title: Mortality in hospitalized chronic kidney disease patients starting unplanned urgent haemodialysis.
abstract: OBJECTIVE
  Data on the outcome of chronic kidney disease (CKD) patients who are hospitalized and start unplanned urgent haemodialysis (HD) are lacking. This prospective, longitudinal, observational study aimed to define the hospital mortality rate and associated factors in CKD patients who start unplanned urgent HD.
  
  
  METHODS
  Between January 2003 and December 2009, all patients with CKD who were hospitalized, diagnosed with ESRD and started unplanned urgent haemodialysis at Haemodialysis Service of the Catholic University of Rome, Italy were recruited. Exclusion criteria were: acute renal failure, prior history of dialysis, multiple organ failure, coma, and dementia. Hospital mortality rate was the primary outcome.
  
  
  RESULTS
  Three and hundred sixteen patients were studied: 99 died after 19.5 ± 27.3 days and 217 survived until discharge. Of these, 154 were prescribed chronic HD and 63 restored renal function. Patients who died were significantly older and had a higher Charlson Comorbidity Index score. The mortality rates were 51.1% in patients with 81-90 years, 37.8% with 71-80 years, 34.1% with 61-70 years and 13.9% with age ≤60 years. Logistic regression analysis showed that age only was an independent risk factor for all-cause mortality.
  
  
  CONCLUSIONS
  In CKD patients who need hospitalization and start unplanned urgent haemodialysis the mortality is very high and significantly related to age.
authors.affiliation: Haemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Panocchia
authors.affiliation: Haemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tazza
authors.affiliation: Department of Biochemistry, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Di Stasio
authors.affiliation: Haemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Liberatori
authors.affiliation: Haemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Vulpio
authors.affiliation: Haemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Giungi
authors.affiliation: Haemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Lucani
authors.affiliation: Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Antocicco
authors.affiliation: Haemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bossola
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D012384:Rome; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
keywords: aging; chronic kidney diseases; end-stage renal disease; haemodialysis; hospitalization; mortality; unplanned; urgent