Korean J Nephrol.  2011 Jan;30(1):73-79.

Mortality Predictors in Patients Treated with Continuous Renal Replacement

• Kim EJ
• Chung CH
• Park MY
• Choi SJ
• Kim JK
• Hwang SD

Abstract

PURPOSE
Acute kidney injury (AKI) is a frequent condition with a high mortality rate that requires continuous renal replacement therapy (CRRT). We evaluated the Simplified Acute Physiology Score 3 (SAPS 3) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score, determined at the start of CRRT, for predicting mortality in AKI.
METHODS
We retrospectively analyzed the demographic, clinical, and laboratory data of 89 patients with AKI or acute-on-chronic kidney disease who received CRRT between September 2006 and September 2009. We calculated the SAPS 3 and APACHE II score at the start of CRRT.
RESULTS
The average age of the 89 patients was 64.4+/-13.9 (17-92) years. Fifty-nine (66.3%) were male. Eighteen (20.2%) patients had chronic kidney disease and 30 (33.7%) had diabetes. The overall mortality was 75.3%. The average SAPS 3 was 89.4+/-14.9 and the average APACHE II score was 28.4+/-5.2. The SAPS 3 was higher in non-survivors than survivors (p=0.038). Infection was more common in non-survivors (p=0.036). There were no significant differences between the two groups for other conditions. The variables influencing mortality on univariate analysis were SAPS 3 and presence of infection. The area under the receiver-operating characteristic curve for SAPS 3 was 0.69 (95% CI. 0.54-0.83). At a SAPS 3 of 84, the sensitivity for predicting mortality was 71.6% and the specificity was 69.2%.
CONCLUSION
The SAPS 3 determined before starting CRRT could be a predictor of hospital mortality in patients with AKI.

Keyword

Renal replacement therapy; Mortality

MeSH Terms

Acute Kidney Injury
APACHE
Hospital Mortality
Humans
Kidney Diseases
Male
Renal Insufficiency, Chronic
Renal Replacement Therapy
Retrospective Studies
Sensitivity and Specificity
Survivors