{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:15:17Z","timestamp":1774530917383,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T00:00:00Z","timestamp":1633737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objective: Acute kidney injury (AKI) remains a serious health condition around the world, and is related to high morbidity, mortality, longer hospitalization duration and worse long-term outcomes. The aim of our study was to estimate the significant related factors for poor outcomes of patients with severe AKI requiring renal replacement therapy (RRT). Materials and Methods: We retrospectively analyzed data from patients (n = 573) with severe AKI requiring RRT within a 5-year period and analyzed the outcomes on discharge from the hospital. We also compared the clinical data of the surviving and non-surviving patients and examined possible related factors for poor patient outcomes. Logistic regression was used to analyze the odds ratio for patient mortality and its related factors. Results: In 32.5% (n = 186) of the patients, the renal function improved and RRT was stopped, 51.7% (n = 296) of the patients died, and 15.9% (n = 91) of the patients remained dialysis-dependent on the day of discharge from the hospital. During the period of 5 years, the outcomes of the investigated patients did not change statistically significantly. Administration of vasopressors, aminoglycosides, sepsis, pulmonary edema, oliguria, artificial pulmonary ventilation (APV), patient age \u2265 65 y, renal cause of AKI, AKI after cardiac surgery, a combination of two or more RRT methods, dysfunction of three or more organs, systolic blood pressure (BP) \u2264 120 mmHg, diastolic BP \u2264 65 mmHg, and Sequential Organ Failure Assessment (SOFA) score on the day of the first RRT procedure \u2265 7.5 were related factors for lethal patient outcome. Conclusions: The mortality rate among patients with severe AKI requiring RRT is very high\u201452%. Patient death was significantly predicted by the causes of AKI (sepsis, cardiac surgery), clinical course (oliguria, pulmonary edema, hypotension, acidosis, lesion of other organs) and the need for a continuous renal replacement therapy.<\/jats:p>","DOI":"10.3390\/medicina57101076","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T21:37:29Z","timestamp":1633901849000},"page":"1076","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy"],"prefix":"10.3390","volume":"57","author":[{"given":"\u017dilvinas","family":"Pa\u0161kevi\u010dius","sequence":"first","affiliation":[{"name":"Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inga","family":"Skarupskien\u0117","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"},{"name":"Hospital of Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vilma","family":"Bal\u010diuvien\u0117","sequence":"additional","affiliation":[{"name":"Hospital of Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Egl\u0117","family":"Dalinkevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"},{"name":"Hospital of Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neda","family":"Ku\u0161leikait\u0117-Pere","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"},{"name":"Hospital of Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Petrulien\u0117","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"},{"name":"Hospital of Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edita","family":"\u017diginskien\u0117","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"},{"name":"Hospital of Lithuanian University of Health Sciences, Eiveni\u0173 2, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.2215\/CJN.13381019","article-title":"Defining Early Recovery of Acute Kidney Injury","volume":"15","author":"Duff","year":"2020","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_2","first-page":"1","article-title":"Long-term outcome in ICU patients with acute kidney injury treated with renal replacement therapy: A prospective cohort study","volume":"20","author":"Dhondt","year":"2016","journal-title":"Crit. Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/sdi.12705","article-title":"Acute kidney injury: Epidemiology, outcomes, complications, and therapeutic strategies","volume":"31","author":"Negi","year":"2018","journal-title":"Semin. Dial."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e042035","DOI":"10.1136\/bmjopen-2020-042035","article-title":"Prediction of outcomes after acute kidney injury in hospitalised patients: Protocol for a systematic review","volume":"10","author":"Arora","year":"2020","journal-title":"BMJ Open"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kate, R.J., Perez, R.M., Mazumdar, D., Pasupathy, K.S., and Nilakantan, V. (2016). Prediction and detection models for acute kidney injury in hospitalized older adults. BMC Med. Inform. Decis. Mak., 16.","DOI":"10.1186\/s12911-016-0277-4"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Koeze, J., Keus, F., Dieperink, W., Van Der Horst, I.C.C., Zijlstra, J.G., and Van Meurs, M. (2017). Incidence, timing and outcome of AKI in critically ill patients varies with the definition used and the addition of urine output criteria. BMC Nephrol., 18.","DOI":"10.1186\/s12882-017-0487-8"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"104270","DOI":"10.1016\/j.ijmedinf.2020.104270","article-title":"Which risk predictors are more likely to indicate severe AKI in hospitalized patients ?","volume":"143","author":"Wu","year":"2020","journal-title":"Int. J. Med. Inform."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/nep.13192","article-title":"Acute kidney injury in critically ill surgical patients: Epidemiology, risk factors and outcomes","volume":"24","author":"Trongtrakul","year":"2019","journal-title":"Nephrology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00134-015-3934-7","article-title":"Epidemiology of acute kidney injury in critically ill patients: The multinational AKI-EPI study Hospital mortality","volume":"41","author":"Hoste","year":"2015","journal-title":"Intensive Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"258","DOI":"10.4097\/kjae.2017.70.3.258","article-title":"Postoperative acute kidney injury","volume":"70","author":"Park","year":"2017","journal-title":"Korean J. Anesthesiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1038\/ki.2012.427","article-title":"Acute kidney injury: Global health alert","volume":"83","author":"Li","year":"2013","journal-title":"Kidney Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1681\/ASN.2017070765","article-title":"Clinical Decision Support for In-Hospital AKI","volume":"29","author":"Dealmeida","year":"2018","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0159944","article-title":"Trends in One-Year outcomes of Dialysis-Requiring acute kidney injury in Denmark 2005-2012: A Population-Based nationwide study","volume":"11","author":"Carlson","year":"2016","journal-title":"PLoS ONE"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4314\/ejhs.v26i1.8","article-title":"Aetiologies and Short-term Outcomes of Acute Kidney Injury in a Tertiary Centre in Southwest Nigeria","volume":"26","author":"Oluseyi","year":"2016","journal-title":"Ethiop. J. Health Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Yang, F., Zhang, L., Wu, H., Zou, H., and Du, Y. (2014). Clinical analysis of cause, treatment and prognosis in acute kidney injury patients. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0085214"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1159\/000447544","article-title":"Incidence and outcomes of acute kidney injury requiring renal replacement therapy: A retrospective cohort study","volume":"133","author":"Rennie","year":"2016","journal-title":"Nephron"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"7862","DOI":"10.1038\/s41598-017-08440-w","article-title":"A new scoring model for the prediction of mortality in patients with acute kidney injury","volume":"7","author":"Luo","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s11684-017-0532-9","article-title":"Risk factors of prognosis after acute kidney injury in hospitalized patients","volume":"11","author":"Nie","year":"2017","journal-title":"Front. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1093\/ckj\/sfz199","article-title":"Effect of multiple episodes of acute kidney injury on mortality: An observational study","volume":"14","author":"Walker","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13017-018-0202-5","article-title":"A combination of SOFA score and biomarkers gives a better prediction of septic AKI and in-hospital mortality in critically ill surgical patients: A pilot study","volume":"13","author":"Lee","year":"2018","journal-title":"World J. Emerg. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1053\/j.jvca.2015.06.017","article-title":"Global Incidence and Outcomes of Adult Patients With Acute Kidney Injury After Cardiac Surgery_ A Systematic Review and Meta-Analysis","volume":"30","author":"Hu","year":"2016","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"13953","DOI":"10.1038\/s41598-017-13763-9","article-title":"Incidence and Risk Factors of in- hospital mortality from AKI after non-cardiovascular operation: A nationwide Survey in China","volume":"7","author":"Pan","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13054-020-03343-1","article-title":"Impact of a computerized decision support tool deployed in two intensive care units on acute kidney injury progression and guideline compliance: A prospective observational study","volume":"24","author":"Bourdeaux","year":"2020","journal-title":"Crit. Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"85","DOI":"10.2147\/IJNRD.S198222","article-title":"Evaluating nephrocheck as a predictive tool for acute kidney injury","volume":"13","author":"Nalesso","year":"2020","journal-title":"Int. J. Nephrol. Renovasc. Dis."},{"key":"ref_25","first-page":"462","article-title":"Stratified Mortality Prediction of Patients with Acute Kidney Injury in Critical Care","volume":"264","author":"Xu","year":"2019","journal-title":"Stud. Health Technol. Inform."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/10\/1076\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:10:45Z","timestamp":1760166645000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/10\/1076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,9]]},"references-count":25,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["medicina57101076"],"URL":"https:\/\/doi.org\/10.3390\/medicina57101076","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,9]]}}}