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KMID : 0359920110300010073
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Korean Journal of Nephrology
2011 Volume.30 No. 1 p.73 ~ p.79
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Mortality Predictors in Patients Treated with Continuous Renal Replacement
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Kim Eun-Jung
Chung Chul-Ho
Park Moo-Yong
Choi Soo-Jeong
Kim Jin-Kuk
Hwang Seung-Duk
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Abstract
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Purpose: Acute kidney injury (AKI) is a frequent condition with a high mortality rate that requires continuous renal replacement therapy (CRRT). We evaluated the Simplified Acute Physiology Score 3 (SAPS 3) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score, determined at the start of CRRT, for predicting mortality in AKI.
Methods: We retrospectively analyzed the demographic, clinical, and laboratory data of 89 patients with AKI or acute-on-chronic kidney disease who received CRRT between September 2006 and September 2009. We calculated the SAPS 3 and APACHE II score at the start of CRRT.
Results: The average age of the 89 patients was 64.4±13.9 (17-92) years. Fifty-nine (66.3%) were male. Eighteen (20.2%) patients had chronic kidney disease and 30 (33.7%) had diabetes. The overall mortality was 75.3%. The average SAPS 3 was 89.4±14.9 and the average APACHE II score was 28.4±5.2. The SAPS 3 was higher in non-survivors than survivors (p=0.038). Infection was more common in non-survivors (p=0.036). There were no significant differences between the two groups for other conditions. The variables influencing mortality on univariate analysis were SAPS 3 and presence of infection. The area under the receiver-operating characteristic curve for SAPS 3 was 0.69 (95% CI. 0.54-0.83). At a SAPS 3 of 84, the sensitivity for predicting mortality was 71.6% and the specificity was 69.2%.
Conslusion: The SAPS 3 determined before starting CRRT could be a predictor of hospital mortality in patients with AKI.
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KEYWORD
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Renal replacement therapy, Mortality
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