Long-term outcomes after severe acute kidney injury in critically ill patients: the SALTO study

Long-term outcomes after severe acute kidney injury in critically ill patients: the SALTO study

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Abstract Background The extent of the consequences of an episode of severe acute kidney injury (AKI) on long-term outcome of critically ill patients remain debated.We conducted a prospective follow-up of patients included in a large multicenter clinical trial of renal replacement therapy (RRT) initiation strategy during severe AKI (the Artificial Kidney Initiation in Kidney Injury, AKIKI) to investigate long-term survival, renal outcome and health related quality of life (HRQOL).We also assessed the influence of RRT initiation strategy on these outcomes.Results Follow-up of patients extended from 60 days to laguna 3hp dust collector a median of 3.35 years [interquartile range (IQR), 1.

89 to 4.09] after the end of initial study.Of the 619 patients included in the AKIKI trial, 316 survived after 60 days.The overall survival rate at 3 years from inclusion was 39.4% (95% CI 35.

4 to 43.4).A total of 46 patients (on the 175 with available data on long-term kidney function) experienced worsening of renal function (WRF) at the time of follow-up [overall incidence of 26%, cumulative incidence at 4 years: 20.6% (CI 95% 13.0 to 28.

3)].Fifteen patients required chronic dialysis (5% of patients who survived after day 90).Among the 226 long-term survivors, 80 (35%) answered the EQ-5D questionnaire.The median index value reported was 0.67 (IQR 0.

40 to 1.00) indicating a noticeable alteration of quality of life.Initiation strategy for RRT had no effect on any long-term outcome.Conclusion ivoryjinelle.com Severe AKI in critically ill patients was associated with a high proportion of death within the first 2 months but less so during long-term follow-up.A quarter of long-term survivors experienced a WRF and suffered from a noticeable impairment of quality of life.

Renal replacement therapy initiation strategy was not associated with mortality outcome.Graphical Abstract.