Severity of Chronic Kidney Disease and Outcomes After Admission to the Intensive Care Unit
Authors' conclusion
In this cohort study of consecutive adults admitted to the ICU, the presence and severity of CKD were associated with adverse health outcomes.
Study context
- Population
- Adults (≥18 years) in Ontario, Canada, admitted to an intensive care unit (ICU) 2008–2021 with a baseline outpatient serum creatinine 7 to 365 days before admission1 in 4 with preexisting chronic kidney disease (CKD)
- Participants
- 531,090 adults
- Exposure
- CKD severity vs no CKD
- Outcome
- Mortality (ICU, hospital, and 90-day) and kidney replacement therapy (KRT) requirement in the ICU and dependence at 90 days
Methodological detailsconsecutive adults
- Consecutive adults
Main finding
As reported in the abstract
Mortality
Each group vs no CKDOdds ratio (95% CI)
Maintenance dialysis
1.92(1.82–2.04)
Non-dialysis-dependent stage 5
2.32(2.14–2.52)
Observational data: associations, not effects.
Further findings
| Outcome | Values | aOR (95% CI) | |
|---|---|---|---|
| KRT initiation in the ICUStage 3a vs No CKD | 1.79 (1.68–1.90) | ||
| KRT initiation in the ICUStage 3b vs No CKD | 3.02 (2.83–3.22) | ||
| KRT initiation in the ICUStage 4 vs No CKD | 6.71 (6.23–7.22) | ||
| KRT initiation in the ICUNon-dialysis-dependent stage 5 vs No CKD | 32.00 (29.07–35.22) | ||
| 0.050.21520Adjusted odds ratio (log scale) |
| Outcome | Values |
|---|---|
| KRT dependence (among those initiating KRT in the ICU and surviving to 90 days) · day 90 | No CKD 7.2% · Stage 3a 14.2% · Stage 3b 22.5% · Stage 4 50.3% · Non-dialysis-dependent stage 5 83.8% |
Original publication
Severity of Chronic Kidney Disease and Outcomes After Admission to the Intensive Care Unit. JAMA Netw Open. Published 1 June 2026. doi:10.
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