Does acute renal failure require dialysis?

American scholars have found that in patients with acute kidney injury (AKI) with a significant increase in serum creatinine, initial dialysis is associated with increased survival. Conversely, for patients with AKI with lower serum creatinine, initial dialysis and mortality. Increase correlation. The paper was published online April 7 in the Journal of the American Society of Nephrology (Clin J Am SocNephrol).

The study included 6119 patients with severe AKI, of which 602 received dialysis. The results of the study showed that after matching the propensity scores, the covariates between the dialysis and non-dialysis patients were well balanced, and the total risk-to-risk ratio (HR) was 1.01 (P=0.89).

For every 1 mg/dl increase in serum creatinine concentration, dialysis increased survival benefit by 20% (P = 0.001). After correcting the severity of the disease, the results remained unchanged. When the serum creatinine concentration is ≥ 3.8 mg / dl, the benefits of dialysis exceed its drawbacks.