The prognostic evaluation for postoperative acute kidney injury (AKI) patients admitted to intensive care unit and renal replacement therapy (RRT)

Abstract

Background: Minimum changes in serum creatinine (SCr) concentration affect the prognosis of patients with acute kidney injury (AKI). AKI backgrounds vary widely, therefore , all cases cannot be compared from the same perspective. Postoperative patients with AKI admitted to the intensive care unit (ICU) were examined. Materials and Methods：Twenty-seven patients diagnosed with AKI were admitted to our ICU from January to August in 2009. These patients were divided into group R, in which the patients underwent renal replacement therapy (RRT), and group NR, in which did not. The duration of ICU stay, mechanical ventilation, sequential organ failure assessment(SOFA)scores, and postoperative death within 1 year (PDWY) were further divided into groups A and D based on whether there was PDWY. Postoperative SCr-concentrations, its increasing rate, and SOFA scores were compared between the 2 groups. Univariate regression analysis was conducted for the SOFA index and RRT to PDWY. Results: Group R showed higher SOFA scores, and a longer duration of ICU stay and mechanical ventilation. Postoperative SCr-concentration and SOFA scores at postoperative day 2 were higher in group D than in group A. Univariate regression analysis revealed that RRT to PDWY was statistically significant with odds ratio of 7.5; however, the SOFA index to PDWY was not significant. Discussion: Because the SOFA score was not sufficiently useful to predict PDWY, long-term prognosis, an early detectable marker for AKI is necessary for the early intervention of patients with AKI and multiple organ dysfunction syndrome (MODS).