112 OUTCOMES OF RENAL REPLACEMENT THERAPY IN INTENSIVE CARE UNITS IN THAILAND

Abstract

Category: Epidemiology and Outcomes from AKI Presenter: Dr SADUDEE PEERAPORNRATANA Keywords: renal replacement therapy, acute kidney injury, intensive care unit, Thailand, outcome Severe acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a common complication in intensive care unit (ICU) patients and associated with high mortality and other bad outcomes. However, the epidemiologic data and outcome of RRT in ICU in Southeast Asia region including Thailand are still lacking. The objectives of this study is to determine the epidemiology and outcomes of RRT in ICU in Thailand. This is the analysis from a prospective cohort study (SEA-AKI study). Data was collected from nine ICUs in secondary and tertiary care centers across Thailand from January 2014 to June 2015. The patients with end-stage renal disease were excluded from analysis. A total of 2,646 patients were admitted in ICUs, 53.3% (1,345 patients) had AKI. About 19.4% of AKI patients (262 patients) undergone RRT. The median time form ICU admission to RRT initiation was 2 days. The median RRT duration was 3 days. Intermittent HD and CRRT were the two most common RRT modalities used in ICU. The mortality in ICU was significant higher in patients undergone RRT compared to patient with no RRT (46.9% vs 31.4%, p <0.001). The in-hospital mortality was also higher in patients undergone RRT significantly (61.0% vs 40.7%, p <0.001). The median length of stay in ICU and hospital were significant longer in AKI patients who needed RRT (7 days vs 5 days, p <0.001; and 19 days vs 13 days, p <0.001; respectively). The ventilator days in patients who needed RRT were significant longer (7 days vs 4 days, p <0.001). Factors associated with RRT in ICU from multivariable analysis were underlying diabetes (OR 1.67, 95% CI 1.08-2.58), SOFA (OR 1.18, 95% CI 1.10-1.28) and serum creatinine (OR 1.15, 95% CI 1.07-1.24) on the day of ICU admission. RRT in ICU associated with high morbidity and mortality. Factors associated with RRT in ICU from multivariable analysis were underlying diabetes, SOFA score and serum creatinine on the day of ICU admission.