Outcomes for dialysis patients with end‐stage renal failure admitted to an intensive care unit or high dependency unit

Abstract

To assess the outcomes for chronic dialysis patients requiring admission to an intensive care unit (ICU) or high dependency unit (HDU). Retrospective audit of prospectively collected data from local and national databases. The ICU and HDU at a tertiary referral hospital. 70 chronic dialysis patients admitted between 2001 and 2006. Unit and hospital mortality, recurrent admission patterns and median survival after discharge from hospital. For patients' last admissions, mortality in the ICU or HDU was 17% and in hospital was 29%. The 12 deaths in the ICU or HDU occurred a median of 18 hours (range, 3-203 hours) after admission, reflecting the severity of their underlying illness. The independent predictors of death in hospital were age and the number of non-renal organ systems failing. Patients with pulmonary oedema had a lower risk of death than patients admitted for other reasons. Although 21 patients accounted for 55 of 104 admissions (53%), recurrent admissions to the ICU or HDU generally occurred during different hospital admissions. They were not associated with a higher risk of death in hospital. Patients discharged home had a median survival of 2.25 years, and a median survival of 3.5 years from starting dialysis. The median survival for patients on dialysis in Australia in general is 4.5 years (Australia and New Zealand Dialysis and Transplant Registry). Dialysis patients discharged home after an ICU or HDU admission have survival similar to that of Australian dialysis patients generally.