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Risk Factors of Rimes-Stigare et al for End-Stage Renal Disease (ESRD) in a Patient Who Has Been Critically Ill

Description

Rimes-Stigare et al identified risk factors for end-stage renal disease (ESRD) developing in a patient who has been critically ill. These can help to identify a patient who may benefit from more aggressive management. The authors are from Karolinska Institute and Karolinska University Hospital in Stockholm, Sweden.


 

Patient selection: adult admitted to intensive care unit (ICU)

 

Parameters from multivariate logistic regression:

(1) congestive heart failure

(2) serum potassium concentration on admission to the ICU in mmol/L

(3) kidney status during ICU stay

 

Parameter

Finding

Hazard Ratio

congestive heart failure

absent

1

 

present

0.091

serum potassium on admission

<= 4.59

1

 

>= 4.60

4.6

kidney status

normal

1

 

acute kidney injury (AKI)

30.4

 

chronic kidney disease

265.7

 

acute on chronic kidney disease

356.6

 

cumulative product of hazard ratios =

= PRODUCT(hazard ratios for the 3 parameters)

 

Interpretation:

• minimum cumulative product: 0.09

• maximum cumulative product: 1,640

 

The authors recommend that any patient with chronic kidney disease who survives the ICU should be evaluated by a nephrologist.

 


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