Abstract
Hutchison and colleagues report a 10-year experience of dialysis patients admitted to intensive care units (ICUs) in the UK excluding Scotland. Their study is the largest published so far and raises issues of interest to both ICU physicians and nephrologists. Overall, the dialysis patients, although sicker on admission and having pre-existing co-morbidities, do as well as other ICU patients. Their clinical progress after leaving the ICU, however, is less good than for other ICU patients, raising the possibility that the patients might be leaving too early, or perhaps that dialysis patients should be discharged to a high-dependency unit rather than go direct to a renal ward. All in all, the paper by Hutchison and colleagues provides a useful foundation for planning the critical care management of dialysis patients in the UK and elsewhere.
Highlights
Improvements in the provision of facilities for dialysis and rising patients’ expectations are likely to lead to a rise in the number of critically ill dialysis patients presenting to intensive care units (ICUs)
Hutchinson and colleagues examined a cohort of 3,420 dialysis patients out of a total of 276,731 ICU admissions between 1995 and 2004
Any future study of critically ill dialysis patients in hospital must include those admitted to coronary care units and high-dependency units (HDUs)
Summary
Improvements in the provision of facilities for dialysis and rising patients’ expectations are likely to lead to a rise in the number of critically ill dialysis patients presenting to intensive care units (ICUs). The study of Hutchison and colleagues [1] in the previous issue of Critical Care reports data from 170 ICUs in England, Wales and Northern Ireland over the period 1995 to 2004. Cardiovascular and infective conditions are the major cause of admission to hospital, and dialysis patients often present critically ill because of associated co-morbidities.
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