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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8537734 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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