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NDT Advance Access published online on December 14, 2004

Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh581
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Nephrol Dial Transplant © ERA-EDTA 2004; all rights reserved
Received March 23, 2004
Accepted August 11, 2004


Original Articles

Optimal follow-up time after Continuous renal replacement therapy in actual renal failure patients stratified with the RIFLE criteria

Max Bell 1*, Eva Liljestam 1, Fredrik Granath 2, Jessica Fryckstedt 3, Anders Ekbom 2, and Claes-Roland Martling 1

1 Department of Anaesthesiology and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
2 Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital, Stockholm, Sweden
3 Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden

* To whom correspondence should be addressed.
Max Bell, E-mail: max.bell{at} karolinska.se



  Abstract

Background. We wished to determine the optimal duration of follow-up for patients with acute renal failure (ARF) treated with continuous renal replacement therapy (CRRT) and tested the hypothesis that a 6 month follow-up would be the minimum to catch most of the mortalities. In addition, we evaluated the association between mortality and the RIFLE classification in the same patients.

Methods. We analysed the data of 8152 consecutive patients who had been admitted to the intensive care unit (ICU) of a Swedish university hospital between 1995 and 2001. Of that population, 207 patients were treated with CRRT, excluding 16 treated for non-renal indications.

Results. ICU mortality in this cohort was 34.8% and 30 day and in-hospital mortalities were 45.9% and 50.2%, respectively. The cohort's all-cause mortality 6 months after inclusion was 59.9%, but 54.6% died as early as after 60 days. Patients in the more severe RIFLE category, F (failure), had a 30 day mortality of 57.9% compared with 23.5% for those in the RIFLE-R (risk) category and 22.0% for RIFLE-I (injury) patients.

Conclusions. In our opinion, a 60 day follow-up is sufficient to catch the majority of deaths in ARF patients treated with CRRT. The patients in the RIFLE-F category had a significantly higher mortality than RIFLE-R and -I patients.

Keywords: acute renal failure; diagnostic criteria; long-term patient survival; outcome; renal replacement therapy.
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