Keywords
renal replacement therapy
hemodialysis
hyperkalaemia
metabolic acidosis
uraemic complications
dialysis urgency
How to Cite
Abstract
Background: The initiation of renal replacement therapy (RRT) in patients with acute kidney injury (AKI) presents a significant clinical challenge.
Purpose: To describe the sociodemographic and clinical characteristics, diagnostic criteria, laboratory thresholds for initiating RRT, and types of therapy used in a tertiary care hospital in Pereira, Risaralda, Colombia.
Methodology: This was a retrospective, descriptive study based on secondary data from clinical records. A total of 214 patients treated between April 2020 and February 2023 who met the inclusion criteria were analyzed.
Results: Of the patients, 68,69% were male, with a mean age of 62.90 years. Metabolic acidosis was the primary indication for RRT (47%), followed by uremic complications (45%) and hyperkalemia (36%). Before initiating dialysis, mean laboratory values were creatinine 5.85 mg/dL, BUN 81 mg/dL, potassium 5.3 mEq/L, and pH 7.31. The leading cause of AKI was decreased renal perfusion (77.1%). Intermittent hemodialysis was the most used therapy (77.1%). Mortality was 36.9%, and at discharge, 38.8% of patients required ongoing RRT. Significant differences in mortality and complications were observed between patients with obstructive and non-obstructive AKI (P < 0.005).
Conclusions: This study highlights the importance of metabolic acidosis, uremic complications, and hyperkalemia as key indicators for initiating hemodialysis. It underscores critical differences between obstructive and non-obstructive causes of AKI, providing valuable insights to improve clinical outcomes.
References
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