Incidence of severe acute renal failure in adults: results of a community based study.

Feest, Terry; Round, Alfred D; Hamad, S

doi:10.1136/bmj.306.6876.481

Cited by 268 publications

(138 citation statements)

References 11 publications

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“…Advanced resuscitation techniques may have shifted the spectrum of acute renal failure towards patients who would not previously have survived. One group has demonstrated that despite the increased burden of chronic illness, the outcome for renal failure in the ICU has improved [14]; however, the improved survival was limited to patients with APACHE II scores of less than 21 and no improvement was seen in the most severely ill. As in previous studies, we found that nonsurviving patients were significantly older [15±17] but not all authors agree that age has a negative influence on survival [11,12].…”

Section: Discussionsupporting

confidence: 71%

“…In that study renal failure was defined as a creatinine of greater than 177 mmol.l 21 or a sudden rise in serum creatinine of more than 50% from baseline in mild to moderate chronic renal failure. A UK study based on laboratory data, and using a creatinine of greater than 500 mmol.l 21 to define severe acute renal failure, found an incidence of 140.5 per million of the total population [12]. We have found an incidence of combined renal and respiratory failure in adult general intensive care units of 55 per million of the population per annum.…”

Section: Discussionmentioning

confidence: 65%

“…The increased proportion of males with acure renal failure was noted in two earlier series and remains unexplained [11,12]. The Madrid group speculated that an increased incidence of vascular disease amongst males may be partly responsible [11].…”

Section: Discussionmentioning

confidence: 89%

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Renal and respiratory failure in Scottish ICUs

Noble¹,

MacKirdy

Donaldson

et al. 2001

Anaesthesia

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SummaryThe purpose of this study was to define the outcome of patients receiving both renal replacement therapy and mechanical ventilation in 16 Scottish intensive care units over a 2-year period. Patients were identified from the Scottish Intensive Care Society's database. Survivors developing end-stage renal failure were identified after examination of the Scottish Renal Registry's database. Mortality was 64.2% (392/612) for all patients receiving renal replacement therapy and mechanical ventilation. End-stage renal failure developed in 1.6% (3/188) of the survivors of acute renal failure and in 33% (4/11) of the survivors with pre-existing chronic renal failure. Mortality has not improved when compared with earlier studies. End-stage renal failure rarely develops following acute renal failure in the intensive care unit.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 65%

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Renal and respiratory failure in Scottish ICUs

Noble¹,

MacKirdy

Donaldson

et al. 2001

Anaesthesia

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“…Data in the literature are ambiguous on this point. Two community-based studies found that older age was associated with a higher incidence of ARF (11,40). In a general medical ICU population and in a population of patients undergoing myocardial revascularization, age was an independent factor associated with the development of ARF in multivariable analysis (14,24,35).…”

Section: Discussionmentioning

confidence: 96%

Acute Renal Failure in Patients with Sepsis in a Surgical ICU

Hoste¹,

Lameire²,

Vanholder³

et al. 2003

Journal of the American Society of Nephrology

379

234

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Abstract. Acute renal failure (ARF) is a common complication in intensive care unit (ICU) patients. Although there are several reports on outcome of septic patients with ARF, there are no data regarding predisposing factors for ARF. Therefore, the incidence of ARF was investigated in 185 sepsis patients admitted in a surgical ICU during a 16-mo period. Variables predisposing to ARF on day 1 of sepsis were evaluated with univariate and multivariable analyses. APACHE II and SOFA scores were compared during a 14-d period. Additionally, the impact of organ failure on mortality was evaluated. ARF developed in 16.2% of the patients, and 70.0% of these needed renal replacement therapy (RRT). Patients with ARF were more severely ill and had a higher mortality. Remarkably, serum creatinine was already increased on day 1. Creatinine Ͼ 1 mg/dl and pH Ͻ 7.30, both on day 1 of sepsis, were independently associated with ARF. Age, need for vasoactive therapy, mechanical ventilation, and RRT, but not ARF itself, were associated with mortality. In conclusion, ARF was a frequent complication in sepsis. Sepsis patients with ARF were more severely ill and had a higher mortality. Need for RRT was independently associated with mortality. A simple risk model for ARF, on basis of two readily available parameters on day 1 of sepsis, was developed. This model allows initiating specific therapeutic measures earlier in the course of sepsis, hopefully resulting in a lower incidence of ARF and needi for RRT, thereby lowering mortality.Acute renal failure (ARF) is a common complication in patients admitted to the intensive care unit (ICU). Numerous causes are responsible for the development of ARF (1); moreover, ARF has often a multi-factorial etiology in critically ill patients. The relative importance of factors contributing to ARF will be different depending on the underlying pathology and patient characteristics. A patient population of young trauma patients developing ARF can probably not be compared with older patients with ischemic and congestive heart disease developing ARF after cardiac surgery. The large differences in mortality for patients with ARF, as reported in recent trials (varying between 28 and 83%) can possibly be explained by differences in patient population (2-25). On the other hand, the relatively stable mortality of patients with ARF over the past decades, despite advances in critical and renal care, is attributed to the changing pattern of associated pathology and patient populations (26 -29).Analysis of a well-described subgroup of ICU patients (e.g., patients after cardiac surgery or sepsis patients) can reveal more precise information concerning the epidemiology and risk factors for development of ARF.Sepsis is a common condition with an annual death toll in the United States comparable to that of acute myocardial infarction (30). Sepsis is also a well-known risk factor for the development of ARF, and 35 to 50% of ARF cases in the ICU can be attributed to sepsis (2,12,20,23). Mortality in this subgroup of patients...

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“…1 In patients .60 years of age, there is a 3-to 8-fold progressive and age-dependent increase in the frequency of AKI. [2][3][4] The elderly also suffer increased rates of progression to CKD, ESRD, and death after an episode of AKI compared with younger patients. 5 Because the number of United States citizens ages 65 years old or older will double over the next 20 years, the burden of AKI in this group will be substantial.…”

mentioning

confidence: 99%

Targeting Endogenous Repair Pathways after AKI

Humphreys

Cantaluppi

Portilla

et al. 2016

Journal of the American Society of Nephrology

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AKI remains a highly prevalent disease associated with poor short-and long-term outcomes and high costs. Although significant advances in our understanding of repair after AKI have been made over the last 5 years, this knowledge has not yet been translated into new AKI therapies. A consensus conference held by the Acute Dialysis Quality Initiative was convened in April of 2014 and reviewed new evidence on successful kidney repair to identify the most promising pathways that could be translated into new treatments. In this paper, we provide a summary of current knowledge regarding successful kidney repair and offer a framework for conceptualizing the therapeutic targeting that may facilitate this process. We outline gaps in knowledge and suggest a research agenda to more efficiently bring new discoveries regarding repair after AKI to the clinic.

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Incidence of severe acute renal failure in adults: results of a community based study.

Abstract: Objective-To determine the age related incidence of severe acute renal failure in adults in two

Cited by 268 publications

References 11 publications

Renal and respiratory failure in Scottish ICUs

Renal and respiratory failure in Scottish ICUs

Acute Renal Failure in Patients with Sepsis in a Surgical ICU

Targeting Endogenous Repair Pathways after AKI

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