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Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy

Background and Objective: 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 o...

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Autores principales: Paškevičius, Žilvinas, Skarupskienė, Inga, Balčiuvienė, Vilma, Dalinkevičienė, Eglė, Kušleikaitė-Pere, Neda, Petrulienė, Kristina, Žiginskienė, Edita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537734/
https://www.ncbi.nlm.nih.gov/pubmed/34684113
http://dx.doi.org/10.3390/medicina57101076
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author Paškevičius, Žilvinas
Skarupskienė, Inga
Balčiuvienė, Vilma
Dalinkevičienė, Eglė
Kušleikaitė-Pere, Neda
Petrulienė, Kristina
Žiginskienė, Edita
author_facet Paškevičius, Žilvinas
Skarupskienė, Inga
Balčiuvienė, Vilma
Dalinkevičienė, Eglė
Kušleikaitė-Pere, Neda
Petrulienė, Kristina
Žiginskienė, Edita
author_sort Paškevičius, Žilvinas
collection PubMed
description Background and Objective: 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). Materials and Methods: We retrospectively analyzed data from patients (n = 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. Results: In 32.5% (n = 186) of the patients, the renal function improved and RRT was stopped, 51.7% (n = 296) of the patients died, and 15.9% (n = 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. Conclusions: 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.
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spelling pubmed-85377342021-10-24 Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy Paškevičius, Žilvinas Skarupskienė, Inga Balčiuvienė, Vilma Dalinkevičienė, Eglė Kušleikaitė-Pere, Neda Petrulienė, Kristina Žiginskienė, Edita Medicina (Kaunas) Article Background and Objective: 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). Materials and Methods: We retrospectively analyzed data from patients (n = 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. Results: In 32.5% (n = 186) of the patients, the renal function improved and RRT was stopped, 51.7% (n = 296) of the patients died, and 15.9% (n = 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. Conclusions: 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. MDPI 2021-10-09 /pmc/articles/PMC8537734/ /pubmed/34684113 http://dx.doi.org/10.3390/medicina57101076 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Paškevičius, Žilvinas
Skarupskienė, Inga
Balčiuvienė, Vilma
Dalinkevičienė, Eglė
Kušleikaitė-Pere, Neda
Petrulienė, Kristina
Žiginskienė, Edita
Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8537734/
https://www.ncbi.nlm.nih.gov/pubmed/34684113
http://dx.doi.org/10.3390/medicina57101076
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