The effects of acute renal failure on long-term renal function.
The relationship between acute renal failure (ARF) and long-term renal function remains unknown. We therefore undertook a study of patients at the Baltimore VA Hospital to examine the effects of a bout of acute renal injury on long-term renal function. We retrospectively reviewed the relationship between serum creatinine and time of observation for 6058 individuals who had values greater than 1.4 mg/dL in any two consecutive years. Individuals were stratified according to total years of observation with a minimum of two years. Severity of acute renal injury was divided into mild, moderate, and severe with elevations in baseline creatinine of < 50%, 50-300% and > 300% respectively. Sporadic elevations in creatinine were evident in 8-15% of the population. There were a total of 1328 episodes of acute renal failure in 916 patients that were suitable for analysis. Mild ARF on a substrate of normal or mildly abnormal renal function resolved without long-term sequelae. Moderate and severe ARF occurred more frequently on a background of reduced renal function but baseline function was retained in at least 60% of patients. We conclude that ARF is more frequent in patients with chronic kidney disease but it is not invariably associated with an accelerated course to end-stage renal disease or death. Overall, the majority of ARF events resolved without adverse long-term effects suggesting appropriate management in the majority of instances.
Division of Nephrology, Department of Medicine, University of Maryland Medical School, Baltimore, Maryland 21201, USA.
Mohammad
M
Salmanullah
Robert
R
Sawyer
Michael K
MK
Hise
D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D000328:Adult; D003404:Creatinine / Q000097:blood; D005500:Follow-Up Studies; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000209:etiology* / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
D003404:Creatinine