Abstract
OBJECTIVE: The purpose of this study was to determine the survival outcome of CPR in patients with Chronic Kidney Disease who underwent cardiopulmonary resuscitation in the emergency department.

Methodology: This observational cohort study was conducted in a tertiary care hospital in Islamabad Pakistan. All the patients who underwent cardiopulmonary resuscitation were included in the study. All patients who were dead on arrival were excluded from the study. Patients with CKD were isolated and were labeled as CKD group. From rest of the patients, a similar number of patients were isolated by consecutive sampling technique. Mortality in the Emergency department and survival to discharge was calculated. Charlson Comorbidity Index was used to compare the mortality outcome in both groups.

Results: From January 2017 to December 2020, we reviewed data from 439 patients, all of whom had undergone the resuscitation in the Emergency Department (ED). Of these, 76 patients were received dead and 5 didn’t have proper documentation of the outcome of resuscitation. From the remaining pool of 363 patients, 207 were male and 156 were female patients. Out of these 363 patients, 107 (29.5%) expired in ED and 251 (69.1%) were admitted. There were 85 patients who had chronic kidney disease (CKD Group) while the remaining 278 patients had no Chronic Kidney Disease. Out of these 278, we selected 85 patients by consecutive sampling to form a non- CKD group. Both groups had other comorbidities for which the Charlson Comorbidity Index (CCI) was calculated (mean=1.47 SD ±1.49). Comparison of survival to discharge from hospital between Non-CKD and CKD groups revealed that of the 59 patients with CKD, 29 (49.2%) patients survived and were successfully discharged from the hospital, while the 56 patients without CKD, only 12 (21.4%) less than half of those with CKD, survived to be discharged.

Conclusion: Survival of in-hospital cardiac arrest patients who undergo Cardiopulmonary resuscitation in an emergency is multifactorial but patients with CKD may have a better outcome due to more reversible causes provided other comorbid conditions are similar.

Key words: Emergency Department. Cardiopulmonary resuscitation (CPR), Chronic Kidney Disease (CKD), Pakistan