Mortality of acute renal failure requiring hemodialysis in intensive care units

Nadia Fretes Servicio de Nefrología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
Juan Pablo Suárez Servicio de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
Estefanía Zambrano León Servicio de Nefrología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
Alexis Marcet Servicio de Nefrología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
María Victoria García Fernández Servicio de Nefrología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
Marina Khoury Epidemiología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
Enrique Dorado Servicio de Nefrología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina

Keywords: mortality, acute kidney failure, intensive care unit

Abstract

Introduction: Acute renal failure in patients admitted to intensive care units is common and is associated with high mortality. The aim of the study was to identify factors related to mortality in patients with acute renal failure, hospitalized in intensive care units, who required renal replacement therapy. Methods: We retrospectively identified 3,732 patients admitted to intensive care units; 2.7% had acute renal failure requiring replacement therapy for renal function. Patients with a history of chronic kidney disease with a glomerular filtration rate of less than 15 mL/m or on chronic dialysis were excluded. Results: 97 cases were analyzed, 55% women, median age: 74 years (interquartile range: 68-78). The most frequent reasons for acute renal failure were sepsis (41.2%) and ischemic acute tubular necrosis (36.1%); 22.7% were diabetic. The median APACHE II score was 23 (interquartile range: 19-28). 75.3% required mechanical ventilation and 81.4%, inotropic drugs. Median time of hospitalization in intensive care units was 8 days (interquartile range: 4-11) and the mortality rate was 58.76%. In the individual analysis, mortality was associated with mechanical ventilation (p<0.0001), the use of inotropic drugs (p<0.0001) and a history of chronic kidney disease (p=0.008), but no association was found with sex, age, APACHE II score, diabetes, or other cardiovascular risk factors. Multivariate model of factors associated with mortality: mechanical ventilation (Odds Ratio=14.16; p=0.003), inotropic drugs (Odds Ratio=8.73; p=0.07) and chronic kidney disease (Odds Ratio=0.27; p=0.020). Conclusions: Patients with acute renal failure who required renal replacement therapy and were admitted to intensive care units presented high mortality. The requirement for mechanical ventilation was associated with higher mortality, as was the use of inotropic drugs, although it did not reach statistical significance in the multivariate analysis. A history of chronic kidney disease was associated with lower mortality.

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Published

2021-03-25

How to Cite

Fretes N, Suárez JP, Zambrano León E, Marcet A, García Fernández MV, Khoury M, Dorado E. Mortality of acute renal failure requiring hemodialysis in intensive care units. Rev Nefrol Dial Traspl. [Internet]. 2021Mar.25 [cited 2024Jul.16];41(1):30-5. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/614

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Vol. 41 No. 1 (2121): Jan.-March

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Original Article

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