Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

Long-term survival and dialysis dependency following acute kidney injury in intensive care: extended follow-up of a randomized controlled trial

Gallagher, Martin, Cass, Alan, Bellomo, Rinaldo, Finfer, Simon, Gattas, David, Lee, Joanne, Lo, Serigne, McGuinness, Shay, Myburgh, John, Parke, Rachael and Rajbhandari, Dorrilyn (2014). Long-term survival and dialysis dependency following acute kidney injury in intensive care: extended follow-up of a randomized controlled trial. PLoS Medicine,11(2 - Article No. e1001601).

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 52
Google Scholar Search Google Scholar
Attached Files (Some files may be inaccessible until you login with your CDU eSpace credentials)
Name Description MIMEType Size Downloads
Download this reading Cass_49087.pdf Published version application/pdf 644.56KB 27
Reading the attached file works best in Firefox, Chrome and IE 9 or later.

IRMA ID 11035xPUB44
NHMRC Grant No. 63281
Title Long-term survival and dialysis dependency following acute kidney injury in intensive care: extended follow-up of a randomized controlled trial
Author Gallagher, Martin
Cass, Alan
Bellomo, Rinaldo
Finfer, Simon
Gattas, David
Lee, Joanne
Lo, Serigne
McGuinness, Shay
Myburgh, John
Parke, Rachael
Rajbhandari, Dorrilyn
Journal Name PLoS Medicine
Publication Date 2014
Volume Number 11
Issue Number 2 - Article No. e1001601
ISSN 1549-1676   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84895469553
Total Pages 13
Place of Publication United States of America
Publisher Public Library of Science
HERDC Category C1 - Journal Article (DIISR)
Abstract Background: The incidence of acute kidney injury (AKI) is increasing globally and it is much more common than end-stage kidney disease. AKI is associated with high mortality and cost of hospitalisation. Studies of treatments to reduce this high mortality have used differing renal replacement therapy (RRT) modalities and have not shown improvement in the short term. The reported long-term outcomes of AKI are variable and the effect of differing RRT modalities upon them is not clear. We used the prolonged follow-up of a large clinical trial to prospectively examine the long-term outcomes and effect of RRT dosing in patients with AKI.

Methods and Findings:
We extended the follow-up of participants in the Randomised Evaluation of Normal vs. Augmented Levels of RRT (RENAL) study from 90 days to 4 years after randomization. Primary and secondary outcomes were mortality and requirement for maintenance dialysis, respectively, assessed in 1,464 (97%) patients at a median of 43.9 months (interquartile range [IQR] 30.0–48.6 months) post randomization. A total of 468/743 (63%) and 444/721 (62%) patients died in the lower and higher intensity groups, respectively (risk ratio [RR] 1.04, 95% CI 0.96–1.12, p = 0.49). Amongst survivors to day 90, 21 of 411 (5.1%) and 23 of 399 (5.8%) in the respective groups were treated with maintenance dialysis (RR 1.12, 95% CI 0.63–2.00, p = 0.69). The prevalence of albuminuria among survivors was 40% and 44%, respectively (p = 0.48). Quality of life was not different between the two treatment groups. The generalizability of these findings to other populations with AKI requires further exploration.

Conclusions:
Patients with AKI requiring RRT in intensive care have high long-term mortality but few require maintenance dialysis. Long-term survivors have a heavy burden of proteinuria. Increased intensity of RRT does not reduce mortality or subsequent treatment with dialysis.
DOI http://dx.doi.org/10.1371/journal.pmed.1001601   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


© copyright

Every reasonable effort has been made to ensure that permission has been obtained for items included in CDU eSpace. If you believe that your rights have been infringed by this repository, please contact digitisation@cdu.edu.au.

 
Versions
Version Filter Type
Access Statistics: 25 Abstract Views, 27 File Downloads  -  Detailed Statistics
Created: Wed, 19 Aug 2015, 12:08:59 CST