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Published in: Clinical and Experimental Nephrology 6/2019

01-06-2019 | Anemia | Original article

Predictors of withdrawal from renal replacement therapy among patients with acute kidney injury requiring renal replacement therapy

Authors: Katsuhito Ihara, Junichi Ishigami, Seiji Inoshita

Published in: Clinical and Experimental Nephrology | Issue 6/2019

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Abstract

Background

Although recovery of renal function after an episode of acute kidney injury (AKI) is an important clinical measure of morbidity, predictors of withdrawal from renal replacement therapy (RRT) among AKI patients remain unclear.

Methods

In this single-center retrospective cohort study, we examined the clinical records of AKI patients requiring RRT who were hospitalized in the ICU or general wards at our hospital from January 2010 to December 2013. A priori-determined covariates of age, sex, cardiovascular disease, chronic kidney disease (CKD), mean arterial pressure (MAP), sepsis, nephrotoxic agents, and hypoalbuminemia were assessed in Cox hazard models to estimate hazard ratio (HR).

Results

A total of 334 patients were enrolled (median age, 68 years; interquartile range [IQR], 57–77 years; male, 71.6%). During follow-up 157 (47.0%) patients achieved RRT withdrawal. Multivariable Cox regression analysis revealed that CKD, MAP between 95 and 105 mmHg and MAP ≥ 105 mmHg, compared with MAP between 65 and 75 mmHg, ventilator use and hypoalbuminemia, were significantly associated with RRT withdrawal.

Conclusion

Among patients with AKI requiring RRT, CKD, ventilator use, hypoalbuminemia, and high MAP were associated with RRT withdrawal. Furthermore, keeping a higher MAP at RRT initiation can potentially lead to dependence on RRT.
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Metadata
Title
Predictors of withdrawal from renal replacement therapy among patients with acute kidney injury requiring renal replacement therapy
Authors
Katsuhito Ihara
Junichi Ishigami
Seiji Inoshita
Publication date
01-06-2019
Publisher
Springer Singapore
Published in
Clinical and Experimental Nephrology / Issue 6/2019
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-019-01711-y

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