Impact of Nephrology Follow-Up on Survival and Clinical Outcomes in Patients Initiating Emergency Dialysis

Abstract

This study aimed to evaluate the clinical and laboratory characteristics of patients presenting with emergency dialysis requirements and to assess the impact of nephrology follow-up on patient outcomes. In this retrospective study. patients who were given an emergency hemodialysis indication in the emergency department were divided into two groups according to the presence or absence of nephrology follow-up within the past year. Dialysis indications. laboratory findings. mortality rates. and transition to routine dialysis were analyzed. The most common indications for emergency dialysis were severe metabolic acidosis and elevated creatinine levels. The 28-day mortality rate was significantly lower in patients with nephrology follow-up (16.2% vs. 36.2%. p=0.001). The transition rate to routine hemodialysis was also higher in this group (p=0.024). However, there was no statistically significant difference between the groups regarding 90-day mortality or hospital readmission rates. Regular nephrology follow-up reduces short-term mortality and increases the transition to planned dialysis in patients requiring emergency dialysis. However, more effective monitoring and early intervention strategies are needed to improve long-term outcomes.

Keywords

• Emergency dialysis
• hemodialysis
• acute kidney injury
• chronic kidney disease
• nephrology follow-up
• mortality
• clinical outcomes

Acil Diyaliz Başlangıcında Nefroloji İzleminin Sağkalım ve Klinik Sonuçlar Üzerindeki Rolü

Abstract

Bu çalışma, acil diyaliz gereksinimi ile başvuran hastaların klinik ve laboratuvar özelliklerini. nefroloji takibinin hasta sonuçları üzerindeki etkisini değerlendirmeyi amaçlamaktadır. Bu retrospektif çalışmada. acil serviste acil hemodiyaliz endikasyonu konulan hastalar. Son bir yıl içinde nefroloji takibi bulunup bulunmamasına göre iki gruba ayrılarak karşılaştırılmıştır. Diyaliz endikasyonları, laboratuvar bulguları, mortalite oranları ve rutin diyaliz geçişleri analiz edilmiştir. Acil diyaliz endikasyonları arasında en sık ağır metabolik asidoz ve kreatinin yüksekliği saptanmıştır. Nefroloji takibi olan hastalarda 28 günlük mortalite oranı anlamlı olarak daha düşük bulunmuştur (%16,2 vs. %36,2. p=0,001). Rutin hemodiyaliz programına geçiş oranı nefroloji takibi olan grupta daha yüksek bulunmuştur (p=0,024). Ancak 90 günlük mortalite ve yeniden hastaneye yatış oranlarında gruplar arasında anlamlı fark izlenmemiştir. Düzenli nefroloji takibi, acil diyaliz gereksinimi olan hastalarda kısa dönem mortaliteyi azaltmakta ve planlı diyaliz geçişini artırmaktadır. Ancak uzun dönem sonuçlar için daha etkin izlem ve erken müdahale stratejilerine ihtiyaç vardır.

Keywords

• Acil diyaliz
• hemodiyaliz
• akut böbrek hasarı
• kronik böbrek hastalığı
• nefroloji takibi
• mortalite
• klinik sonuçlar

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