Incidence, risk factors and prognostic factors of acute renal failure in patients admitted to an intensive care unit

Incidence, risk factors and prognostic factors of acute renal failure in patients admitted to an intensive care unit

Author Mataloun, Sergio Elia Autor UNIFESP Google Scholar
Machado, Flávia Ribeiro Autor UNIFESP Google Scholar
Senna, Ana Paula Resque Autor UNIFESP Google Scholar
Guimarães, Hélio Penna Autor UNIFESP Google Scholar
Amaral, José Luiz Gomes do Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The objective of the present study was to assess the incidence, risk factors and outcome of patients who develop acute renal failure (ARF) in intensive care units. In this prospective observational study, 221 patients with a 48-h minimum stay, 18-year-old minimum age and absence of overt acute or chronic renal failure were included. Exclusion criteria were organ donors and renal transplantation patients. ARF was defined as a creatinine level above 1.5 mg/dL. Statistics were performed using Pearsons' chi2 test, Student t-test, and Wilcoxon test. Multivariate analysis was run using all variables with P < 0.1 in the univariate analysis. ARF developed in 19.0% of the patients, with 76.19% resulting in death. Main risk factors (univariate analysis) were: higher intra-operative hydration and bleeding, higher death risk by APACHE II score, logist organ dysfunction system on the first day, mechanical ventilation, shock due to systemic inflammatory response syndrome (SIRS)/sepsis, noradrenaline use, and plasma creatinine and urea levels on admission. Heart rate on admission (OR = 1.023 (1.002-1.044)), male gender (OR = 4.275 (1.340-13642)), shock due to SIRS/sepsis (OR = 8.590 (2.710-27.229)), higher intra-operative hydration (OR = 1.002 (1.000-1004)), and plasma urea on admission (OR = 1.012 (0.980-1044)) remained significant (multivariate analysis). The mortality risk factors (univariate analysis) were shock due to SIRS/sepsis, mechanical ventilation, blood stream infection, potassium and bicarbonate levels. Only potassium levels remained significant (P = 0.037). In conclusion, ARF has a high incidence, morbidity and mortality when it occurs in intensive care unit. There is a very close association with hemodynamic status and multiple organ dysfunction.
Keywords Acute renal failure
Risk factors
Prognostic factors
Intensive care unit
Mortality
Language English
Date 2006-10-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 39, n. 10, p. 1339-1347, 2006.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 1339-1347
Origin http://dx.doi.org/10.1590/S0100-879X2006001000010
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000242173300010
SciELO ID S0100-879X2006001000010 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/3300

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