Long-term outcomes after severe acute kidney injury in critically ill patients: the SALTO study.
| Title: | Long-term outcomes after severe acute kidney injury in critically ill patients: the SALTO study. |
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| Authors: | Chaïbi K; Service de Réanimation Médico-Chirurgicale, AP-HP, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France.; UMR_S1155, French National Institute of Health and Medical Research (INSERM), CORAKID, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Ehooman F; UMR_S1155, French National Institute of Health and Medical Research (INSERM), CORAKID, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service Anesthésie Réanimation Hôpital Privé Claude Gallien, Quincy-Sous-Sénart, France.; Pons B; Service de Réanimation, CHU de Pointe à Pitre-Abymes, CHU de la Guadeloupe, France.; Martin-Lefevre L; Réanimation médico-chirurgicale, CHG, La Roche-sur-Yon, France.; Boulet E; Réanimation polyvalente, CH René Dubos, Pontoise, France.; Boyer A; Réanimation médicale CHU Bordeaux, Hôpital Pellegrin, Bordeaux, France.; Chevrel G; Service de réanimation, Centre Hospitalier Sud Francilien, Corbeil Essonne, France.; Lerolle N; Département de réanimation médicale et médecine hyperbare, CHU Angers, Universitéd'Angers, Angers, France.; Carpentier D; Réanimation médicale, CHU Rouen, Rouen, France.; de Prost N; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, DHU A-TVB, Service de réanimation médicale, Créteil, France.; CARMAS research group and UPEC-Université Paris-Est Créteil Val de Marne, Créteil, France.; Lautrette A; Réanimation médicale, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont- Ferrand, France.; Bretagnol A; Réanimation médico-chirurgicale, Hôpital de La Source, Centre Hospitalier Régional d'Orléans, BP 6709, 45067, Orléans Cedex, France.; Mayaux J; Service de Pneumologie et Réanimation Médicale, APHP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.; Nseir S; Centre de Réanimation, Faculté de Médecine, CHU de Lille, Université de Lille, 59000, Lille, France.; Megarbane B; Réanimation Médicale et Toxicologique, Hôpital Lariboisière, INSERM U1144, Université Paris-Diderot, Paris, France.; Thirion M; Réanimation polyvalente, CH Victor Dupouy, 95107, Argenteuil Cedex, France.; Forel JM; Service de réanimation des Détresses respiratoires aiguës et infections sévères, Hôpital Nord Marseille, Marseille, France.; Maizel J; Service de réanimation médicale INSERM U1088, Centre hospitalier universitaire de picardie, Amiens, France.; Yonis H; Réanimation médicale, Hôpital de la Croix Rousse, Lyon, France.; Markowicz P; Réanimation, CH, Cholet, France.; Thiery G; Réanimation médicale, CHU Saint Etienne, 42270, Saint Priest en Jarez, France.; Schortgen F; Centre Hospitalier Intercommunal, Service de Réanimation Polyvalente Adulte, Créteil, France.; Couchoud C; REIN registry, Agence de la biomédecine, Saint Denis La Plaine, France.; Dreyfuss D; UMR_S1155, French National Institute of Health and Medical Research (INSERM), CORAKID, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service de Médecine Intensive Réanimation, Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Paris, France.; Université Paris-Cité, Paris, France.; Gaudry S; Service de Réanimation Médico-Chirurgicale, AP-HP, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France. stephanegaudry@gmail.com.; UMR_S1155, French National Institute of Health and Medical Research (INSERM), CORAKID, Hôpital Tenon, Sorbonne Université, 75020, Paris, France. stephanegaudry@gmail.com. |
| Source: | Annals of intensive care [Ann Intensive Care] 2023 Mar 13; Vol. 13 (1), pp. 18. Date of Electronic Publication: 2023 Mar 13. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 101562873 Publication Model: Electronic Cited Medium: Print ISSN: 2110-5820 (Print) Linking ISSN: 21105820 NLM ISO Abbreviation: Ann Intensive Care Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Heidelberg : Springer-Verlag, 2011- |
| 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 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: 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.; (© 2023. The Author(s).) |
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| Contributed Indexing: | Keywords: Acute kidney injury; Long-term outcomes; Renal replacement therapy; Worsening renal failure |
| Entry Date(s): | Date Created: 20230313 Latest Revision: 20260329 |
| Update Code: | 20260329 |
| PubMed Central ID: | PMC10008759 |
| DOI: | 10.1186/s13613-023-01108-x |
| PMID: | 36907976 |
| Database: | MEDLINE |
Journal Article