Followup to Randomised Evaluation of Normal vs Augmented Level of renal replacement therapy in ICU (POST-RENAL)
The number of patients experiencing acute kidney injury (AKI), when a kidney suddenly stops working properly, has been increasing in recent years. In the worst cases, patients have to stay in intensive care units for dialysis. The mortality of these patients is over 50%. There are no known treatments that can reduce these mortalities, and the long-term outcomes for the patients who do survive are unknown.
The POST-RENAL study followed up patients from the original RENAL study for over 3 years to better understand how their health and lives have been affected by acute kidney injury. The results showed a further 1 in 3 patients had died during the extended follow up and 1 in 20 of the survivors in the original RENAL Study entered a maintenance dialysis program, suggesting the burden of mortality continues well beyond hospital discharge and is much greater than the requirement for dialysis. In addition, there is a high prevalence of protein in the urine amongst survivors suggesting significant ongoing risk of chronic kidney disease and mortality. A final manuscript is in progress with target submission to the New England Journal of Medicine by end of Dec 2012.