title: Acquired renal insufficiency in critically ill patients.
abstract: We undertook a study to determine the frequency, predisposing factors, and outcome in 315 patients admitted to a medical-surgical ICU, of whom 47 (14.9%) subsequently acquired renal insufficiency (ARI) during their stay in the unit. Four well-recognized risk factors for ARI were present alone or in combination in all episodes: hypotension, sepsis, aminoglycoside antibiotics, and radiocontrast dye. Hypotension was the most prevalent factor, present in 42 (85.8%) episodes, and was the sole factor present in 18 (36.7%). Patients with ARI but without hypotension all survived their ICU stay, while only 13 (33%) of 40 with hypotension survived (p less than .05). Neither initial, peak nor change in BUN or creatinine predicted mortality; oliguria was marginally associated with poor prognosis. Our findings indicate that: a) ARI was a frequent and important contributing factor to mortality in our critically ill patients, b) hypotension was the most common of well-recognized risk factors, and c) conditions that predisposed to ARI also predisposed to mortality, although mortality did not appear to depend on the severity of renal insufficiency.
authors.affiliation: Department of Medicine, Norwalk Hospital, CT.
authors.forename: P I
authors.initials: PI
authors.lastname: Menashe
authors.forename: S A
authors.initials: SA
authors.lastname: Ross
authors.forename: J E
authors.initials: JE
authors.lastname: Gottlieb
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D000368:Aged; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D006801:Humans; D007022:Hypotension / Q000150:complications; D007362:Intensive Care Units; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
chemical_list: D003404:Creatinine