Sciences, Eivenių 2, LT-50161 Kaunas, LithuaniaDepartment of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, LT-50161 Kaunas, LithuaniaDepartment of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, LT-50161 Kaunas, LithuaniaDepartment of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, LT-50161 Kaunas, LithuaniaDepartment of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, LT-50161 Kaunas, Lithuania<i>Background and Objective</i>: Acute kidney injury (AKI) remains a serious health condition around the world, and is related to high morbidity, mortality, longer hospitalization duration and worse long-term outcomes. The aim of our study was to estimate the significant related factors for poor outcomes of patients with severe AKI requiring renal replacement therapy (RRT). <i>Materials and Methods</i>: We retrospectively analyzed data from patients (<i>n</i> = 573) with severe AKI requiring RRT within a 5-year period and analyzed the outcomes on discharge from the hospital. We also compared the clinical data of the surviving and non-surviving patients and examined possible related factors for poor patient outcomes. Logistic regression was used to analyze the odds ratio for patient mortality and its related factors. <i>Results:</i> In 32.5% (<i>n</i> = 186) of the patients, the renal function improved and RRT was stopped, 51.7% (<i>n</i> = 296) of the patients died, and 15.9% (<i>n</i> = 91) of the patients remained dialysis-dependent on the day of discharge from the hospital. During the period of 5 years, the outcomes of the investigated patients did not change statistically significantly. Administration of vasopressors, aminoglycosides, sepsis, pulmonary edema, oliguria, artificial pulmonary ventilation (APV), patient age ≥ 65 y, renal cause of AKI, AKI after cardiac surgery, a combination of two or more RRT methods, dysfunction of three or more organs, systolic blood pressure (BP) ≤ 120 mmHg, diastolic BP ≤ 65 mmHg, and Sequential Organ Failure Assessment (SOFA) score on the day of the first RRT procedure ≥ 7.5 were related factors for lethal patient outcome. <i>Conclusions:</i> The mortality rate among patients with severe AKI requiring RRT is very high—52%. Patient death was significantly predicted by the causes of AKI (sepsis, cardiac surgery), clinical course (oliguria, pulmonary edema, hypotension, acidosis, lesion of other organs) and the need for a continuous renal replacement therapy.https://www.mdpi.com/1648-9144/57/10/1076acute kidney injuryrenal replacement therapymortality prediction |
| spellingShingle | Žilvinas Paškevičius Inga Skarupskienė Vilma Balčiuvienė Eglė Dalinkevičienė Neda Kušleikaitė-Pere Kristina Petrulienė Edita Žiginskienė Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy Medicina acute kidney injury renal replacement therapy mortality prediction |
| title | Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy |
| title_full | Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy |
| title_fullStr | Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy |
| title_full_unstemmed | Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy |
| title_short | Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy |
| title_sort | mortality prediction in patients with severe acute kidney injury requiring renal replacement therapy |
| topic | acute kidney injury renal replacement therapy mortality prediction |
| url | https://www.mdpi.com/1648-9144/57/10/1076 |
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