Emergency dialysis indications, application, clinical findings, and outcomes at Cerrahpaşa Medical School between 2010 and 2025

Background and Aims: This study aimed to evaluate the demographic, clinical, and laboratory characteristics, as well as renal and overall survival outcomes, and to identify mortality-related factors among adult patients who underwent emergency HD at the Nephrology Department of IUC Cerrahpaşa Medical Faculty between January 1, 2010, and March 1, 2025. Materials and Methods: This retrospective study included 1731 adult patients treated with emergency HD. Data were collected from patient files, electronic health records and telephone interviews Results: The mean age of the patients was 60,85 ± 15,64 years, and 60% were male. Chronic kidney disease (CKD) was present in 60% of cases, and at least one comorbid condition was identified in 64%. The most common indications for emergency HD were uremic symptoms, hypervolemia, and pulmonary edema. Acute kidney injury (AKI) accounted for 51% of cases, CKD for 26%, and AKI superimposed on CKD for 23%. In-hospital mortality was 28%, with the highest rate observed in the AKI group (35%). Conclusion: Among patients who underwent emergency HD, the in-hospital mortality rate was found to be 28%, while the 15-year mortality rate reached 82%. The 5-year and 10-year survival rates were determined as 38% and 31%, respectively. Advanced age, the presence of comorbidities, underlying CKD, and emergency HD indications such as hypercalcemia, hypervolemia, and metabolic acidosis were identified as the most significant predictors of both short- and long-term survival. Keywords: Emergency hemodialysis, acute kidney injury, chronic kidney disease, renal survival, mortality