Korean J Intern Med.  2016 Sep;31(5):930-937. 10.3904/kjim.2014.290.

Duration of anuria predicts recovery of renal function after acute kidney injury requiring continuous renal replacement therapy

• Jung HY
• Lee JH
• Park YJ
• Kim SU
• Lee KH
• Choi JY
• Park SH
• Kim CD
• Kim YL
• Cho JH

• KMID: 2350982
• DOI: http://doi.org/10.3904/kjim.2014.290

Abstract

BACKGROUND/AIMS
Little is known regarding the incidence rate of and factors associated with developing chronic kidney disease after continuous renal replacement therapy (CRRT) in acute kidney injury (AKI) patients. We investigated renal outcomes and the factors associated with incomplete renal recovery in AKI patients who received CRRT.
METHODS
Between January 2011 and November 2013, 408 patients received CRRT in our intensive care unit. Of them, patients who had normal renal function before AKI and were discharged without maintenance renal replacement therapy (RRT) were included in this study. We examined the incidence of incomplete renal recovery with an estimated glomerular filtration rate < 60 mL/min/1.73 m² and factors that increased the risk of incomplete renal recovery after AKI.
RESULTS
In total, 56 AKI patients were discharged without further RRT and were followed for a mean of 8 months. Incomplete recovery of renal function was observed in 20 of the patients (35.7%). Multivariate analysis revealed old age and long duration of anuria as independent risk factors for incomplete renal recovery (odds ratio [OR], 1.231; 95% confidence interval [CI], 1.041 to 1.457; p = 0.015 and OR, 1.064; 95% CI, 1.001 to 1.131; p = 0.047, respectively). In a receiver operating characteristic curve analysis, a cut-off anuria duration of 24 hours could predict incomplete renal recovery after AKI with a sensitivity of 85.0% and a specificity of 66.7%.
CONCLUSIONS
The renal outcome of severe AKI requiring CRRT was poor even in patients without further RRT. Long-term monitoring of renal function is needed, especially in severe AKI patients who are old and have a long duration of anuria.

Keyword

Acute kidney injury; Anuria; Chronic kidney disease; Continuous renal replacement therapy; Renal recovery

MeSH Terms

Acute Kidney Injury*
Anuria*
Glomerular Filtration Rate
Humans
Incidence
Intensive Care Units
Multivariate Analysis
Renal Insufficiency, Chronic
Renal Replacement Therapy*
Risk Factors
ROC Curve
Sensitivity and Specificity