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Survival to discharge among patients treated with continuous renal replacement therapy.
Hemodial Int. 2006 Jan; 10(1):82-7.HI

Abstract

Continuous renal replacement therapy (CRRT) is widely used in critically ill patients with acute renal failure (ARF). The survival of patients who require CRRT and the factors predicting their outcomes are not well defined. We sought to identify clinical features to predict survival in patients treated with CRRT. We reviewed the charts of all patients who received CRRT at the Toronto General Hospital during the year 2002. Our cohort (n=85) represented 97% of patients treated with this modality in 3 critical care units. We identified demographic variables, underlying diagnoses, transplantation status, location (medical-surgical, coronary, or cardiovascular surgery intensive care units), CRRT duration, baseline estimated glomerular filtration rate (eGFR), and presence of oliguria (<400 mL/day) on the day of CRRT initiation. The principal outcome was survival to hospital discharge. Among those alive at discharge, we assessed whether there was an ongoing need for renal replacement therapy. Greater than one-third (38%, 32/85) of patients survived to hospital discharge. Three (9%) survivors remained dialysis-dependent at the time of discharge. Survivors were younger than nonsurvivors (mean age 56 vs. 60 years), were on CRRT for a shorter duration (7 vs. 13 days), and had a higher baseline eGFR (74 vs. 62 mL/min/m(2)). Patient survival varied among different critical care units (medical surgical 33%, coronary 38%, and cardiovascular surgery 45%). Multivariable logistic regression revealed that shorter duration of CRRT, nonoliguria, and baseline eGFR >60 mL/min/m(2) were independently associated with survival to hospital discharge (p<0.05). Critically ill patients with ARF who require CRRT continue to have high in-hospital mortality. A shorter period of CRRT dependence, nonoliguria and higher baseline renal function may predict a more favorable prognosis. The majority of CRRT patients who survive their critical illness are independent of dialysis at the time of hospital discharge.

Authors+Show Affiliations

Department of Medicine, University of Toronto, Toronto, ON, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16441832

Citation

Wald, Ron, et al. "Survival to Discharge Among Patients Treated With Continuous Renal Replacement Therapy." Hemodialysis International. International Symposium On Home Hemodialysis, vol. 10, no. 1, 2006, pp. 82-7.
Wald R, Deshpande R, Bell CM, et al. Survival to discharge among patients treated with continuous renal replacement therapy. Hemodial Int. 2006;10(1):82-7.
Wald, R., Deshpande, R., Bell, C. M., & Bargman, J. M. (2006). Survival to discharge among patients treated with continuous renal replacement therapy. Hemodialysis International. International Symposium On Home Hemodialysis, 10(1), 82-7.
Wald R, et al. Survival to Discharge Among Patients Treated With Continuous Renal Replacement Therapy. Hemodial Int. 2006;10(1):82-7. PubMed PMID: 16441832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival to discharge among patients treated with continuous renal replacement therapy. AU - Wald,Ron, AU - Deshpande,Rushi, AU - Bell,Chaim M, AU - Bargman,Joanne M, PY - 2006/1/31/pubmed PY - 2006/6/9/medline PY - 2006/1/31/entrez SP - 82 EP - 7 JF - Hemodialysis international. International Symposium on Home Hemodialysis JO - Hemodial Int VL - 10 IS - 1 N2 - Continuous renal replacement therapy (CRRT) is widely used in critically ill patients with acute renal failure (ARF). The survival of patients who require CRRT and the factors predicting their outcomes are not well defined. We sought to identify clinical features to predict survival in patients treated with CRRT. We reviewed the charts of all patients who received CRRT at the Toronto General Hospital during the year 2002. Our cohort (n=85) represented 97% of patients treated with this modality in 3 critical care units. We identified demographic variables, underlying diagnoses, transplantation status, location (medical-surgical, coronary, or cardiovascular surgery intensive care units), CRRT duration, baseline estimated glomerular filtration rate (eGFR), and presence of oliguria (<400 mL/day) on the day of CRRT initiation. The principal outcome was survival to hospital discharge. Among those alive at discharge, we assessed whether there was an ongoing need for renal replacement therapy. Greater than one-third (38%, 32/85) of patients survived to hospital discharge. Three (9%) survivors remained dialysis-dependent at the time of discharge. Survivors were younger than nonsurvivors (mean age 56 vs. 60 years), were on CRRT for a shorter duration (7 vs. 13 days), and had a higher baseline eGFR (74 vs. 62 mL/min/m(2)). Patient survival varied among different critical care units (medical surgical 33%, coronary 38%, and cardiovascular surgery 45%). Multivariable logistic regression revealed that shorter duration of CRRT, nonoliguria, and baseline eGFR >60 mL/min/m(2) were independently associated with survival to hospital discharge (p<0.05). Critically ill patients with ARF who require CRRT continue to have high in-hospital mortality. A shorter period of CRRT dependence, nonoliguria and higher baseline renal function may predict a more favorable prognosis. The majority of CRRT patients who survive their critical illness are independent of dialysis at the time of hospital discharge. SN - 1492-7535 UR - https://www.unboundmedicine.com/medline/citation/16441832/Survival_to_discharge_among_patients_treated_with_continuous_renal_replacement_therapy_ L2 - https://doi.org/10.1111/j.1542-4758.2006.01179.x DB - PRIME DP - Unbound Medicine ER -