Keuskamp, Dominic

Davies, Christopher E

Secombe, Paul

Pilcher, David V

Chavan, Shaila

Jones, Sarah L

Reddi, Benjamin E

McDonald, Stephen P

2025-02-28

Limited data are available on intensive care unit (ICU) admissions for adults receiving kidney replacement therapy (KRT - dialysis or transplantation) in Australia. Our aim is to characterise admissions for patients receiving long-term dialysis and kidney transplant recipients relative to the general intensive care population in Australia.Retrospective registry-based data linkage cohort study.All ICUs in Australia that reported to the Australian and New Zealand Intensive Care Society Adult Patient Database, 1 January 2018-31 December 2020.All admissions were included. Data were deterministically linked to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Subgroups analysed were defined by sex, age, admission type, APACHE III-j diagnostic category, diabetes status, body mass index (BMI), dialysis modality, dialysis vintage, and kidney transplant vintage.Admission to ICU for patients receiving KRT at the time of admission (as reported to the ANZDATA Registry).Patients receiving long-term dialysis prior to admission and those with a kidney transplant numbered 2826 (0.6% of all admissions) and 1194 (0.3%), respectively. Age-sex standardised admission rates relative to the non-KRT cohort (n = 438,271 or 99.1%) were highest for long-term dialysis patients (relative rate 10.18 [95% CI: 9.46,10.93]) and associated with diabetes and sepsis, cardiovascular and respiratory diagnoses.Rates of ICU admission for people receiving long-term dialysis or kidney transplantation were many times higher than the general population, with particularly increased relative risk among younger age groups and for key medical diagnoses. Given the burden on patients and health services, exploration of strategies to reduce this risk is important.

Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.

Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.

Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

Intensive Care Unit, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.

Australian and New Zealand Intensive Care Research Centre, School of Public and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcomes and Resources Evaluation, Prahran, Victoria, Australia.

Australian and New Zealand Intensive Care Research Centre, School of Public and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcomes and Resources Evaluation, Prahran, Victoria, Australia.

Department of Intensive Care, Alfred Hospital, Melbourne, Victoria, Australia.

Australian and New Zealand Intensive Care Research Centre, School of Public and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcomes and Resources Evaluation, Prahran, Victoria, Australia.

Intensive Care Unit, Northern Health, Epping, Victoria, Australia.

Department of Nephrology, Northern Health, Epping, Victoria, Australia.

Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia.

Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

Intensive Care Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.

Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

Central and Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Crit Care Resusc . 2025 Feb 28;27(1):100099. doi: 10.1016/j.ccrj.2025.100099. eCollection 2025 Mar.

1441-2772

https://pubmed.ncbi.nlm.nih.gov/40109289/?otool=iaurydwlib

https://hdl.handle.net/10137/14196

ANZDATA

ANZICS

Dialysis

Kidney replacement therapy

Kidney transplant

Intensive care admissions for adults with treated kidney failure in Australia: A national retrospective cohort study.

Journal Article

Publication