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

Autor 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
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo 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.
Palavra-chave Acute renal failure
Risk factors
Prognostic factors
Intensive care unit
Mortality
Idioma Inglês
Data de publicação 2006-10-01
Publicado em 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, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 1339-1347
Fonte http://dx.doi.org/10.1590/S0100-879X2006001000010
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000242173300010
SciELO S0100-879X2006001000010 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/3300

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