Acute pulmonary oedema in chronic dialysis patients was primarily driven by pulmonary infection (26%) and excessive interdialytic weight gain (25%), resulting in 9 deaths among 102 patients.
Observational (n=102)
No
In chronic dialysis patients admitted to the ICU for acute pulmonary edema, the leading causes are acute pulmonary infection, excessive interdialytic weight gain, and inappropriate dry weight prescription, with high mortality among those referred from other services.
BACKGROUND: Acute pulmonary oedema (APO) in patients undergoing chronic dialysis (CD), a common cause of hospital admission in this population, is poorly documented. The objective of this study was to determine the causes, profile, clinical course and outcomes of APO in CD patients admitted in an intensive care unit (ICU). METHODS: Medical charts of all CD patients consecutively admitted for APO in the renal ICU of the Tenon Hospital (Paris, France) between January 2000 and December 2007 were considered. Data collection included patient characteristics, etiologic factors for chronic renal failure and co-morbidities, past history of APO, precipitating factors, clinical evolution and outcomes. RESULTS: Of the 112 files considered, 102 (65% men) were included in the final analysis. Patients were aged 20-88 years and had been dialysed for a median duration of 2 years. Hypertension (36.3%), chronic glomerulonephritis (25.5%) and diabetes mellitus (17.6%) were the main etiologic factors of chronic renal failure; 38.2% had a past history of APO. Acute pulmonary infection (26%), excessive interdialytic weight gain (25%) and inappropriate dry weight prescription (23%) were the leading causes of APO. The duration of hospitalization was <4 days in 60% of participants. Nine deaths (four being of cardiac origin) were recorded. Being referred from another hospital service was the main predictor of death. CONCLUSIONS: APO fuelled in part by chest infection, excessive interdialytic weight gain and inappropriate dry weight are important causes of hospitalization in CD patients. Mortality is high among those referred from other services usually in critical conditions.
Halle et al. (Thu,) conducted a observational in Acute pulmonary oedema in chronic dialysis patients (n=102). Acute pulmonary oedema in chronic dialysis patients was primarily driven by pulmonary infection (26%) and excessive interdialytic weight gain (25%), resulting in 9 deaths among 102 patients.