A prospective national study of acute renal failure treated with RRT: incidence, aetiology and outcomes

Prescott, Gordon; Metcalfe, Wendy; Baharani, Jyoti; Khan, Izhar; Simpson, Keith; Smith, W. C.; MacLeod, Alison Murray

doi:10.1093/ndt/gfm264

Cited by 83 publications

(89 citation statements)

References 17 publications

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“…Among hospitalized Medicare beneficiaries, patients with CKD have a 10-fold higher incidence of AKI. It is unclear whether patients with AKI and prior CKD experience a different disease course and outcomes than those without prior CKD, because data from several studies are conflicting (5)(6)(7). Most studies have suggested that patients with prior CKD are more likely to remain dialysis dependent after an episode of dialysis-requiring AKI (5,8,9).…”

mentioning

confidence: 99%

Preexisting Chronic Kidney Disease

Khosla

Soroko

Chertow

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Acute kidney injury (AKI) is associated with adverse outcomes in critically ill patients. The influence of preexisting chronic kidney disease (CKD) on AKI outcomes is unclear.Design, setting, participants, & measurements: We analyzed data from a prospective observational cohort study of AKI in critically ill patients who received nephrology consultation: the Program to Improve Care in Acute Renal Disease. In-hospital mortality rate, length of stay, and dialysis dependence were compared in patients with and without a prior history of CKD, defined by an elevated serum creatinine, proteinuria, and/or abnormal renal ultrasound within a year before hospitalization. We hypothesized that patients with AKI and prior history of CKD would have lower mortality rates, shorter lengths of stay, and higher rates of dialysis dependence than patients without prior history of CKD.Results: Patients with AKI and a prior history of CKD were older and underwent nephrology consultation earlier in the course of AKI. In-hospital mortality rate was lower (31 versus 40%, P ‫؍‬ 0.04), and median intensive care unit length of stay was 4.6 d shorter (14.7 versus 19.3 d, P ‫؍‬ 0.001) in patients with a prior history of CKD. Among dialyzed survivors, patients with prior CKD were also more likely to be dialysis dependent at hospital discharge. Differences in outcome were most evident in patients with lower severity of illness.Conclusions: Among critically ill patients with AKI, those with prior CKD experience a lower mortality rate but are more likely to be dialysis dependent at hospital discharge. Future studies should determine optimal strategies for managing AKI with and without a prior history of CKD.

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confidence: 99%

Preexisting Chronic Kidney Disease

Khosla

Soroko

Chertow

et al. 2009

Clinical Journal of the American Society of Nephrology

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“…15 In a similar study of UK patients, Prescott reported similar findings with respect to an apparent mortality benefit conferred by CKD in AKI. 11 This association of improved mortality was also exhibited in critically ill patients. 16 In 618 patients with AKI from the PICARD study, the mortality among patients with CKD was 31% compared to 40% without CKD.…”

Section: Mortality In Aki On Ckdmentioning

confidence: 83%

Acute Kidney Injury and Chronic Kidney Disease: It’s a Two-Way Street

Kline

Rachoin

2013

Renal Failure

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Acute kidney injury (AKI) is frequently seen in hospitalized patients and its incidence increases with the severity of illness. Recent studies have further illuminated the interdependent relationship between AKI and chronic kidney disease (CKD). CKD and proteinuria have been demonstrated to be risk factors for AKI. Moreover, the previous dogma that prognosis is excellent for patients who recover after AKI episodes may not be universally accurate as CKD is emerging as a long-term consequence after AKI. Short-term mortality is lower in CKD patients with AKI.

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“…Our patients were recruited from ICU unit, as in Egypt ARF is usually treated in ICU and attributed mostly to sepsis. The latter was reported as the commonest causative factor of ARF (up to 50%) [2,10,11]. In fact, ARF is nowadays mostly observed as part of the multi-organ dysfunction syndrome in severe sepsis and septic shock [12].…”

Section: Discussionmentioning

confidence: 99%

“…10/40 [25%] of our patients died in the ICU admission period and this agrees with Prescott et al study as many of his deaths [20% -30%] were very early where ARF was sepsis-induced. They concluded that the presence of sepsis increased the risk of death; both as an etiological factor and poor indicator of prognosis in a startling manner [2].…”

Section: Discussionmentioning

confidence: 99%

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Short Term Prognostic Utility of Tc-99m DMSA Renal Imaging in Sepsis Induced Acute Renal Failure; Provisional Data

Amin¹,

Nasr²,

Younis³

et al. 2013

IJCM

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Background: Sound prognostic data in sepsis induced acute renal failure (SARF) are lacking especially on the short term outcome [STO] in the intensive care unit [ICU]. We addressed the use of Tc-99m DMSA [2,3-dimercaptosuccinicacid] renal cortical imaging as a prognostic tool in SARF. This preliminary data could raise Tc-99m DMSA renal imaging as a prognostic tool in SARF that could allow influential interference to prohibit dramatic outcomes as mortality.

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A prospective national study of acute renal failure treated with RRT: incidence, aetiology and outcomes

Cited by 83 publications

References 17 publications

Preexisting Chronic Kidney Disease

Preexisting Chronic Kidney Disease

Acute Kidney Injury and Chronic Kidney Disease: It’s a Two-Way Street

Short Term Prognostic Utility of Tc-99m DMSA Renal Imaging in Sepsis Induced Acute Renal Failure; Provisional Data

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