Skip to main content


Log in

Survival and quality of life of patients requiring acute renal replacement therapy

  • Original
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript



To assess long-term survival and health-related quality of life in patients with acute renal failure.

Design and setting

Cross-sectional cohort study in the ten-bed medical-surgical intensive care unit and the three-bed acute dialysis unit in a tertiary care hospital.


703 patients receiving renal replacement therapy for acute renal failure during 1998–2002.

Measurements and results

The mortality rate was 41% at 28 days, 57% at 1 year, and 70% at 5 years. SOFA score, age, and continuous renal replacement therapy were independent predictors of 1-year mortality. The median follow-up time was 3.9 years for mortality and 2.4 years for health-related quality of life. Of the 229 survivors in 2003, 153 (67%) responded to the health-related quality of life questionnaire. Health-related quality of life was evaluated with the EuroQol (EQ-5D) instrument including a visual analogue scale (VAS) score to evaluate the patient’s perceived health. The EQ-5D score was significantly lower in the study population than in the age- and gender-matched Finnish population (0.68 vs. 0.86). Median VAS scores were 69.5 and 70.0, respectively. Patients’ age and duration of follow-up had no significant effect on EQ-5D or VAS scores. Mortality and EQ-5D data were used to calculate quality-adjusted life years. Quality-adjusted survival was poor (15 quality-adjusted life years per 100 patients in the first year of follow-up).


The long-term survival of patients with acute renal failure is poor. Although survivors have a low health-related quality of life, they are as satisfied with their health as the general population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Ridley SA, Chrispin PS, Scotton H, Rogers J, Lloyd D (1997) Changes in quality of life after intensive care: comparison with normal data. Anaesthesia 52:195–202

    CAS  PubMed  Google Scholar 

  2. Hurel D, Loirat P, Saulnier F, Nicolas F, Brivet F (1997) Quality of life 6 months after intensive care: results of a prospective multicenter study using a generic health status scale and satisfaction scale. Intensive Care Med 23:331–337

    CAS  PubMed  Google Scholar 

  3. Kaarlola A, Pettilä V, Kekki P (2004) Quality of life six years after intensive care. Intensive Care Med 29:1294–1299

    Google Scholar 

  4. Niskanen M, Kari A, Halonen P (1996) Five-year survival after intensive care—comparison of 12:180 patients with the general population. Crit Care Med 24:1962–1967

    CAS  PubMed  Google Scholar 

  5. Guyatt GH, Feeny DH, Patrick DL (1993) Measuring health-related quality of life. Ann Intern Med 118:622–629

    CAS  PubMed  Google Scholar 

  6. Angus DC, Carlet J on behalf of the 2002 Brussels Roundtable Participants (2003) Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensive Care Med 29:368–377

    PubMed  Google Scholar 

  7. Wu A, Gao F (2004) Long-term outcomes in survivors from critical illness. Anaesthesia 59:1049–1052

    CAS  PubMed  Google Scholar 

  8. Tian ZM, Miranda DR (1995) Quality of life after intensive care with the sickness impact profile. Intensive Care Med 21:422–428

    CAS  PubMed  Google Scholar 

  9. Granja C, Teixeira-Pinto A, Costa-Pereira A (2002) Quality of life after intensive care-evaluation with EQ-5D questionnaire. Intensive Care Med 28:898–907

    PubMed  Google Scholar 

  10. Konopaid E, Noseworthy T, Johnston R, Shustack A, Grace M (1995) Quality of life measures before and one year after admission to an intensive care unit. Crit Care Med 23:1653–1659

    PubMed  Google Scholar 

  11. Badia X, Diaz-Prieto A, Gorriz MT, Herdman M, Torrado H, Farrero E, Cavanilles JM (2001) Using the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med 27:1901–1907

    CAS  PubMed  Google Scholar 

  12. Diaz-Pricto A, Gorriz MT, Badia X, Torrado H, Farrero F, Amador J, Abos R (1998) Proxy-perceived prior heath status and hospital outcome among the critically ill: is there any relationship? Intensive Care Med 24:691–698

    PubMed  Google Scholar 

  13. Brivet FG, Kleinknecht DJ, Loirat P, Landais PJ (1996) Acute renal failure in intensive care units-Causes, outcome, and prognostic factors of hospital mortality: a prospective, multicenter study. Crit Care Med 24:192–198

    CAS  PubMed  Google Scholar 

  14. Groeneveld AB, Tran DD, van der Meulen J, Nauta JJ, Thijs LG (1991) Acute renal failure in the medical intensive care unit: predisposing, complicating factors and outcome. Nephron 59:602–610

    CAS  PubMed  Google Scholar 

  15. De Mendonca A, Vincent JL, Suter PM, Moreno R, Dearden NM, Antonelli M, Takala J, Sprung C, Cantraine F (2000) Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score. Intensive Care Med 26:915–921

    PubMed  Google Scholar 

  16. Schwilk B, Wiedeck H, Stein B, Reinelt H, Treiber H, Bothner U (1997) Epidemiology of acute renal failure and outcome of haemodiafiltration in intensive care. Intensive Care Med 23:1204–1211

    CAS  PubMed  Google Scholar 

  17. Liano F, Junco E, Pascaual J, Madero R, Verde E (1998) The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group. Kidney Int 66:S16–S24

    CAS  Google Scholar 

  18. Levy E, Viscoli CM, Horwitz RI (1996) The effect of acute renal failure on mortality: a cohort analysis. JAMA 275:1480–1494

    Google Scholar 

  19. Metnitz PG, Krenn CG, Steltzer H, Lang T, Ploder J, Lenz K, Le Gall J-R, Drumi W (2002) Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med 30:2051–2058

    PubMed  Google Scholar 

  20. Gopal I, Bhonagiri S, Ronco C, Bellomo R (1997) Out of hospital outcome and quality of life in survivors of combined acute multiple organ and renal failure treated with continuous venovenous hemofiltration / hemodiafiltration. Intensive Care Med 23:766–772

    CAS  PubMed  Google Scholar 

  21. Korkeila M, Ruokonen E, Takala J (2000) Costs of care, long-term prognosis and quality of life in patients requiring renal replacement therapy during intensive care. Intensive Care Med 26:1824–1831

    CAS  PubMed  Google Scholar 

  22. Morgera S, Kraft AK, Siebert G, Luft FC, Neumayer HH (2002) Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapy. Am J Kidney Dis 40:275–279

    PubMed  Google Scholar 

  23. Maynard SE, Whittle J, Chelluri L, Arnold R (2003) Quality of life and dialysis decisions in critically ill patients with acute renal failure. Intensive Care Med 29:1589–1593

    PubMed  Google Scholar 

  24. Åhlström A, Tallgren M, Peltonen S, Räsänen P, Pettilä V (2004) Long-term survival and health related quality of life of patients with acute renal failure. Crit Care Med 32S:A75

  25. Brooks R, with the EuroQol Group (1996) EuroQol: the current state of play. Health Policy 37:53–72

    CAS  PubMed  Google Scholar 

  26. Angus D, Musthafa A, Clermont G, Griffin M, Linde-Zwirble W, Dremsizov T, Pinsky M (2001) Quality-adjusted survival in the first years after the acute respiratory distress syndrome. Am J Respir Crit Care Med 163:1389–1394

    CAS  PubMed  Google Scholar 

  27. Hemel MB, Phillips RS, Davis RB, Desbiens N, Connors AF, Teno JM, Wnger N, Lynn J, Wu AW, Fulkerson W, Tsevat J (1997) Outcomes and cost-effectiveness of initiating dialysis and continuing aggressive care in seriously ill hospitalized adults. Ann Intern Med 127:195–202

    PubMed  Google Scholar 

  28. Sznajder M, Aegerter P, Launois R, Merliere Y, Guidet B (2001) A cost-effectiveness analysis of stays in intensive care units. Intensive Care Med 27:146–153

    CAS  PubMed  Google Scholar 

Download references


We thank prof. Seppo Sarna for his help in the statistical analysis. The work was performed in the Intensive Care Unit of Meilahti Hospital, Helsinki University Central Hospital, which provided support for the research. This study was presented at the 34th Critical Care Congress of the Society of Critical Care Medicine in 2005 and published as an abstract in Critical Care Medicine.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Annika Åhlström.

Additional information

This article refers to the editorial available at

Rights and permissions

Reprints and permissions

About this article

Cite this article

Åhlström, A., Tallgren, M., Peltonen, S. et al. Survival and quality of life of patients requiring acute renal replacement therapy. Intensive Care Med 31, 1222–1228 (2005).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: