Soum et al identified risk factors for chronic kidney disease after acute kidney injury (AKI) requiring renal replacement therapy (RRT) in the intensive care unit ICU (ICU). These factors can help to identify a patient who may require closer follow-up. The authors are from multiple institutions in France.
Patient selection: renal replacement therapy for acute kidney injury in the ICU
Chronic kidney disease (CKD) was staged from 1 to 5, with CKD defined as a GFR less than 60 mL per min per 1.73 sq meters (cutoff between Stage 2 and 3).
For some reasons there was lumping of Stage 1, 2 and 3 patients into 1 group. The combining of Stage 4 and 5 makes more sense.
Factors associated with severe chronic kidney disease:
(1) longer duration of renal replacement therapy (10 to 56 days in severe; 7 to 35 in no/mild)
(2) chronic kidney disease prior to AKI (Table 1, for CKD at 3 months)
(3) older age (range 62 to 76 years for severe and 48 to 66 for no or mild)
The SOFA score at initiation of renal replacement therapy was not a risk factor for severe CKD for up to 5 years after RRT (OR 0.82 to 0.88 for the various intervals). Data for SOFA on admission not provided.
