Mortality and Complications of Unplanned Dialysis in End Stage Kidney Disease Patients in Chumphae Hospital
Keywords:
end stage kidney disease, unplanned dialysis, mortality, complicationsAbstract
Background: Hemodialysis, peritoneal dialysis and kidney transplantation are recent modalities for renal replacement therapies (RRT) in end stage kidney disease (ESKD) patients. Mostly, the initiation of renal replacement therapy was delayed and unintended, then lead to more complications and unfavorable survival outcomes. Due to the nonexistence of this kind of the study in Thailand, we explored the mortality and complications between unplanned and planned dialysis of ESKD patients.
Methods: A retrospective descriptive study of ESKD patients with renal replacement therapies at renal unit, Chumphae Hospital were collected between October 2019 and November 2020. The inclusion criteria were age > 15 years and received treatment in Chumphae Hospital. Exclusion criteria were ESKD patients who denial of RRT or had initiation of RRT from another hospital. Patient factors such as age at initiation of dialysis, comorbidities (i.e., diabetes mellitus, ischemic heart disease, hypertension), clinical status, laboratory data and dialysis modalities were analyzed. We also compared mortality and complications between planned and unplanned dialysis groups.
Results : From 63 patients, 46(73.02%) were unplanned and 17(26.98%) were planned, underwent dialysis. Unplanned dialysis patient group increased needs of urgent start dialysis, ICU admission and mechanical ventilator more than planned dialysis group. There were no statistical significant difference between planned and unplanned dialysis groups in all causes of mortality (17.65% vs. 8.7%, respectively) and complications (41.18% vs. 39.13%, respectively).
Conclusions : The ESKD patients with planned and unplanned dialysis were comparable in all cause of mortalities and complications. However, unplanned dialysis patients were increased prevalent of urgent start dialysis, ICU admissions and mechanical ventilators used.
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