Abstract: FR-PO029
Recovery and Survival at Three Months Following Dialysis-Dependent AKI
Session Information
- AKI: Clinical, Outcomes, Trials - I
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Bertoni, Isabela V., Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, United Kingdom
- Zhu, Doreen, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, United Kingdom
- Turner, Michael P., University of Oxford, Oxford, United Kingdom
- Haynes, Richard, University of Oxford, Oxford, United Kingdom
Background
Recovery from dialysis-dependent AKI is desirable because long-term dialysis is associated with significant morbidity and mortality. We examined how previous CKD stage, aetiology of AKI and co-morbidities influenced survival and dialysis dependence at three months after initial presentation.
Methods
245 consecutive cases of AKI requiring RRT were identified from a tertiary referral centre in the UK, treated between 2008 and 2018. Baseline demographic and comorbidity data were extracted and logistic regression was used to assess the association of these characteristics with the primary outcome of renal recovery and survival at three months, in uni- and multi-variate models.
Results
Median age was 66 years (IQR 56.5-75). The most common diagnosis was ATN (60%) followed by vasculitis (9%) and myeloma (8%). At three months after presentation, 187 (76%) individuals were dialysis independent and 30 (12%) had died. Unadjusted and adjusted odds ratios (OR) are shown in table one. (Odds >1 means factor was associated with worse outcome).
Conclusion
This single centre study demonstrated that prior CKD stage and a history of cancer and higher were of the strongest predictors of renal recovery and survival at three months. This could assist clinical decision making and information given to patients.
Table 1: Unadjusted and adjusted odds ratios (OR) for association of patient characteristics with dialysis dependence and/or mortality at three months post presentation
Variable | Unadjusted OR | 95% CI | p-value | Adjusted OR | 95% CI | p-value |
Age (decades) | 1.25 | 1.03-1.53 | 0.024 | 1.11 | 0.80-1.55 | 0.447 |
Male sex (ref female) | 1.10 | 0.61-1.98 | 0.757 | 1.03 | 0.41-2.63 | 0.944 |
Diagnosis (ref ATN) | ||||||
Myeloma | 2.62 | 0.98-6.99 | 0.054 | 3.80 | 0.68-21.4 | 0.130 |
Vasculitis | 3.28 | 1.29-8.31 | 0.012 | 3.56 | 0.77-16.5 | 0.104 |
Obstruction | 2.62 | 0.87-7.94 | 0.088 | 1.23 | 0.26-5.85 | 0.799 |
Other | 1.31 | 0.54-3.21 | 0.553 | 2.17 | 0.62-7.48 | 0.220 |
Previous CKD | ||||||
Stage 2 | 1.13 | 0.22-5.86 | 0.887 | 1.13 | 0.19-6.91 | 0.887 |
Stage 3 | 3.10 | 1.18-8.12 | 0.021 | 2.68 | 0.83-8.67 | 0.100 |
Stage 4 | 4.13 | 1.35-12.6 | 0.013 | 4.56 | 1.22-17.1 | 0.024 |
Stage 5 | 2.76 | 0.71-10.7 | 0.142 | 4.25 | 0.95-19.1 | 0.059 |
Co-morbidities | ||||||
History of cancer | 2.14 | 1.11-4.14 | 0.023 | 3.11 | 1.19-8.08 | 0.020 |
Prior vascular disease * | 1.76 | 1.00-3.09 | 0.049 | 1.76 | 0.66-4.69 | 0.261 |
Prior diabetes mellitus | 0.80 | 0.44-1.45 | 0.459 | 1.02 | 0.38-2.74 | 0.971 |
Dementia | 2.58 | 0.36-18.7 | 0.348 | 1.65 | 0.12-23.5 | 0.710 |
*not included in final model