Intensive Care Medicine

, Volume 34, Issue 1, pp 101–108 | Cite as

Risk factors of early redialysis after weaning from postoperative acute renal replacement therapy

  • Vin-Cent Wu
  • Wen-Je Ko
  • Hong-Wei Chang
  • Yung-Wei Chen
  • Yu-Feng Lin
  • Chih-Chung Shiao
  • Yung-Ming Chen
  • Yih-Sharng Chen
  • Pi-Ru Tsai
  • Fu-Chang Hu
  • Jann-Yuan Wang
  • Yen-Hung Lin
  • Kwan-Dun Wu
  • The National Taiwan University Surgical ICU Acute Renal Failure Study Group (NSARF)
Original

Abstract

Objective

The aim of this study was to identify risk factors for redialysis in postoperative patients with acute renal failure (ARF) who had previously been weaned from acute dialysis. Although recovery of renal function is anticipated in patients with ARF, no data have been reported on successful weaning from acute dialysis.

Design and setting

Retrospective observational case-control study in a 64-bed surgical ICU.

Patients and methods

Success in discontinuing dialysis was defined as cessation from dialysis for at least 30 days. A total of 304 postoperative patients who underwent acute renal replacement therapy in a surgical ICU between July 2002 and April 2005 were included. SOFA score biochemical data and renal function parameters were assessed on the day after the last session of renal replacement therapy, designated as day 0 (D0).

Results

We could wean 94 patients (30.9%) from acute dialysis for more than 5 days, and 64 of these (21.1%) were successfully weaned for at least 30 days. The independent predictors for resuming dialysis within 30 days were: (a) longer duration of dialysis (OR 1.06), (b) higher SOFA score on D0 (OR 1.44), (c) oliguria (urine output < 100cc/8 h; OR 4.17) on D1, and (d) age over 65 years (OR 6.35). The area under the ROC curve was 0.880. Two-way analysis of variance with repeated measurements over time showed a larger decline in SOFA score and an increase in urine output in patients with successful cessation of dialysis. Kaplan–Meier analysis showed a significant difference in early resumption of dialysis between patients with or without oliguria at D0.

Conclusions

More than two-thirds of patients weaned from postoperative acute dialysis for more than 5 days were free of dialysis for at least 30 days. Less urine output, longer duration of dialysis, age over 65 years, and higher disease severity score are predictive of a patient's redialysis after initial weaning from acute dialysis.

Keywords

Acute renal failure Renal replacement therapy Redialysis Sequential Organ Failure Assessment Urine output Dialysis duration 

Supplementary material

134_2007_813_MOESM1_ESM.doc (109 kb)
Electronic Supplementary Material (DOC 109K)

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Vin-Cent Wu
    • 1
  • Wen-Je Ko
    • 2
  • Hong-Wei Chang
    • 1
  • Yung-Wei Chen
    • 2
  • Yu-Feng Lin
    • 1
  • Chih-Chung Shiao
    • 4
  • Yung-Ming Chen
    • 1
  • Yih-Sharng Chen
    • 2
  • Pi-Ru Tsai
    • 2
  • Fu-Chang Hu
    • 3
  • Jann-Yuan Wang
    • 1
  • Yen-Hung Lin
    • 1
  • Kwan-Dun Wu
    • 1
  • The National Taiwan University Surgical ICU Acute Renal Failure Study Group (NSARF)
    • 1
  1. 1.Department of Internal MedicineNational Taiwan University HospitalTaipeiTaiwan
  2. 2.Department of SurgeryNational Taiwan UniversityTaipeiTaiwan
  3. 3.College of Public HealthNational Taiwan UniversityTaipeiTaiwan
  4. 4.St. Mary’s Hospital 5Lo TungTaiwan

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