Prognostic indicators and patterns of renal recovery in patients requiring hemodialysis for acute kidney injury

The outcome of patients with acute kidney injury (AKI) is highly variable. Patients who receive renal replacement therapy (RRT) for similar diseases may recover differently. The factors that operate in each patient may alter the prognosis and outcome.

Our study aims at identification of prognostic factors influencing recovery in patients who required hemodialysis for AKI.

Patients admitted in different ICUs with AKI who underwent hemodialysis in a tertiary care hospital over a three year period were included in the study. Time from day one of disease to first dialysis, hematological and biochemical parameters were noted. Patients were grouped based on the time taken for recovery of renal function following hemodialysis into group A (<2 weeks) and group B (>2 weeks). Studied parameters have been statistically analyzed to find any significant association with recovery time.

Out of 63 patients, 9 progressed to chronic kidney disease. In the remaining 54, Group A comprised 31 and group B 23. Out of all the factors studied, serum creatinine (7.0±1.3 vs 8.4±3.8; P=0.018), S. bicarbonate (21.7±2.8 vs 19.7±3.8; P=0.03), pH at admission (7.25±0.13 vs 7.1±0.19; P=0.048); number of hemodialysis sessions (3.5 ±1.5 vs 5±2.4; P=0.016) and time lag from day one of disease to first hemodialysis (8.6 ± 3.6 vs 11.5±5.9; P=0.007) showed significant association with recovery time.

Recovery following AKI is influenced by factors liked delayed presentation, late initiation of hemodialysis, low pH and low bicarbonate which can predict delayed renal recovery following hemodialysis.