Clinical and Renal Function Determinants of Successful Renal Replacement Therapy Discontinuation in Acute Kidney Injury

Abstract

Kidney dysfunction is a significant clinical condition which can lead to serious renal impairment, dialysis or renal replacement therapy. The purpose of this study was to assess the clinical, renal-function, and dialysis-related factors; and to determine factors associated with dialysis requirement and renal dysfunction in kidney disease patients. A quantitative, retrospective, secondary data, analytical design was used with a combined dataset of 4,304 records from two cohorts related to kidney disease. Descriptive statistics, independent-samples t-tests, chi-square tests, Pearson correlation analysis, and binary logistic regression (when appropriate) were used for the demographic, clinical, renal-function and dialysis-related variables. The clinical cohort of dialysis patients had significant renal dysfunction with high levels of serum creatinine and urea, low levels of urine output, and a significant number of severe disease patients. Within the kidney-risk group, 31 patients started dialysis and 2,273 did not. Patients who required dialysis had significantly lower GFR than patients who did not require dialysis (8.33 ± 3.31 vs. 69.78 ± 23.78, p < 0.001). The other factors that were significant were the presence of chronic kidney disease (p < 0.001) and dialysis (p < 0.001), but not age, creatinine, BUN, urine output, diabetes, or hypertension. The results show that GFR was the best renal-function predictor for dialysis. Longitudinal studies with outcomes specific to AKI and with RRT-discontinuation outcomes are warranted.