Metabolism, endocrinology, nephrology and nutrition: Nephrology
CHARACTERISTICS AND PROGNOSIS OF PATIENTS RECEIVING CONTINUOUS RENAL REPLACEMENT THERAPY IN AN INTENSIVE CARE UNIT
L. Santana Cabrera1, M. Sánchez Palacios1, S. Martinez Cuellar1, F. Rodríguez González1, A. Villanueva Ortiz1, R. Lorenzo Torrent1
1Intensive Care Unit. Universitary Hospital Insular in Gran Canaria, Las Palmas de Gran Canaria, Spain
Objetive. To describe the characteristics and prognostic factors of patients receiving Continuous Renal Replacement Therapy (CRRT) in an intensive care unit (ICU).
Design. Retrospective analysis of prospectively collected simple data over 6 consecutive years.
Setting. Polyvalent ICU of the Insular University Hospital in Gran Canaria, Canary Islands, Spain.
Patients. Adult patients admitted in ICU who receiving CRRT.
Primary variables of interest. Demographic data, clinical diagnosis on ICU admission, Apache II, days of stay in ICU, days of mechanical ventilation and CRRT. Hospitalary mortality and at one year later was collected.
Results. During the study period, 3786 patients were admitted to the ICU. Of these 182 (4'8%) received CRRT, during an average of 9'1±5'1 days, with a mortality in ICU of 43'4%. In the moment of the discharge of the ICU 12 patients continued needing dialysis but only 1 did not receive it previously to its admission. 12 (11´6 %) of the surviving patients in the ICU, died in plant and 73 (70´8 %) were still alive one year later. When we compare them with the patients who didn´t needed CRRT, they had a major stay in ICU (p 0´02), major need of mechanical ventilation (p < 0 ´ 001) and a significantly major mortality (43´4% vs 18´3%, p< 0´001). The multivariate analysis showed as independent variables associated with the mortality, the mean of days at ICU, the days of mechanical ventilation and the Apache II (p< 0'0001).
Conclusions. Critically ill patients who require CRRT have high in-hospital mortality though the survival at one year was high. The majority of patients are independent of dialysis at the time of hospital discharge.
Key words. Renal Replacement Therapy. Intensive care units. Prognosis. Mortality.