• Paul Secombe, Pei-Ying Chiang, Basant Pawar, and Alice Springs Hospital Renal-ICU Research Group.
• Department of Intensive Care, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
• Intern Med J. 2019 Oct 1; 49 (10): 1252-1261.

BackgroundCentral Australia (CA) has a high prevalence of haemodialysis-dependent chronic kidney disease (CKD5D). CKD5D is associated with an increased need for critical care services.AimsTo describe the demographic features, critical care resource use and outcomes of patients with CKD5D requiring intensive care admission in CA.MethodsRetrospective matched cohort database study. Patients with CKD5D who required admission for critical illness between 1 July 2015 and 30 June 2016 were identified using the Centre for Outcome and Resource Evaluation Outcome Measurement and Evaluation Tool (CORE COMET) and matched with patients without CKD5D. The primary outcome was all cause mortality. Secondary outcomes explored use of critical care and other ongoing healthcare use.ResultsThere were 621 critical care admissions during the study period. Of these, CKD5D patients comprised 88 admissions (14%), representing 63 patients. Compared to matched controls, these patients had a similar mortality at a median follow up of 463 days (17% vs 22%, P = 0.50) which did not change when patients with an intensive care unit length of stay (ICU LoS) less than 4 days were excluded. CKD5D patients had a shorter median ICU LoS (1.3 vs 2.9). Although those with CKD5D had higher healthcare resource use, the rate of utilisation remained unchanged by their ICU admission.ConclusionsThis retrospective observational matched cohort study examining the burden of disease amongst CKD5D patients in CA suggests that there is no additional mortality burden in this group, nor do they require significantly higher critical care resources compared to a matched cohort.© 2019 Royal Australasian College of Physicians.

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