• Emilie Lambourg, Heather Walker, Jacqueline Campbell, Chrissie Watters, Martin O'Neil, Lorraine Donaldson, SiddiquiMoneeza KMKDivision of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom., Alison Almond, Katharine Buck, Zoe Cousland, Nicola Joss, Wendy Metcalfe, Shona Methven, Vinod Sanu, Elaine Spalding, Jamie P Traynor, Nazir I Lone, Samira Bell, and Scottish Renal Registry.
• Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, United Kingdom.
• Crit. Care Med. 2023 Jan 1; 51 (1): 697969-79.

ObjectivesTo determine the incidence and characteristics of ICU admissions in the Scottish population of patients treated with chronic kidney replacement therapy (KRT) over an 11-year period and determine factors associated with post-ICU admission mortality.DesignRetrospective observational cohort study.SettingWe analyzed admissions to Scottish intensive care environments between January 1, 2009, and December 31, 2019.PatientsAll patients receiving chronic KRT-including maintenance dialysis and kidney transplant-in Scotland.InterventionNone.Measurements And Main ResultsDescriptive statistics and factors associated with mortality using logistic regression and Cox proportional hazard models. From 10,657 unique individuals registered in the Scottish Renal Registry over the 11-year study period and alive as of January 1, 2009, 1,402 adult patients were identified as being admitted to a Scottish critical care setting. Between 2009 and 2019, admissions to ICU increased in a nonlinear manner driven by increases in admissions for renal causes and elective cardiac surgery. The ICU admission rate was higher among patients on chronic dialysis than in kidney transplant recipients (59.1 vs 19.9 per 1,000 person-years), but post-ICU mortality was similar (about 24% at 30 d and 40% at 1 year). Admissions for renal reasons were most common (20.9%) in patients undergoing chronic dialysis, whereas kidney transplant recipients were most frequently admitted for pneumonia (19.3%) or sepsis (12.8%). Adjusted Cox PH models showed that receiving invasive ventilation and vasoactive drugs was associated with an increased risk of death at 30 days post-ICU admission (HR, 1.75; 95% CI, 1.28-2.39 and 1.72; 95% CI, 1.28-2.31, respectively).ConclusionsWith a growing population of kidney transplant recipients and the improved survival of patients on chronic dialysis, the number of ICU admissions is rising in the chronic KRT population. Mortality post-ICU admission is high for these patients.Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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