• Ginivaldo Victor Ribeiro do Nascimento, André Luis Balbi, Daniela Ponce, and Juliana Maria Gera Abrão.
• Faculdade Integral Diferencial, e NOVAFAPI.
• J Bras Nefrol. 2012 Oct 1; 34 (4): 337-42.

IntroductionThe decision of when to start dialysis in Acute Kidney Injury (AKI) patients with overt uremia is strongly established, however, when blood urea nitrogen (BUN) levels is < 100 mg/dL the timing of initiation of dialysis remains uncertain.PurposeThe aim of this study was to assess mortality and renal function recovery AKI patients started on dialysis at different BUN levels.MethodsThis was a retrospective study performed at Medical School Hospital, São Paulo, Brazil, enrolling 86 patients underwent to dialysis.ResultsDialysis was started when BUN < 75 mg/dl in 23 patients (Group I) and BUN > 75 mg/dl in 63 patients (Group II). Hypervolemia and mortality were higher in Group I than in Group II (65.2% vs. 14.3% - p < 0.05, 39.1% vs. 68.9%- p < 0.05, respectively). Among survivors, the rate of renal function recovery was higher in Group I (71.4% and 36.8%, respectively--p < 0.05). Multivariate analysis showed that sepsis, age > 60 years, peritoneal dialysis and BUN > 75 mg/dl at dialysis initiation were independently related with mortality.ConclusionsLower mortality and higher renal function recovery rates were associated with early dialysis initiated at lower BUN levels in AKI patients.

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