Abstract: TH-PO1045
The Crash-Lander Advanced Renal Disease Study (CLARD) Study
Session Information
- CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- El Madhoun, Ihab, Al Wakra Hospital- HMC, Al Wakra, Qatar
- Pulikkan, Rony, Al Wakra Hospital- HMC, Al Wakra, Qatar
- Bouarour, Mourad, Al Wakra Hospital- HMC, Al Wakra, Qatar
- Karipoth, Krishnakumar, Al Wakra Hospital- HMC, Al Wakra, Qatar
- Mahi, Saad, Al Wakra Hospital- HMC, Al Wakra, Qatar
- Jacob, Shibu, Al Wakra Hospital- HMC, Al Wakra, Qatar
- Emam, Ahmed, Al Wakra Hospital- HMC, Al Wakra, Qatar
Background
Advanced renal disease (ARD) patients can present very late which carries a high risk of morbidity and mortality. Patients with ARD need dialysis support and treatment to be planned ahead. The aim of this study is to review the characters, presentation, renal replacement therapy requirement and outcome of advanced renal diseases cases who required unplanned dialysis in our institution.
Methods
All adult patients who presented acutely to our secondary care Al Wakra Hospital, Hamad Medical Corporation Qatar with serum creatinine >1000mmol/L between 1/1/2016 to 31/12/2022 reviewed. Their initial presentation and need for urgent dialysis, comorbidities, clinical and biochemical parameters, duration of hospital stay have been studied. We intend to assess their outcome with regards to dialysis need, morbidity and mortality during admission and 90 days after presentation. Data collected from the hospital electronic health records.
Results
Out of initially screened 340 patients, 172 fulfilled the inclusion criteria.149 (86%) were males. The mean age was 47 years. 144 (83%) required dialysis during their admission. 12 (6.9%) patients improved without the need for dialysis and 16 (9.3%) patients refused dialysis. 64 (37.2%) patients were sick enough to require ICU/HDU admission. Most patients (93%) managed with hemodialysis. 94 (65%) required temporary vascular access, 38 (26%) Permcath, 9 (6%) peritoneal catheter and only 3 (2%) AVF. The main renal disease was Diabetes in 47 (27.3%) patients, unknown in 49 (28.5%) patients and Hypertension in 26 (15%) patients. 66 (38%) patients were diabetic. 68 (39%) patients had previous encounter with nephrologist sometime in the past. Out of the dialyzed patients, 122 (85%) required to be on long term dialysis. Length of hospital stay was 2 weeks,1 week and 3 weeks for 60 (34%), 57 (33%) and 26 (15%) patients, respectively. Out of the172 patients, on day 90 from admission, 94 (55%) patients were alive, 3 (2%) expired and 75 (43%) lost follow up.
Conclusion
- Crash- lander ARD is not uncommon in day to day practice and carries high morbidity and represent a heavy burden on health system.
- 85% of patients with presenting creatinine > 1000mmol/L will need long term renal replacement therapy.
- Despite the severity of the presenting illness, there was low mortality rate for the patients on 90 days follow up.