Six-month outcome in acute kidney injury requiring renal replacement therapy in the ICU: a multicentre prospective study

Intensive Care Med. 2009 Nov;35(11):1907-15. doi: 10.1007/s00134-009-1588-z. Epub 2009 Aug 20.

Abstract

Objective: To assess quality of life (QOL), mortality rate and renal function 6 months after onset of renal replacement therapy (RRT) for acute kidney injury (AKI) in the ICU.

Participants and setting: This prospective observational study was conducted in seven ICUs in France over 9 months. Inclusion criteria were: age > or =18 years, RRT delivered for AKI and informed consent signed. AKI was defined from the RIFLE score. Recipients of kidney grafts or patients undergoing chronic RRT were not included.

Measurements and results: QOL was assessed using the Short Form Health Survey (SF-36) questionnaire together with the Index of Activities of Daily Living (ADL) (0: full assistance to 6: no assistance). SF-36 was compared to a reference age- and sex-matched French population. Patient status, place of residence, and persistence of RRT, ADL and SF-36 were assessed at 28 days, 3 months and 6 months from inclusion. In the study period, 205 patients were included and 1 withdrew. At 6 months, 77/204 were alive (mortality 62%). SF-36 and ADL significantly increased from day 28 to 6 months. In the survivors at 6 months, SF-36 items were significantly lower than in the reference population, with the physical items more severely affected than the mental items; 64% were fully autonomous (ADL score = 6); 69% were living in their homes, and 12% were still undergoing RRT; 94% would agree to undergo the same management again.

Conclusions: ICU survivors from RRT for AKI have an impaired QOL at 6 months, but sustained autonomy in their daily lives.

MeSH terms

  • Activities of Daily Living / psychology
  • Acute Kidney Injury* / mortality
  • Acute Kidney Injury* / psychology
  • Acute Kidney Injury* / therapy
  • Aged
  • Analysis of Variance
  • Comorbidity
  • Critical Care / methods
  • Critical Care / statistics & numerical data
  • Female
  • France / epidemiology
  • Health Status
  • Health Surveys
  • Humans
  • Length of Stay / statistics & numerical data
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life* / psychology
  • Renal Replacement Therapy* / methods
  • Renal Replacement Therapy* / statistics & numerical data
  • Surveys and Questionnaires
  • Survival Rate
  • Treatment Outcome