Appropriateness and clinical outcomes of short sustained low-efficiency dialysis: A national experience

• Published in: Open medicine (Warsaw, Poland) Vol. 18; no. 1; p. 20230868
• Main Authors: Rahhal, Alaa, Najim, Mostafa, Mahfouz, Ahmed, Habib, Mhd Baraa, Hassen, Sara Seife, Al-Shekh, Isra'a, Ahmed, Ashraf Omer, Toba, Haneen, Abbarh, Shahem, El Hassan, Mawahib, Al Yafei, Sumaya, Badr, Amr, Mahmoud, Khaled Mohamed
• Format: Journal Article
• Language: English
• Published: Poland Walter de Gruyter GmbH 01.01.2023; De Gruyter
• Subjects: acute kidney injury; Clinical outcomes; dialysis; Hemodialysis; Mortality; sustained low-efficiency dialysis; dialysis; mortality; sustained low-efficiency dialysis; acute kidney injury
• ISSN: 2391-5463; 2391-5463
• DOI: 10.1515/med-2023-0868

Sustained low-efficiency dialysis (SLED) is usually performed over 6-12 h among hemodynamically unstable patients. Conduction of 4-h SLED may spare time and manpower during hospitalization. Therefore, we conducted a retrospective observational study to explore the appropriateness and clinical outcomes of 4-h SLED among critically ill patients admitted to our center from 1/06/2016 to 1/06/2020. Renal parameters including blood urea nitrogen, serum creatinine, sodium, phosphorus, potassium, and bicarbonate were determined on the day of dialysis before SLED and within 24 h after SLED, and clinical outcomes including, acute kidney injury (AKI) recovery, in-hospital mortality, 30-day mortality, 180-day mortality, and re-admission with AKI, were evaluated. Of the 304 patients included, 69.4% were male. The majority of patients were from the Middle East (65.8%), followed by 28.6% from Asia. Four-hour SLED resulted in a significant improvement in the renal parameters. Recovery from AKI was observed in 25.4%, in-hospital mortality rate was 48.7%, while the 30- and 180-day mortality outcomes were 3.2 and 9.6%, respectively, and re-admission with AKI was observed in 16.9%. Our findings suggest that 4-h SLED significantly improved renal parameters and was associated with favorable clinical outcomes in terms of survival and AKI recovery, suggesting possible utilization of SLED shorter than 6 h in the acute settings to preserve time and manpower for procedures.