Optimal follow-up time after continuous renal replacement therapy in actual renal failure patients stratified with the RIFLE criteria.
BACKGROUND
We wished to determine the optimal duration of follow-up for patients with acute renal failure (ARF) treated with continuous renal replacement therapy (CRRT) and tested the hypothesis that a 6 month follow-up would be the minimum to catch most of the mortalities. In addition, we evaluated the association between mortality and the RIFLE classification in the same patients.


METHODS
We analysed the data of 8152 consecutive patients who had been admitted to the intensive care unit (ICU) of a Swedish university hospital between 1995 and 2001. Of that population, 207 patients were treated with CRRT, excluding 16 treated for non-renal indications.


RESULTS
ICU mortality in this cohort was 34.8% and 30 day and in-hospital mortalities were 45.9% and 50.2%, respectively. The cohort's all-cause mortality 6 months after inclusion was 59.9%, but 54.6% died as early as after 60 days. Patients in the more severe RIFLE category, F (failure), had a 30 day mortality of 57.9% compared with 23.5% for those in the RIFLE-R (risk) category and 22.0% for RIFLE-I (injury) patients.


CONCLUSIONS
In our opinion, a 60 day follow-up is sufficient to catch the majority of deaths in ARF patients treated with CRRT. The patients in the RIFLE-F category had a significantly higher mortality than RIFLE-R and -I patients.
Bell
Max
M
Department of Anaesthesiology and Intensive Care, Karolinska University Hospital, S-171 76 Stockholm, Sweden. max.bell@karolinska.se
Liljestam
Eva
E
Granath
Fredrik
F
Fryckstedt
Jessica
J
Ekbom
Anders
A
Martling
Claes-Roland
CR
D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D003404:Creatinine