Korean Journal of Nephrology 2011;30(1):73-79.
Mortality Predictors in Patients Treated with Continuous Renal Replacement
Eun Jung Kim, Chul Ho Chung, Moo Yong Park, Soo Jeong Choi, Jin Kuk Kim and Seung Duk Hwang
Department of Internal Medicine, Soonchunhyang University, College of Medicine, Bucheon Hospital, Korea
원저 : 지속적 신대체 요법을 시행받은 급성 신부전증 환자들에서 사망률 예측인자에 대한 분석
김은정, 정철호, 박무용, 최수정, 김진국, 황승덕
순천향대학교 부천병원 신장내과
Abstract
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%. Conclusion: The SAPS 3 determined before starting CRRT could be a predictor of hospital mortality in patients with AKI.
Key Words: Renal replacement therapy, Mortality


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