Acute renal failure in critically ill patients: prognosis for recovery of kidney function after prolonged dialysis support.
OBJECTIVE
To clarify the prognosis for eventual recovery of kidney function in patients who experience prolonged dialysis dependence after acute renal failure (ARF).


METHODS
Retrospective, chart review.


METHODS
Inpatients of a large, referral-based hospital.


METHODS
Twenty-six consecutive survivors of ARF who required greater than 4 wk of dialysis support.


RESULTS
All 26 patients were critically ill and developed ARF during treatment in an ICU. The clinical course of these patients was characterized by multiple episodes of renal ischemia or nephrotoxin exposure during dialysis dependence. However, despite multiple renal insults and prolonged dialysis support (mean duration 8.4 +/- 0.7 wk), 23 (88%) of the 26 patients recovered sufficient kidney function to discontinue dialysis. Preexisting renal impairment was associated with a greater risk of irreversible renal failure, and, in patients able to discontinue dialysis, renal recovery was often incomplete.


CONCLUSIONS
Despite some renal damage, most critically ill patients who survive ARF requiring prolonged dialysis support recover life-sustaining kidney function.
Spurney
R F
RF
Department of Medicine, Duke University Medical Center, Durham, NC 27710.
Fulkerson
W J
WJ
Schwab
S J
SJ
D058186:Acute Kidney Injury / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D013997:Time Factors
D003404:Creatinine