Prognosis of patients with heart disease with acute kidney injury undergoing dialysis treatment.
Daniela Ferreira, Maria Aparecida Batistão Gonçalves, Dayana Souza Fram and 2 others
PMID 36197431WHAT IT FOUND
Patients on dialysis in the ICU with acute kidney injury had more lack of urine output, longer stays and lower hemoglobin than patients not on dialysis.
Mortality was high in both groups, and the reported death risk numbers conflict.
Key findings
01Patients on dialysis had more anuria (34.2% vs 8%) and longer stays (median 18 days vs 10 days).
02The paper reported 50% deaths in dialysis patients and 67.1% deaths in non-dialysis patients, while also reporting a 1.46 times greater death risk in dialysis patients.
03In patients with urine output, dialysis was more likely when hemoglobin was less than 10.5 g/dl.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used a convenience sample of only 101 patients from one cardiology hospital, so it may not represent other ICUs or patient groups. The number of patients was too small for a multivariate model, so the reported differences may be explained by other factors. Patients with chronic kidney disease or transplantation were excluded, so the results do not apply to those groups. The paper's mortality statements conflict: it reports 50% deaths in dialysis patients and 67.1% deaths in non-dialysis patients, while also reporting a 1.46 times greater death risk in dialysis patients. Patients in both groups received several treatments, so the study cannot separate the effect of dialysis from other ICU care.
The easy way to misread this
Do not read the 1.46 times greater death risk as proof that dialysis worsens survival. The paper also reported 50% deaths in dialysis patients and 67.1% deaths in non-dialysis patients, and it did not use a multivariate model, so severity may explain the difference.