Renal failure in the ICU: Comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes

摘要: Background Acute renal failure (ARF) is associated with a persistent high mortality in critically ill patients intensive care units (ICUs). Most studies to date have focused on established, intrinsic ARF or relatively severe due multiple factors. None examined outcomes of dialysis-dependent chronic [end-stage disease (ESRD)] the ICU. We incidence and ICU using standard definition compared these either ESRD no failure. sought determine impact dysfunction and/or loss organ function outcome. Methods prospectively scored 1530 admissions eight ICUs over 10-month period for illness severity at admission Physiological Chronic Health Evaluation (APACHE III) evaluation tool. Patients were defined as having based Hou et al (Am J Med 74:243-248,1983) designed detect significant measurable declines serum creatinine. identified being chronically prior remainder had Clinical characteristics hospital between three groups. Results 254 cases ARF, 57 1219 an 17%. Roughly half developed during their stay. Only 11% required dialysis support. significantly higher acute scores than those failure, whereas intermediate scores. was 23% ESRD, 5% There difference outcome who enough require 57%. APACHE III predicted very well time scoring but underpredicted after overestimated ESRD. Conclusions common has negative outcomes, although majority not The from all causes almost exactly similar that noted same criteria two decades ago. More profound requiring continues even greater mortality. Nevertheless, are explained simply by function. did still considerably patients, whom dialysis; while much morality patients. performs captures scoring. Development effect standardized unable identify unique presence insufficiency be sensitive marker poor