An improvement in the outcome of acute renal failure.
BACKGROUND
Acute renal failure (ARF) requiring hemodialysis (HD) treatment is related to high mortality. The aim of this study was to analyze the influence of age, disease severity, and catabolism intensity on ARF outcome in patients requiring HD treatment during a 15-year period (1987-2001).


METHODS
The retrospective, single-center study included 583 patients, 428 male, 155 female, age 49+/-15 years, treated by intermittent HD using cuprophane membranes with surface area of 1.3 m2. Liano's Acute Tubular Necrosis Individual Severity Score (ATNISS) score and Hypercatabolism Depuration Score (HDS) score were calculated to estimate disease severity and catabolism intensity in ARF patients.


RESULTS
Average age of patients significantly increased during the 15-year period for more than one decade (44 to 55 years; p=0.0359), especially during the last five-year period (47+/-14.5 vs. 53+/-14.7, p=0.00015). Disease severity showed significant increase comparing periods 1992-1996 and 1997-2001 (ATNISS 0.385+/-0.197 vs. 0.437+/-0.208; p=0.00137), while catabolism intensity during these periods was similar (HDS 0.569+/-0.145 vs. 0.582+/-0.127; p=0.357). Despite the older and more severely ill population of ARF patients, mortality showed a sustained decrease during the 15-year period. Mortality in the period from 1987 to 1991 (49/83; 59%) was similar with the period 1992-1996 (chi2=0.44, p=0.5081), but significantly higher than in the period 1997-2001 (114/250; 45.6%; chi2=3.98, p = 0.0471).


CONCLUSIONS
The results showed an improvement in the outcome of patients with ARF requiring HD treatment, despite increasing age, disease severity, and use of bioincompatible membranes.
Radovic
Milan
M
Clinic of Nephrology, Clinical Center of Serbia, Belgrade, Serbia. milan.r@Eunet.yu
Tomovic
Mina
M
Simic-Ogrizovic
Sanja
S
Stosovic
Milan
M
Lezaic
Visnja
V
Ostric
Vladimir
V
Djukanovic
Ljubica
L
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D007683:Kidney Tubular Necrosis, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome