Clinical features and prognosis of the patients with acute renal failure in the intensive care unit

Objective

To examine the etiologies of acute renal failure (ARF) and to evaluate the hemodynamic and ventilatory data, mortality, ICU and hospital stays and therapies of the patients with ARF. We compared these parameters between the patients who had ARF at ICU admission and those who developed ARF during their ICU stay.

Methods

Seven hundred and thirty patients admitted to the ICU from January 2001 to January 2002 were retrospectively evaluated in terms of ARF. A serum creatinine level of 2 mg/dl or more was defined as ARF, and 72 patients were diagnosed as ARF. Among 72 patients with ARF, Group 1 (n = 47) consisted of the patients who had ARF at ICU admission. Group 2 (n = 25) consisted of the patients who developed ARF during their ICU stay.

Results

There was no difference in the demographic data and APACHE II scores between the two groups (P > 0.05). The mortality rate of the patients who had ARF at ICU admission was 72%. The patients who developed ARF in the ICU had a mortality of 68%. The mean durations of the mechanical ventilation, ICU and hospital stay of the patients in Group 1 and Group 2 were 9.04 ± 10.9 and 9.7 ± 9.04 days, 10.6 ± 13.3 and 12.3 ± 9.6 days, and 20.5 ± 20.6 and 17.5 ± 11.8 days, respectively. There was no significant difference in terms of the mortality rate, ICU and hospital stay, hemodynamic and respiratory data between the two groups (P > 0.05). The mean serum creatinine levels were 4.4 ± 2.3 vs 3.2 ± 0.7 mg/dl (P < 0.01), and the mean serum lactate levels were 2.17 ± 2.8 vs 0.94 ± 0.9 mmol/l (P < 0.01). Hemodialysis was required in 37.5% of all patients with ARF. The most frequent reason causing ARF was sepsis (61%).

Conclusion

The mortality rate of our critically ill patients with ARF was approximately 70%, which is comparable with the results of the literature. There was no significant difference in terms of mortality and morbidity between patients who had ARF at ICU admission and those who developed ARF during their ICU stay.