Acute renal failure in the medical ICU still predictive of high mortality.
BACKGROUND
We aimed to determine the outcome and certain predictors of outcome for acute renal failure (ARF) in the medical intensive care unit (ICU) at Tygerberg Hospital.


METHODS
We conducted a retrospective, single-centre cohort study over 12 months comprising all patients admitted to the medical ICU with all causes of renal failure or who developed renal failure following admission to the ICU.


RESULTS
Of 198 medical patients admitted to the ICU, ARF occurred in 46 (23.2%). The leading cause of ARF was acute tubular necrosis. The ICU mortality for ARF patients was 47.8%, compared with 17.5% in ICU patients without ARF. Acute haemodialysis was performed in only 17.3% of the 46 ARF patients. Using Cox proportional hazard regression, we found that mean duration of stay (p<0.001), acute physiology and chronic health evaluation II (Apache II) score (p<0.001), mechanical ventilation (p<0.01), dialysis (p<0.04) and multi-organ failure (p<0.05) affected survival time.


CONCLUSIONS
We found that ARF is still associated with a high mortality rate and longer duration of stay, higher Apache II score, and need for mechanical ventilation; dialysis and presence of multi-organ failure were indicators of a higher mortality rate.
Friedericksen
D V
DV
Department of Medicine, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, W Cape.
Van der Merwe
L
L
Hattingh
T L
TL
Nel
D G
DG
Moosa
M R
MR
D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D000328:Adult; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007362:Intensive Care Units; D007683:Kidney Tubular Necrosis, Acute / Q000150:complications* / Q000628:therapy; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome