Predictors of outpatient kidney function recovery among patients who initiate hemodialysis in the hospital.

摘要: Background Recent policy clarifications by the Centers for Medicare & Medicaid Services have changed access to outpatient dialysis care at end-stage renal disease (ESRD) facilities individuals with acute kidney injury in United States. Tools predict "ESRD" and "acute" status terms of function recovery among patients who previously initiated therapy hospital could help inform patient management decisions. Study Design Historical cohort study. Setting Participants Incident hemodialysis Mayo Clinic Health System in-hospital replacement (RRT) continued following dismissal (2006 through 2009). Predictor Baseline estimated glomerular filtration rate (eGFR), tubular necrosis from sepsis or surgery, heart failure, intensive unit, access. Outcomes Kidney defined as sufficient discontinuation. Results Cohort consisted 281 a mean age 64 years, 63% men, 45% baseline eGFR≥30mL/min/1.73m 2 46%. During median 8 months, 52 (19%) recovered, most (94%) within 6 months. Higher eGFR (HR per 10–mL/min/1.73m increase eGFR, 1.27; 95% CI, 1.16-1.39; P =0.007) were independent predictors whereas first RRT unit catheter not. There was positive interaction between absence failure predicting ( Limitations Sample size. Conclusions initiation is not rare. As expected, higher an important determinant recovery. However, are less likely recover even eGFR. Consideration of these factors discharge informs decisions on ESRD designation long-term care.