title: Acute renal failure requiring renal replacement therapy after orthotopic liver transplantation.
abstract: OBJECTIVE
  Acute renal failure (ARF) is a severe complication in patients undergoing orthotopic liver transplantation (OLT), which predicts a poor outcome. The aim of this study was to analyze risk factors for the development of ARF, including severity of illness, onset time of ARF prognostic factors of outcome, and mortality in a group of critically patients requiring renal replacement therapy (RRT).
  
  
  METHODS
  Retrospective analysis of 240 consecutive liver transplant cases from 1999 to 2001 admitted to the intensive care unit (ICU) was performed to identify risk factors for ARF development after OLT. The analyzed factors were: age, sex, CrS, BUN, diuresis, sepsis, hypovolemia, cardiac failure, nephrotoxic drugs (cyclosporine or FK506, antibiotics), hyperbilirubinemia, associated diseases (DM, CRF), onset time of renal failure and progressiveness, timing of RRT, number of days of RRT, and mortality. We examined variables upon admission to the ICU, before the first RRT, and on the last ICU day before resignation or death. We used Students' t test. Quantitative parameters were expressed as mean values +/- SD.
  
  
  RESULTS
  Of the 240 patients, 20 (8.3%) experienced ARF needing renal replacement therapy during the postoperative period. The results of our study suggested that ARF among patients undergoing RRT conferred an excessive risk of in-hospital death: eight patients died (40%). This increased risk cannot be explained solely by a more pronounced severity of illness.
  
  
  CONCLUSIONS
  Our results provide strong evidence that ARF presents a specific, independent risk factor for a poor prognosis.
authors.affiliation: Dipartimento di Discipline Chirurgiche, Rianimatorie e dei Trapianti, Rianimatorie e dei Trapianti, Italy. aneria@med.unibo.it
authors.forename: S
authors.initials: S
authors.lastname: Faenza
authors.forename: A
authors.initials: A
authors.lastname: Santoro
authors.forename: E
authors.initials: E
authors.lastname: Mancini
authors.forename: S
authors.initials: S
authors.lastname: Pareschi
authors.forename: A
authors.initials: A
authors.lastname: Siniscalchi
authors.forename: C
authors.initials: C
authors.lastname: Zanzani
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D000208:Acute Disease; D000328:Adult; D001806:Blood Urea Nitrogen; D004231:Diuresis; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors