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Long-term prognosis after acute kidney injury requiring renal replacement therapy

Triverio, Pierre-Alain ; Martin, Pierre-Yves ; Romand, Jacques ; Pugin, Jerome ; Perneger, Thomas ; Saudan, Patrick

In: Nephrology Dialysis Transplantation, 2009, vol. 24, no. 7, p. 2186-2189

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    Title
    • Long-term prognosis after acute kidney injury requiring renal replacement therapy
    Author
    • Triverio, Pierre-Alain. Service de Néphrologie
    • Martin, Pierre-Yves. Service de Néphrologie
    • Romand, Jacques. Services des Soins Intensifs de Chirurgie et de Médecine
    • Pugin, Jerome. Services des Soins Intensifs de Chirurgie et de Médecine
    • Perneger, Thomas. Groupe Qualité, Hôpitaux Universitaires de Genève, Geneva, Switzerland
    • Saudan, Patrick. Service de Néphrologie
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Nephrology Dialysis Transplantation, 2009, vol. 24, no. 7, p. 2186-2189. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:303514
    Summary
    Background. Data on the long-term survival and renal function of patients with acute kidney injury (AKI) treated with continuous renal replacement therapy are scarce. Methods. We investigated the 3-year survival and need for chronic dialysis in critically ill patients, who had survived an episode of AKI requiring continuous renal replacement therapy. Results. A total of 206 ICU patients with AKI were randomized in a trial comparing haemofiltration versus haemodiafiltration. Of these, 95 (46%) survived at 90 days. Post-discharge information relating to 3-year survival and renal function was successfully obtained in 89 (94%) of the patients. Of the 89 patients studied, chronic kidney disease (CKD) was present in 32 subjects from the onset, and CKD developed de novo in 25 patients following AKI. End-stage renal disease (ESRD) developed in 9 patients (of whom 8 had pre-existing CKD) and 29 patients died. Three-year survival was 67% overall; the mortality at 3 years was 50% for those with pre-existing kidney disease, and 71 and 82% for those with de novo and without CKD, respectively. Conclusion. After an episode of AKI necessitating a continuous renal replacement therapy, rapid progression to ESKD is commonly observed in patients with pre-existing chronic renal impairment. Medical care with an emphasis on nephroprotection is necessary in these patients