[The importance of comorbidity in nephrologists' assessment of acute renal failure].
OBJECTIVE
To study the features of acute renal failure (ARF) in our hospital and to determine prognosis and mortality associated factors.


METHODS
Retrospective study of ARF episodes during a two years period (2005-2007). ARF was considered when a sudden rise in serum creatinine concentration was more than 0,5 mg/dl in patients with normal renal function and more than 1 mg/dl in patients with previous mild to moderate chronic renal failure. We analyzed epidemiologic, clinical, laboratories results, therapeutics and prognosis factors.


RESULTS
Two hundred and one patients were evaluated (62,7% males; Age= 67,35 16,38 years (63,68%>65 years); Comorbility Index of Charlson 3,49 2,43). 115 episodes presented in patients with previous renal failure. ARF was pre-renal in 52,7%, renal in 34,8% and post-renal in 8,5%. 35,8% of ARF patients had oliguria or anuria. The mean duration of ARF/hospitalization was 22,47 days (22,47 21,83). The percentage of resolved ARF was 70,1%. Mortality was 30,8%. The univariated analysis showed comorbility Index of Charlson, oliguria, low serum albumin and cholesterol, and anemia were significantly associated with mortality (p<0,05). The lineal regression analysis found three factors associated to the mortality rate: Comorbility Index of Charlson, oliguria and low serum cholesterol. Mortality predictive model was carried out.


CONCLUSIONS
Highest basal comorbility of patients, oliguria and malnutrition-inflammation dates are princess prognosis and mortality factors in ARF today A new approach is needed in ARF because this new type/class of population.
Ortiz Librero
M
M
Area de Nefrologia, Hospital Severo Ochoa, Leganés, Madrid. mortizl.hsvo@salud.madrid.org
Mon Mon
C
C
Herrero Berrón
J C
JC
Lentisco Ramírez
C
C
Gracia Iguacel
C
C
Oliet Pala
A
A
Vigil Medina
A I
AI
Ortega Marcos
O
O
Gallar Ruiz
P
P
Rodríguez Villareal
I
I
Sánchez Sánchez
M
M
D058186:Acute Kidney Injury / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009398:Nephrology; D011379:Prognosis; D012189:Retrospective Studies