XXXX in kidney transplant recipients: a multicenter study.

@entity1 @entity10592 @entity3126 @entity649 @entity26 @entity2348 @entity364 @entity358 @entity19141 @entity1576 @entity2028
INTRODUCTION: Data on @entity358 in renal transplant recipients are scarce. The aim of this study was to evaluate @entity1576 ( @entity1576 ) in renal transplant recipients. METHODS: We conducted a retrospective observational study in nine transplant centers of consecutive kidney transplant recipients admitted to the intensive care unit (ICU) for @entity1576 from 2000 to 2008. RESULTS: Of 6,819 kidney transplant recipients, 452 (6.6%) required ICU admission, including 200 admitted for @entity1576 . Fifteen (7.5%) of these @entity1 had combined kidney-pancreas transplantations. The most common causes of @entity1576 were @entity2028 (35.5%), @entity3126 (24.5%) and extrapulmonary @entity649 ( @entity649 ) (15.5%). @entity10592 occurred in 11.5% of @entity1 . Mechanical ventilation was used in 93 @entity1 (46.5%), vasopressors were used in 82 @entity1 (41%) and dialysis was administered in 104 @entity1 (52%). Both the in-hospital and 90-day mortality rates were 22.5%. Among the 155 day 90 survivors, 115 @entity1 (74.2%) were dialysis-free, including 75 @entity1 (65.2%) who recovered prior renal function. Factors independently associated with in-hospital mortality were shock at admission (odds ratio (OR) 8.70, 95% confidence interval (95% CI) 3.25 to 23.29), opportunistic @entity364 (OR 7.08, 95% CI 2.32 to 21.60) and @entity2348 (OR 2.53, 95% CI 1.07 to 5.96). Five factors were independently associated with day 90 dialysis-free survival: renal Sequential Organ Failure Assessment (SOFA) score on day 1 (OR 0.68/SOFA point, 95% CI 0.52 to 0.88), @entity2348 (OR 0.43, 95% CI 0.21 to 0.90), three or four quadrants involved on chest X-ray (OR 0.44, 95% CI 0.21 to 0.91), time from hospital to ICU admission (OR 0.98/day, 95% CI 0.95 to 0.99) and @entity26 flow at admission (OR 0.93/liter, 95% CI 0.86 to 0.99). CONCLUSIONS: In kidney transplant recipients, @entity1576 is associated with high mortality and graft loss rates. Increased @entity19141 and bacterial prophylaxis might improve these outcomes. Early ICU admission might prevent graft loss.
