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Fluid overload at initiation of renal replacement therapy is associated with lack of renal recovery in patients with acute kidney injury
- Source :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 27(3)
- Publication Year :
- 2011
-
Abstract
- Background. Patients with acute kidney injury (AKI) requiring initiation of renal replacement therapy (RRT) have poor short- and long-term outcomes, including the development of dialysis dependence. Currently, little is known about what factors may predict renal recovery in this population. Methods. We conducted a single-center, retrospective analysis of 170 hospitalized adult patients with AKI attributed to acute tubular necrosis who required inpatient initiation of RRT. Data collection included patient characteristics, laboratory data, details of hospital course and degree of fluid overload at RRT initiation. The primary outcome was recovery of renal function to dialysis independence. Results. Within 1 year of RRT initiation, 35.9% (61/170) of patients reached the primary end point of renal recovery. The median (interquartile range) duration of RRT was 11 (3–33) days and 83.6% (51/61) recovered prior to hospital discharge. Recovering patients had significantly less fluid overload at the time of RRT initiation compared to non-recovering patients (3.5 versus 9.3%, P ¼ 0.004). In multivariate Cox proportional hazard regression analysis, a rise in percent fluid overload at dialysis initiation remained a significant negative predictor of renal recovery (hazard ratio 0.97, 95% confidence interval 0.95–1.00, P ¼ 0.024). Conclusions. In patients with AKI, a higher degree of fluid overload at RRT initiation predicts worse renal recovery at 1 year. Clinical trials are needed to determine whether interventions targeting fluid overload may improve patient and renal outcomes.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Renal function
urologic and male genital diseases
Internal medicine
medicine
Humans
Renal replacement therapy
Dialysis
Acute tubular necrosis
Aged
Retrospective Studies
Transplantation
Kidney
business.industry
Hazard ratio
Acute kidney injury
Water Intoxication
Original Articles
Acute Kidney Injury
Middle Aged
medicine.disease
female genital diseases and pregnancy complications
Surgery
Body Fluids
Renal Replacement Therapy
Survival Rate
medicine.anatomical_structure
Nephrology
Fluid Therapy
Female
Hemodialysis
business
Subjects
Details
- ISSN :
- 14602385
- Volume :
- 27
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
- Accession number :
- edsair.doi.dedup.....bfbff96fac335644b7f3eb4c8f633ab0