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Comparative Study
. 2010 Oct;5(10):1755-62.
doi: 10.2215/CJN.00770110. Epub 2010 Jul 15.

Outcome of acute kidney injury with different treatment options: long-term follow-up

An M Van Berendoncks  1 , Monique M Elseviers, Robert L Lins; SHARF Study Group
Affiliations
Comparative Study

Outcome of acute kidney injury with different treatment options: long-term follow-up

An M Van Berendoncks et al. Clin J Am Soc Nephrol. 2010 Oct.

Abstract

Background and objectives: The multicenter Stuivenberg Hospital Acute Renal Failure 4 study investigated outcome in patients with acute kidney injury (AKI) stratified according to disease severity by the Stuivenberg Hospital Acute Renal Failure score. Patients in need of renal replacement therapy (RRT) received intermittent RRT or continuous RRT. This study investigated long-term mortality, renal function, comorbidity, and quality of life.

Design, setting, participants, & measurements: All AKI hospital survivors were included. Mortality at 1 and 2 years of follow-up was traced for all patients. Between 1 and 2 years after hospital discharge, survivors were visited at home to determine morbidity (renal function), comorbidity (Charlson comorbidity index [CCI]), and quality of life (Medical Outcome Survey SF-36).

Results: The baseline population consisted of 595 AKI patients. Mortality rates were 23.0 and 7.6%, respectively, during the first and second year after discharge. Total mortality increased from 50.7% at discharge to 65.7% 2 years after AKI and was not related to disease severity or treatment modality offered during hospitalization. Two hundred four survivors could be visited at home. Mean serum creatinine did not differ between discharge and follow-up. CCI was only related with age. SF-36 scores were negatively correlated with CCI, age, and body mass index, but not with disease severity, renal function, or dialysis modality.

Conclusions: Long-term outcome of AKI consists of a high additional mortality unrelated to treatment modality offered during hospitalization, varying evolution of renal recovery, and many comorbidities, but a mental health at the same level as the general population.

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Figures

Figure 1.
Figure 1.
Study population flow chart. Baseline population consisted of 595 hospital survivors. The investigated population was composed of 204 patients that received a home visit.
Figure 2.
Figure 2.
Mortality in AKI patients admitted to the intensive care unit. Mortality could be traced for all patients at 1 and 2 years after discharge. Delayed mortality = mortality during the first/second year after release.
Figure 3.
Figure 3.
Two-year survival according to treatment option. A general comparison showed no difference in long-term survival according to different treatment options.
Figure 4.
Figure 4.
Creatinine clearance at baseline and follow-up according to NKF K/DOQI categories at baseline. The spread within each category increases toward follow-up, both in the positive and in the negative direction.
Figure 5.
Figure 5.
Medical Outcome Survey Short-Form 36 mean physical component summary and mental component summary scores by age groups. The scores were normed based on the general U.S. population with a standard mean of 50 ± 10 (SD).
Appendix.
Appendix.
SHARF score.
See this image and copyright information in PMC

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