Prognostic Patterns in Acute Renal Failure: The New York Hospital, 1981–1982

Abstract

Sixty four patients who developed acute renal failure at The New York Hospital between July 1981 and June 1982 were studied. The average age was found to be 59.5 years. The overall mortality rate was 62.5%. Patients with non-oliguric renal failure had a lower mortality rate (25%) than those with oliguric renal failure (79%). Those patients with non-oliguric renal failure were more likely to have a discrete cause of renal failure (drugs) and to be in a more stable cardiovascular status. Tachycardia, hypotension, respiratory failure, and documented (or presumed) sepsis all adversely affected prognosis.

A Comparison of Nonoliguric and Oliguric Severe Acute Kidney Injury according to the Risk Injury Failure Loss End-Stage (RIFLE) Criteria

“…It has been well known that nonoliguric AKI is associated with a better prognosis [2,3,4,5]. The exact mechanisms through which nonoliguric AKI confers survival benefits over oliguric AKI remain uncertain.…”

“…Evidence suggests that nonoliguric AKI, either spontaneously or in response to frusemide, is associated with a better prognosis than oliguric AKI [2,3,4,5]. It appears that some degree of renal function may be preserved when urine output is maintained in nonoliguric AKI.…”

Acute Renal Failure in the Medical Intensive Care Unit: Predisposing, Complicating Factors and Outcome

“…The prevalence of ARF(16%) in our medical ICU, however, averages that in other ICUs, ranging from 3 to 30% [5,6,9,14,26,30] and generally exceeding the 2-5% prevalence outside these units [13,24], The reported risk factors for ARF are hard to com pare, partly due to differences in patient populations, definitions, and reliance on univariate analyses [1][2][3][4][5][6][7]9,10,[12][13][14]16,19,[21][22][23][24][26][27][28][29][30][31]. Nevertheless, the factors pred isposing to ARF in these populations generally include advanced age, prior chronic disease such as renal failure and hypertension, hypovolemia, sepsis, pigmenturia, use of radiocontrast and aminoglycosides, with hypotension as the main risk factor.…”

“…When explored in mixed patient populations, the pre valence of ARF may be lower in patients with a primary medical disease than in surgical patients [1,3,10,11,14,18,19,21,27], but others recently suggested the opposite because of a rising incidence of ARF of medical origin [8,12,13,16,19,22,24,28,31]. The prevalence of ARF(16%) in our medical ICU, however, averages that in other ICUs, ranging from 3 to 30% [5,6,9,14,26,30] and generally exceeding the 2-5% prevalence outside these units [13,24], The reported risk factors for ARF are hard to com pare, partly due to differences in patient populations, definitions, and reliance on univariate analyses [1][2][3][4][5][6][7]9,10,[12][13][14]16,19,[21][22][23][24][26][27]…”

“…The risk factors for ARF development and subsequent mortality have been studied in mixed patient popula tions, mostly including patients with trauma, burns or major surgery [1][2][3][4][5][6][7][8][9][10][12][13][14][15][16][17][18][19][21][22][23][24][25][26][27][28]30,31]. Studies are hard to compare, partly due to differences in patient popula tions, definitions and reliance on univariate analyses, precluding assessment of the interdependence of vari ables [1-9,11,12,19-22,26,29.31].…”