Predictors of renal function non-recovery in critically ill patients with acute kidney injury treated with continuous renal replacement therapy

Abstract

Introduction/Objective. Acute kidney injury (AKI) is a highly prevalent complication among the critically ill individuals who are admitted to the intensive care unit (ICU). This study deals with identifying the frequency and predictors of the lack of renal function recovery in non-renal functions among critically ill patients requiring dialysis for AKI (AKI-D). Methods. The study included 440 ICU patients from the University Clinical Center of Vojvodina in the period from 2014 to 2018. The patients required Continuous Renal Replacement Therapy (CRRT). In this study, we analyzed various factors including demographic features, clinical characteristics, laboratory parameters, co-morbidities, as well as the need for vasopressor therapy and mechanical ventilation on the day when AKI was confirmed. Additionally, we examined the different modalities of CRRT, which were used. Results. A retrospective analysis of the results included discovered that out of 440 patients with AKI-D, 242 (55%), average age 63.14, did not recover renal function. Significant predictors of renal function non-recovery in critically ill patients with AKI-D were: the patients age over 65 (p = 0.044), starting time of CRRT (p = 0.043), mechanical ventilation (p = 0.044) and previous kidney disease (p = 0.005). Significant predictors of renal function non-recovery in critically ill septic patients with AKI-D were: the patients age over 65 (p = 0.002), diabetes mellitus (p = 0.023), previous kidney disease (p = 0.045), CRP values < 100 mg/l (p = 0.033) and procalcitonin (p = 0.010), while in non-septic patients, the significant predictors of renal function non-recovery includes previous kidney disease (p = 0.035). Conclusion. Out of all examined predictors, both in septic and non-septic patients, previous kidney damage presents the greatest risk for renal function non-recovery in critically ill patients with AKI-D.