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https://ahro.austin.org.au/austinjspui/handle/1/11334
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DC Field | Value | Language |
---|---|---|
dc.contributor.author | Schneider, Antoine G | en |
dc.contributor.author | Uchino, Shigehiko | en |
dc.contributor.author | Bellomo, Rinaldo | en |
dc.date.accessioned | 2015-05-16T00:55:26Z | |
dc.date.available | 2015-05-16T00:55:26Z | |
dc.date.issued | 2011-09-08 | en |
dc.identifier.citation | Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association 2011; 27(3): 947-52 | en |
dc.identifier.govdoc | 21908413 | en |
dc.identifier.other | PUBMED | en |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/11334 | en |
dc.description.abstract | Only a proportion of critically ill patients with severe [RIFLE (Risk, Injury, Failure, Loss, End-stage renal disease) criteria, class-F] acute kidney injury (AKI) appear to receive renal replacement therapy (RRT). The aim of this study was to study the characteristics and outcome of patients with severe (RIFLE-F) AKI who did not receive RRT.We identified all consecutive patients admitted to our institution that developed RIFLE-F AKI by creatinine criteria over a 3-year period and did not receive RRT, and compared their characteristics and outcomes with those of RIFLE-F RRT-treated patients.Within the study period, 20,126 patients were admitted to our institution for >24 h. Among them, 2949 were admitted to the intensive care unit (ICU) and 195 developed RIFLE-F AKI. Of these, 90 received RRT (RRT patients) and 105 did not (no-RRT patients). Compared with RRT patients, no-RRT patients were similar in terms of age, gender and ward of origin. However, they had a shorter median ICU stay (2.7 versus 7.9 days; P < 0.001), required less mechanical ventilation (56.2 versus 70%; P < 0.05) and had a lower mean Acute Physiology and Chronic Health Evaluation III score (82.7 versus 86.7; P < 0.05). The two main reasons these patients did not receive RRT were limitations of medical therapy (LOMT) orders in 41 (39%) cases and expected renal functional improvement in 59 (56.2%). Mortality in no-RRT patients was 58.1% compared with 55.5% in the RRT group (P = 0.72). After exclusion of LOMT patients, the mortality of the no-RRT group, although lower than that of the RRT group, remained high (30.5 versus 55%; P < 0.001). Most of these deaths occurred after ICU discharge and appeared secondary to underlying chronic diseases or recurrence of the initial insult.After exclusion of LOMT patients, about a third of critically ill patients with severe (RIFLE-F) AKI did not receive RRT. A third of these patients died in hospital. The timing of the deaths and their underlying causes do not suggest that a broader application of RRT would have changed patient outcomes. | en |
dc.language.iso | en | en |
dc.subject.other | Acute Kidney Injury.mortality.therapy | en |
dc.subject.other | Aged | en |
dc.subject.other | Critical Illness.mortality | en |
dc.subject.other | Female | en |
dc.subject.other | Humans | en |
dc.subject.other | Intensive Care Units.statistics & numerical data | en |
dc.subject.other | Male | en |
dc.subject.other | Renal Replacement Therapy.mortality | en |
dc.subject.other | Retrospective Studies | en |
dc.subject.other | Survival Rate | en |
dc.subject.other | Treatment Outcome | en |
dc.title | Severe acute kidney injury not treated with renal replacement therapy: characteristics and outcome. | en |
dc.type | Journal Article | en |
dc.identifier.journaltitle | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association | en |
dc.identifier.affiliation | Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia | en |
dc.identifier.doi | 10.1093/ndt/gfr501 | en |
dc.description.pages | 947-52 | en |
dc.relation.url | https://pubmed.ncbi.nlm.nih.gov/21908413 | en |
dc.type.austin | Journal Article | en |
local.name.researcher | Bellomo, Rinaldo | |
item.cerifentitytype | Publications | - |
item.languageiso639-1 | en | - |
item.grantfulltext | none | - |
item.openairetype | Journal Article | - |
item.fulltext | No Fulltext | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
crisitem.author.dept | Intensive Care | - |
crisitem.author.dept | Data Analytics Research and Evaluation (DARE) Centre | - |
Appears in Collections: | Journal articles |
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