Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study
Introduction: Continuous dialysis in hemodynamically stable patients with acute kidney injury (AKI) may impact outcomes differently than intermittent dialysis. We evaluated differences in patient and kidney outcomes between the two modalities. Methods: Clinical and 30-day outcome data for...
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Karger Publishers
2025-01-01
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| Series: | Medical Principles and Practice |
| Online Access: | https://karger.com/article/doi/10.1159/000543882 |
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| author | Ali AlSahow Omar Alkandari Yousif Bahbahani Anas AlYousef Bassam AlHelal Heba AlRajab Ahmed AlQallaf Monther AlSharekh Abdulrahman AlKandari Gamal Nessim Bassem Mashal Ahmad Mazroue Alaa Abdelmoteleb Mohamed ElAbbadi Ali Abdelzaher Emad Abdallah Mohamed Abdellatif Ziad ElHusseini Ahmed Abdelrady |
| author_facet | Ali AlSahow Omar Alkandari Yousif Bahbahani Anas AlYousef Bassam AlHelal Heba AlRajab Ahmed AlQallaf Monther AlSharekh Abdulrahman AlKandari Gamal Nessim Bassem Mashal Ahmad Mazroue Alaa Abdelmoteleb Mohamed ElAbbadi Ali Abdelzaher Emad Abdallah Mohamed Abdellatif Ziad ElHusseini Ahmed Abdelrady |
| author_sort | Ali AlSahow |
| collection | DOAJ |
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Introduction: Continuous dialysis in hemodynamically stable patients with acute kidney injury (AKI) may impact outcomes differently than intermittent dialysis. We evaluated differences in patient and kidney outcomes between the two modalities. Methods: Clinical and 30-day outcome data for inpatients with AKI who were hemodynamically stable and not on ventilation and who received intermittent hemodialysis (IHD) or continuous kidney replacement therapy (CKRT) in public hospitals in Kuwait from January 1 to December 31, 2021, were prospectively collected. Results: We recruited 229 patients (age: 59.9 years; males, 60.3%; baseline estimated baseline glomerular filtration [eGFR], 56 mL/min). CKRT accounted for 72.9% of cases due to lack of access to water treatment. No statistically significant differences were observed between groups in terms of age, baseline eGFR, sex, comorbidities, cause of AKI, or fluid administration. The intensive care unit contributed 21% of cases, with no significant difference between groups. More IHD patients received diuretics (62.9% vs. 43.1% for CKRT, p = 0.008). At 30 days, 21.8% of patients had died. There was no statistically significant difference in mortality between groups (16.1% for IHD vs. 24% for CKRT, p = 0.2). Final eGFR was 53.2 mL/min, with no difference between groups. Complete kidney recovery was greater with CKRT (33.1% vs. 13.5%, p = 0.009). Baseline eGFR < 60 mL/min did not influence mortality or kidney recovery. Conclusion: Compared with IHD, CKRT did not lower mortality at 30 days, which is similar to that of randomized trials; however, it was associated with better complete kidney recovery, which was reported in observational studies. |
| format | Article |
| id | doaj-art-515b825e9319400aa8d36fda3dd788b6 |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-515b825e9319400aa8d36fda3dd788b62025-08-20T01:51:04ZengKarger PublishersMedical Principles and Practice1423-01512025-01-0134326227010.1159/000543882Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter StudyAli AlSahowhttps://orcid.org/0000-0001-8081-3244Omar AlkandariYousif BahbahaniAnas AlYousefBassam AlHelalHeba AlRajabAhmed AlQallafMonther AlSharekhAbdulrahman AlKandariGamal NessimBassem MashalAhmad MazroueAlaa AbdelmotelebMohamed ElAbbadiAli AbdelzaherEmad AbdallahMohamed AbdellatifZiad ElHusseiniAhmed Abdelrady Introduction: Continuous dialysis in hemodynamically stable patients with acute kidney injury (AKI) may impact outcomes differently than intermittent dialysis. We evaluated differences in patient and kidney outcomes between the two modalities. Methods: Clinical and 30-day outcome data for inpatients with AKI who were hemodynamically stable and not on ventilation and who received intermittent hemodialysis (IHD) or continuous kidney replacement therapy (CKRT) in public hospitals in Kuwait from January 1 to December 31, 2021, were prospectively collected. Results: We recruited 229 patients (age: 59.9 years; males, 60.3%; baseline estimated baseline glomerular filtration [eGFR], 56 mL/min). CKRT accounted for 72.9% of cases due to lack of access to water treatment. No statistically significant differences were observed between groups in terms of age, baseline eGFR, sex, comorbidities, cause of AKI, or fluid administration. The intensive care unit contributed 21% of cases, with no significant difference between groups. More IHD patients received diuretics (62.9% vs. 43.1% for CKRT, p = 0.008). At 30 days, 21.8% of patients had died. There was no statistically significant difference in mortality between groups (16.1% for IHD vs. 24% for CKRT, p = 0.2). Final eGFR was 53.2 mL/min, with no difference between groups. Complete kidney recovery was greater with CKRT (33.1% vs. 13.5%, p = 0.009). Baseline eGFR < 60 mL/min did not influence mortality or kidney recovery. Conclusion: Compared with IHD, CKRT did not lower mortality at 30 days, which is similar to that of randomized trials; however, it was associated with better complete kidney recovery, which was reported in observational studies. https://karger.com/article/doi/10.1159/000543882 |
| spellingShingle | Ali AlSahow Omar Alkandari Yousif Bahbahani Anas AlYousef Bassam AlHelal Heba AlRajab Ahmed AlQallaf Monther AlSharekh Abdulrahman AlKandari Gamal Nessim Bassem Mashal Ahmad Mazroue Alaa Abdelmoteleb Mohamed ElAbbadi Ali Abdelzaher Emad Abdallah Mohamed Abdellatif Ziad ElHusseini Ahmed Abdelrady Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study Medical Principles and Practice |
| title | Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study |
| title_full | Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study |
| title_fullStr | Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study |
| title_full_unstemmed | Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study |
| title_short | Outcomes of Intermittent Hemodialysis versus Continuous Kidney Replacement Therapy in Hemodynamically Stable Patients with Acute Kidney Injury: A Prospective, Observational, Multicenter Study |
| title_sort | outcomes of intermittent hemodialysis versus continuous kidney replacement therapy in hemodynamically stable patients with acute kidney injury a prospective observational multicenter study |
| url | https://karger.com/article/doi/10.1159/000543882 |
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