Prognostics factors for mortality and renal recovery in critically ill patients with acute kidney injury and renal replacement therapy.
OBJECTIVE
Identify prognostic factors related to mortality and non-recovery of renal function.


METHODS
A prospective single-center study was conducted at the intensive care medicine department of a university hospital between 2012 and 2015. Patients with acute kidney injury receiving continuous renal replacement therapy were included in the study. Clinical and analytical parameters were collected, and the reasons for initiation and discontinuation of renal replacement therapy were examined.


RESULTS
A total of 41 patients were included in the study, of whom 43.9% had sepsis. The median Simplified Acute Physiology Score II (SAPSII) was 56 and the mortality was 53.7%, with a predicted mortality of 59.8%. The etiology of acute kidney injury was often multifactorial (56.1%). Survivors had lower cumulative fluid balance (median = 3,600mL, interquartile range [IQR] = 1,175 - 8,025) than non-survivors (median = 12,000mL, IQR = 6,625 - 17,875; p = 0.004). Patients who recovered renal function (median = 51.0, IQR = 45.8 - 56.2) had lower SAPS II than those who do not recover renal function (median = 73, IQR = 54 - 85; p = 0.005) as well as lower fluid balance (median = 3,850, IQR = 1,425 - 8,025 versus median = 11,500, IQR = 6,625 - 16,275; p = 0.004).


CONCLUSIONS
SAPS II at admission and cumulative fluid balance during renal support therapy were risk factors for mortality and non-recovery of renal function among critically ill patients with acute kidney injury needing renal replacement therapy.
Centro Hospitalar de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Sérgio Mina
SM
Gaião
Centro Hospitalar de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
André Amaral
AA
Gomes
Centro Hospitalar de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
José Artur Osório de Carvalho
JA
Paiva
D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D000368:Aged; D016638:Critical Illness; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D017582:Renal Replacement Therapy / Q000379:methods*; D012307:Risk Factors; D017741:Survivors