• Daniel H Li, Ron Wald, Daniel Blum, Eric McArthur, Matthew T James, Burns Karen E A KEA Critical Care and Medicine Departments, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada., Jan O Friedrich, Adhikari Neill K J NKJ Department of Critical Care Medicine, Sunnybrook Health Sciences Centre; Interdepartmental Division of Critical Care, University of Toronto, Toront, Danielle M Nash, Gerald Lebovic, Andrea K Harvey, Stephanie N Dixon, Samuel A Silver, Sean M Bagshaw, and William Beaubien-Souligny.
• Division of Nephrology, St. Michael's Hospital and University of Toronto, Toronto, Canada.
• J Crit Care. 2020 Apr 1; 56: 113-119.

PurposeSevere acute kidney injury (AKI) is associated with a significant risk of mortality and persistent renal replacement therapy (RRT) dependence. The objective of this study was to develop prediction models for mortality at 90-day and 1-year following RRT initiation in critically ill patients with AKI.MethodsAll patients who commenced RRT in the intensive care unit for AKI at a tertiary care hospital between 2007 and 2014 constituted the development cohort. We evaluated the external validity of our mortality models using data from the multicentre OPTIMAL-AKI study.ResultsThe development cohort consisted of 594 patients, of whom 320(54%) died and 40 (15% of surviving patients) remained RRT-dependent at 90-day Eleven variables were included in the model to predict 90-day mortality (AUC:0.79, 95%CI:0.76-0.82). The performance of the 90-day mortality model declined upon validation in the OPTIMAL-AKI cohort (AUC:0.61, 95%CI:0.54-0.69) and showed modest calibration. Similar results were obtained for mortality model at 1-year.ConclusionsRoutinely collected variables at the time of RRT initiation have limited ability to predict mortality in critically ill patients with AKI who commence RRT.Copyright © 2019 Elsevier Inc. All rights reserved.

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