Epidemiology of acute renal failure and outcome of haemodiafiltration in intensive care

Schwilk, B.; Wiedeck, H; Stein, Brian; Reinelt, Helmut; Treiber, H.; Bothner, Ulrich

doi:10.1007/s001340050487

Cited by 115 publications

(58 citation statements)

References 30 publications

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“…Other authors [31] have also demonstrated that the occurrence of postoperative mild to moderate acute kidney injury (AKI) was associated with a mortality rate of 10% to 20%, indings that are consistent with results from our study. Interestingly, AKI incidents in this study were associated with even much higher in-hospital mortality rates (50%) despite the application of postoperative CVVH.…”

Section: Discussionsupporting

confidence: 83%

The Risk-Adjusted Impact of Intraoperative Hemofiltration on Real-World Outcomes of Patients Undergoing Cardiac Surgery

BM¹

2017

J Clini Nephrol

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Objectives: The role of perioperative hemofi ltration (HF) in adult patients with impaired renal function undergoing cardiac surgery is controversial. There are suggestions that it may be benefi cial for high risk patients undergoing prolonged cardiopulmonary bypass (CPB) surgery. However, long term outcomes in coronary artery bypass graft (CABG) surgery patients have not been investigated. Methods:To address this we retrospectively followed 7620 patients who underwent CABG between April 2001 and March 2006. Logistic regression was used to risk adjust in-hospital outcomes. Cox proportional hazards analysis was used to risk adjust Kaplan-Meier freedom from death curves. Outcomes were adjusted for American Heart Association and American College of College of Cardiology recommended variables.Results: 113 patients had intraoperative HF, 38 had postoperative HF and control group of 7006 that had no HF. After adjusting for differences in case-mix, patients with preoperative kidney disease who received postoperative HF proportionately had signifi cantly higher rates of hospital deaths as compared with intraoperative HF patients. In addition, 5-year follow-up risk-adjusted freedom from death indicated signifi cant differences between intraoperative HF group and postoperative HF patients. Conclusions:These fi ndings support the hypothesis that after adjusting for differences in case mixes, the use of intraoperative hemofi ltration may offer superior short term clinical outcomes and longer-term survival benefi ts for patients with preoperative kidney disease.

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Section: Discussionsupporting

confidence: 83%

The Risk-Adjusted Impact of Intraoperative Hemofiltration on Real-World Outcomes of Patients Undergoing Cardiac Surgery

BM¹

2017

J Clini Nephrol

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“…Other studies have indicated that comorbid conditions or surgical complications only partly account for the mortality difference between patients with and without ARF (23,24). Multiple organ failures primarily contributed to high mortality in patients with ARF and were strong predictors of death (6,26). In our study, when the logistic regression model included other organ failure, ARF was still significant for death, suggesting that ARF is an independent predictor of death.…”

Section: Figure 2 Odds Ratio (Or) For Arf Defined By Diagnosis Codinmentioning

confidence: 47%

Incidence and Mortality of Acute Renal Failure in Medicare Beneficiaries, 1992 to 2001

Xue

Daniels

Star

et al. 2006

Journal of the American Society of Nephrology

692

465

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This study's objective was to determine the incidence and mortality of acute renal failure (ARF) in Medicare beneficiaries. Data were from hospitalized Medicare beneficiaries (5,403,015 discharges) between 1992 and 2001 from the 5% sample of Medicare claims. For 1992 to 2001, the overall incidence rate of ARF was 23.8 cases per 1000 discharges, with rates increasing by approximately 11% per year. Older age, male gender, and black race were strongly associated (P < 0.0001) with ARF. The overall in-hospital death rate was 4.6% in discharges without ARF, 15.2% in discharges with ARF coded as the principal diagnosis, and 32.6% in discharges with ARF as a secondary diagnosis. In-hospital death rates were 32.9% in discharges with ARF that required renal dialysis and 27.5% in those with ARF that did not require dialysis. Death within 90 d after hospital admission was 13.1% in discharges without ARF, 34.5% in discharges with ARF coded as the principal diagnosis, and 48.6% in discharges with ARF as a secondary diagnosis. Discharges with ARF were more (P < 0.0001) likely to have intensive care and other acute organ dysfunction than those without ARF. For discharges both with and without ARF, rates for death within 90 d after hospital admission showed a declining trend. In conclusion, the incidence rate of ARF in Medicare beneficiaries has been increasing. Those of older age, male gender, and black race are more likely to have ARF. These data show ARF to be a major contributor to morbidity and mortality in hospitalized patients.

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“…These results are similar to those of previous research. [23] The mortality of patients who received conservative treatment was 35.6%, while that of patients who received RRT was 23.2%. Thus, early initiation of dialysis seems important for patients with severe ARF, especially the elderly.…”

Section: Discussionmentioning

confidence: 95%

Acute Renal Failure in Hospitalized Patients in China: A Prospective Study

Wang

et al. 2009

Renal Failure

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Acute renal failure (ARF) is a common complication in hospitalized patients, but little is known about the epidemiology of ARF in China. In this study, we performed a prospective examination of the cause, prognosis, and risk factors associated with ARF at a hospital in Shanghai, China. We considered all ARF patients who were admitted to our hospital from December 2003 to December 2006. Among the 320 ARF patients, 135 (42.2%) were over the age of 60. Sepsis, heart failure, and nephrotoxic drug use were the leading causes of ARF. The overall mortality rate was 31.9%, and mortality rate was significantly higher among the elderly. Logistic regression indicated that heart failure, respiratory failure, and malignant cancer were risk factors independently associated with poor prognosis. In this Shanghai hospital, there was a high incidence and mortality rate of patients hospitalized with ARF. The prognosis of patients who underwent renal replacement therapy was better than those who were treated more conservatively.

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Epidemiology of acute renal failure and outcome of haemodiafiltration in intensive care

Abstract: General measures of severity are not useful in predicting the outcome of ARF. Only the nature and number of dysfunctioning organ systems and massive transfusion at the beginning of CVVHDF and the age of the patients gave a reliable prognosis in this group of patients.

Cited by 115 publications

References 30 publications

The Risk-Adjusted Impact of Intraoperative Hemofiltration on Real-World Outcomes of Patients Undergoing Cardiac Surgery

The Risk-Adjusted Impact of Intraoperative Hemofiltration on Real-World Outcomes of Patients Undergoing Cardiac Surgery

Incidence and Mortality of Acute Renal Failure in Medicare Beneficiaries, 1992 to 2001

Acute Renal Failure in Hospitalized Patients in China: A Prospective Study

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