The 90-day mortality and the subsequent renal recovery in critically ill surgical patients requiring acute renal replacement therapy.
BACKGROUND
Particular attention should be paid to postoperative patients that suffer from severe acute kidney injury (AKI) requiring renal replacement therapy (RRT).


METHODS
This multicenter prospective observational study included 342 patients with postoperative AKI requiring RRT from January 2002 to December 2006.


RESULTS
There were 137 (40%) survivors at 90 days after the commencement of RRT. Independent predictors of 90-day mortality were older age, presence of sepsis, status post-cardiopulmonary resuscitation, necessity of continuous renal replacement therapy (CRRT), requirement of total parenteral nutrition, lower body mass index, higher Sequential Organ Failure Assessment score, and higher serum lactate level at the commencement of RRT. Further analysis among the survivors showed that lower serum creatinine at intensive care unit admission, lower Simplified Acute Physiology Score II and inotropic equivalent score at the commencement of RRT, and using CRRT were independent predictors for subsequent renal recovery.


CONCLUSIONS
The development of AKI requiring RRT in postoperative critical patients represents a substantial risk for mortality and morbidity.
Lin
Yu-Feng
YF
Department of Nephrology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Ko
Wen-Je
WJ
Chu
Tzong-Shinn
TS
Chen
Yih-Sharng
YS
Wu
Vin-Cent
VC
Chen
Yung-Ming
YM
Wu
Ming-Shiou
MS
Chen
Yung-Wei
YW
Tsai
Ching-Wei
CW
Shiao
Chih-Chung
CC
Li
Wen-Yi
WY
Hu
Fu-Chang
FC
Tsai
Pi-Ru
PR
Tsai
Tun-Jun
TJ
Wu
Kwan-Dun
KD
D018806:APACHE; D058186:Acute Kidney Injury / Q000401:mortality* / Q000628:therapy*; D000368:Aged; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000401:mortality* / Q000628:therapy*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D017582:Renal Replacement Therapy / Q000379:methods*; D016896:Treatment Outcome
D003404:Creatinine