title: Outcomes following dialysis for acute kidney injury among different stages of chronic kidney disease.
abstract: BACKGROUND
  Information is limited regarding the outcomes of patients with preexisting chronic kidney disease (CKD) who develop dialysis-requiring acute kidney injury.
  
  
  METHODS
  131 adult patients with advanced CKD who received emergent hemodialysis from January to June in 2002 were recruited and monitored for all-cause mortality and end-stage renal disease until the end of 2007.
  
  
  RESULTS
  Among patients investigated, 21 (16%) were successfully withdrawn from acute hemodialysis after an average of 8 sessions of dialysis therapy (range: 1-44). Multivariate analysis revealed that larger kidney size (odds ratio, OR = 1.755, p = 0.018), lower predialysis creatinine (OR = 0.722, p = 0.002), and non-diabetes (OR = 0.271, p = 0.037) were predictors for withdrawal. After 5 years, all patients in the non-withdrawal group remained on chronic dialysis, whereas only 8/21 (38%) patients in the withdrawal group developed end-stage renal disease. Cox's analysis showed that age (hazard ratio, HR = 1.043, p < 0.0001), prerenal azotemia (HR = 1.040, p = 0.002), and adjusted propensity score for assigning to dialysis withdrawal (HR = 6.819, p = 0.008) were associated with mortality. Withdrawal from acute dialysis was not related to long-term mortality (p = 0.34).
  
  
  CONCLUSIONS
  Among the advanced CKD patients, predictors of the successful weaning from acute dialysis were non-diabetes, larger kidney size and lower serum creatinine levels. The strategy of removal from emergent dialysis was not related to long-term mortality.
authors.affiliation: Renal Division, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Po-Hung
authors.initials: PH
authors.lastname: Lee
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.forename: Fu-Chang
authors.initials: FC
authors.lastname: Hu
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Lai
authors.forename: Yung-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Tun-Jun
authors.initials: TJ
authors.lastname: Tsai
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000401:mortality / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome