Skip to main content
Erschienen in: Intensive Care Medicine 9/2005

01.09.2005 | Original

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

verfasst von: Annika Åhlström, Minna Tallgren, Seija Peltonen, Pirjo Räsänen, Ville Pettilä

Erschienen in: Intensive Care Medicine | Ausgabe 9/2005

Einloggen, um Zugang zu erhalten

Abstract

Objective

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.

Patients

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).

Conclusions

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.
Literatur
1.
Zurück zum Zitat Ridley SA, Chrispin PS, Scotton H, Rogers J, Lloyd D (1997) Changes in quality of life after intensive care: comparison with normal data. Anaesthesia 52:195–202PubMed Ridley SA, Chrispin PS, Scotton H, Rogers J, Lloyd D (1997) Changes in quality of life after intensive care: comparison with normal data. Anaesthesia 52:195–202PubMed
2.
Zurück zum Zitat 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 23:331–337PubMed 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 23:331–337PubMed
3.
Zurück zum Zitat Kaarlola A, Pettilä V, Kekki P (2004) Quality of life six years after intensive care. Intensive Care Med 29:1294–1299 Kaarlola A, Pettilä V, Kekki P (2004) Quality of life six years after intensive care. Intensive Care Med 29:1294–1299
4.
Zurück zum Zitat 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 24:1962–1967PubMed 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 24:1962–1967PubMed
5.
Zurück zum Zitat Guyatt GH, Feeny DH, Patrick DL (1993) Measuring health-related quality of life. Ann Intern Med 118:622–629PubMed Guyatt GH, Feeny DH, Patrick DL (1993) Measuring health-related quality of life. Ann Intern Med 118:622–629PubMed
6.
Zurück zum Zitat 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 29:368–377PubMed 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 29:368–377PubMed
7.
Zurück zum Zitat Wu A, Gao F (2004) Long-term outcomes in survivors from critical illness. Anaesthesia 59:1049–1052PubMed Wu A, Gao F (2004) Long-term outcomes in survivors from critical illness. Anaesthesia 59:1049–1052PubMed
8.
Zurück zum Zitat Tian ZM, Miranda DR (1995) Quality of life after intensive care with the sickness impact profile. Intensive Care Med 21:422–428PubMed Tian ZM, Miranda DR (1995) Quality of life after intensive care with the sickness impact profile. Intensive Care Med 21:422–428PubMed
9.
Zurück zum Zitat Granja C, Teixeira-Pinto A, Costa-Pereira A (2002) Quality of life after intensive care-evaluation with EQ-5D questionnaire. Intensive Care Med 28:898–907PubMed Granja C, Teixeira-Pinto A, Costa-Pereira A (2002) Quality of life after intensive care-evaluation with EQ-5D questionnaire. Intensive Care Med 28:898–907PubMed
10.
Zurück zum Zitat 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 23:1653–1659PubMed 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 23:1653–1659PubMed
11.
Zurück zum Zitat 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 27:1901–1907PubMed 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 27:1901–1907PubMed
12.
Zurück zum Zitat 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 24:691–698PubMed 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 24:691–698PubMed
13.
Zurück zum Zitat 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 24:192–198PubMed 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 24:192–198PubMed
14.
Zurück zum Zitat 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 59:602–610PubMed 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 59:602–610PubMed
15.
Zurück zum Zitat 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 26:915–921PubMed 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 26:915–921PubMed
16.
Zurück zum Zitat 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 23:1204–1211PubMed 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 23:1204–1211PubMed
17.
Zurück zum Zitat 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 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
18.
Zurück zum Zitat Levy E, Viscoli CM, Horwitz RI (1996) The effect of acute renal failure on mortality: a cohort analysis. JAMA 275:1480–1494 Levy E, Viscoli CM, Horwitz RI (1996) The effect of acute renal failure on mortality: a cohort analysis. JAMA 275:1480–1494
19.
Zurück zum Zitat 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 30:2051–2058PubMed 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 30:2051–2058PubMed
20.
Zurück zum Zitat 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 23:766–772PubMed 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 23:766–772PubMed
21.
Zurück zum Zitat 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 26:1824–1831PubMed 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 26:1824–1831PubMed
22.
Zurück zum Zitat 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 40:275–279PubMed 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 40:275–279PubMed
23.
Zurück zum Zitat 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 29:1589–1593PubMed 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 29:1589–1593PubMed
24.
Zurück zum Zitat 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 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.
Zurück zum Zitat Brooks R, with the EuroQol Group (1996) EuroQol: the current state of play. Health Policy 37:53–72PubMed Brooks R, with the EuroQol Group (1996) EuroQol: the current state of play. Health Policy 37:53–72PubMed
26.
Zurück zum Zitat 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 163:1389–1394PubMed 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 163:1389–1394PubMed
27.
Zurück zum Zitat 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 127:195–202PubMed 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 127:195–202PubMed
28.
Zurück zum Zitat Sznajder M, Aegerter P, Launois R, Merliere Y, Guidet B (2001) A cost-effectiveness analysis of stays in intensive care units. Intensive Care Med 27:146–153PubMed Sznajder M, Aegerter P, Launois R, Merliere Y, Guidet B (2001) A cost-effectiveness analysis of stays in intensive care units. Intensive Care Med 27:146–153PubMed
Metadaten
Titel
Survival and quality of life of patients requiring acute renal replacement therapy
verfasst von
Annika Åhlström
Minna Tallgren
Seija Peltonen
Pirjo Räsänen
Ville Pettilä
Publikationsdatum
01.09.2005
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 9/2005
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2681-6

Weitere Artikel der Ausgabe 9/2005

Intensive Care Medicine 9/2005 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.