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Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy : a matched cohort study

Sandra Oeyen (UGent) , Wouter De Corte (UGent) , Dominique Benoit (UGent) , Lieven Annemans (UGent) , Annemieke Dhondt (UGent) , Raymond Vanholder (UGent) , Johan Decruyenaere (UGent) and Eric Hoste (UGent)
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Abstract
Introduction: Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients and is associated with increased morbidity and mortality. We compared long-term outcome and quality of life (QOL) in ICU patients with AKI treated with renal replacement therapy (RRT) with matched non-AKI-RRT patients. Methods: Over 1 year, consecutive adult ICU patients were included in a prospective cohort study. AKI-RRT patients alive at 1 year and 4 years were matched with non-AKI-RRT survivors from the same cohort in a 1: 2 (1 year) and 1: 1 (4 years) ratio based on gender, age, Acute Physiology and Chronic Health Evaluation II score, and admission category. QOL was assessed by the EuroQoL-5D and the Short Form-36 survey before ICU admission and at 3 months, 1 and 4 years after ICU discharge. Results: Of 1953 patients, 121 (6.2 %) had AKI-RRT. AKI-RRT hospital survivors (44.6 %; N = 54) had a 1-year and 4-year survival rate of 87.0 % (N = 47) and 64.8 % (N = 35), respectively. Forty-seven 1-year AKI-RRT patients were matched with 94 1-year non-AKI-RRT patients. Of 35 4-year survivors, three refused further cooperation, three were lost to follow-up, and one had no control. Finally, 28 4-year AKI-RRT patients were matched with 28 non-AKI-RRT patients. During ICU stay, 1-year and 4-year AKI-RRT patients had more organ dysfunction compared to their respective matches (Sequential Organ Failure Assessment scores 7 versus 5, P < 0.001, and 7 versus 4, P < 0.001). Long-term QOL was, however, comparable between both groups but lower than in the general population. QOL decreased at 3 months, improved after 1 and 4 years but remained under baseline level. One and 4 years after ICU discharge, 19.1 % and 28.6 % of AKI-RRT survivors remained RRT-dependent, respectively, and 81.8 % and 71 % of them were willing to undergo ICU admission again if needed. Conclusion: In long-term critically ill AKI-RRT survivors, QOL was comparable to matched long-term critically ill non-AKI-RRT survivors, but lower than in the general population. The majority of AKI-RRT patients wanted to be readmitted to the ICU when needed, despite a higher severity of illness compared to matched non-AKI-RRT patients, and despite the fact that one quarter had persistent dialysis dependency.
Keywords
SURVIVORS, OUTCOMES, DIALYSIS, MORTALITY, FAILURE, INTENSIVE-CARE, DISEASE, QUESTIONNAIRE, MULTICENTER, VALIDITY

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MLA
Oeyen, Sandra, Wouter De Corte, Dominique Benoit, et al. “Long-term Quality of Life in Critically Ill Patients with Acute Kidney Injury Treated with Renal Replacement Therapy : a Matched Cohort Study.” CRITICAL CARE 19 (2015): n. pag. Print.
APA
Oeyen, S., De Corte, W., Benoit, D., Annemans, L., Dhondt, A., Vanholder, R., Decruyenaere, J., et al. (2015). Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy : a matched cohort study. CRITICAL CARE, 19.
Chicago author-date
Oeyen, Sandra, Wouter De Corte, Dominique Benoit, Lieven Annemans, Annemieke Dhondt, Raymond Vanholder, Johan Decruyenaere, and Eric Hoste. 2015. “Long-term Quality of Life in Critically Ill Patients with Acute Kidney Injury Treated with Renal Replacement Therapy : a Matched Cohort Study.” Critical Care 19.
Chicago author-date (all authors)
Oeyen, Sandra, Wouter De Corte, Dominique Benoit, Lieven Annemans, Annemieke Dhondt, Raymond Vanholder, Johan Decruyenaere, and Eric Hoste. 2015. “Long-term Quality of Life in Critically Ill Patients with Acute Kidney Injury Treated with Renal Replacement Therapy : a Matched Cohort Study.” Critical Care 19.
Vancouver
1.
Oeyen S, De Corte W, Benoit D, Annemans L, Dhondt A, Vanholder R, et al. Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy : a matched cohort study. CRITICAL CARE. 2015;19.
IEEE
[1]
S. Oeyen et al., “Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy : a matched cohort study,” CRITICAL CARE, vol. 19, 2015.
@article{6994986,
  abstract     = {Introduction: Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients and is associated with increased morbidity and mortality. We compared long-term outcome and quality of life (QOL) in ICU patients with AKI treated with renal replacement therapy (RRT) with matched non-AKI-RRT patients. 
Methods: Over 1 year, consecutive adult ICU patients were included in a prospective cohort study. AKI-RRT patients alive at 1 year and 4 years were matched with non-AKI-RRT survivors from the same cohort in a 1: 2 (1 year) and 1: 1 (4 years) ratio based on gender, age, Acute Physiology and Chronic Health Evaluation II score, and admission category. QOL was assessed by the EuroQoL-5D and the Short Form-36 survey before ICU admission and at 3 months, 1 and 4 years after ICU discharge. 
Results: Of 1953 patients, 121 (6.2 %) had AKI-RRT. AKI-RRT hospital survivors (44.6 %; N = 54) had a 1-year and 4-year survival rate of 87.0 % (N = 47) and 64.8 % (N = 35), respectively. Forty-seven 1-year AKI-RRT patients were matched with 94 1-year non-AKI-RRT patients. Of 35 4-year survivors, three refused further cooperation, three were lost to follow-up, and one had no control. Finally, 28 4-year AKI-RRT patients were matched with 28 non-AKI-RRT patients. During ICU stay, 1-year and 4-year AKI-RRT patients had more organ dysfunction compared to their respective matches (Sequential Organ Failure Assessment scores 7 versus 5, P < 0.001, and 7 versus 4, P < 0.001). Long-term QOL was, however, comparable between both groups but lower than in the general population. QOL decreased at 3 months, improved after 1 and 4 years but remained under baseline level. One and 4 years after ICU discharge, 19.1 % and 28.6 % of AKI-RRT survivors remained RRT-dependent, respectively, and 81.8 % and 71 % of them were willing to undergo ICU admission again if needed. 
Conclusion: In long-term critically ill AKI-RRT survivors, QOL was comparable to matched long-term critically ill non-AKI-RRT survivors, but lower than in the general population. The majority of AKI-RRT patients wanted to be readmitted to the ICU when needed, despite a higher severity of illness compared to matched non-AKI-RRT patients, and despite the fact that one quarter had persistent dialysis dependency.},
  articleno    = {289},
  author       = {Oeyen, Sandra and De Corte, Wouter and Benoit, Dominique and Annemans, Lieven and Dhondt, Annemieke and Vanholder, Raymond and Decruyenaere, Johan and Hoste, Eric},
  issn         = {1466-609X},
  journal      = {CRITICAL CARE},
  keywords     = {SURVIVORS,OUTCOMES,DIALYSIS,MORTALITY,FAILURE,INTENSIVE-CARE,DISEASE,QUESTIONNAIRE,MULTICENTER,VALIDITY},
  language     = {eng},
  pages        = {11},
  title        = {Long-term quality of life in critically ill patients with acute kidney injury treated with renal replacement therapy : a matched cohort study},
  url          = {http://dx.doi.org/10.1186/s13054-015-1004-8},
  volume       = {19},
  year         = {2015},
}

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