Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/9979
Title: Acute renal failure in critically ill patients: a multinational, multicenter study.
Authors: Uchino, Shigehiko;Kellum, John A;Bellomo, Rinaldo;Doig, Gordon S;Morimatsu, Hiroshi;Morgera, Stanislao;Schetz, Miet;Tan, Ian;Bouman, Catherine;Macedo, Ettiene;Gibney, Noel;Tolwani, Ashita;Ronco, Claudio
Institutional Author: Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators
Affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia.
Issue Date: 17-Aug-2005
Citation: Jama; 294(7): 813-8
Abstract: Although acute renal failure (ARF) is believed to be common in the setting of critical illness and is associated with a high risk of death, little is known about its epidemiology and outcome or how these vary in different regions of the world.To determine the period prevalence of ARF in intensive care unit (ICU) patients in multiple countries; to characterize differences in etiology, illness severity, and clinical practice; and to determine the impact of these differences on patient outcomes.Prospective observational study of ICU patients who either were treated with renal replacement therapy (RRT) or fulfilled at least 1 of the predefined criteria for ARF from September 2000 to December 2001 at 54 hospitals in 23 countries.Occurrence of ARF, factors contributing to etiology, illness severity, treatment, need for renal support after hospital discharge, and hospital mortality.Of 29 269 critically ill patients admitted during the study period, 1738 (5.7%; 95% confidence interval [CI], 5.5%-6.0%) had ARF during their ICU stay, including 1260 who were treated with RRT. The most common contributing factor to ARF was septic shock (47.5%; 95% CI, 45.2%-49.5%). Approximately 30% of patients had preadmission renal dysfunction. Overall hospital mortality was 60.3% (95% CI, 58.0%-62.6%). Dialysis dependence at hospital discharge was 13.8% (95% CI, 11.2%-16.3%) for survivors. Independent risk factors for hospital mortality included use of vasopressors (odds ratio [OR], 1.95; 95% CI, 1.50-2.55; P<.001), mechanical ventilation (OR, 2.11; 95% CI, 1.58-2.82; P<.001), septic shock (OR, 1.36; 95% CI, 1.03-1.79; P = .03), cardiogenic shock (OR, 1.41; 95% CI, 1.05-1.90; P = .02), and hepatorenal syndrome (OR, 1.87; 95% CI, 1.07-3.28; P = .03).In this multinational study, the period prevalence of ARF requiring RRT in the ICU was between 5% and 6% and was associated with a high hospital mortality rate.
Internal ID Number: 16106006
URI: http://ahro.austin.org.au/austinjspui/handle/1/9979
DOI: 10.1001/jama.294.7.813
URL: http://www.ncbi.nlm.nih.gov/pubmed/16106006
Type: Journal Article
Subjects: Acute Kidney Injury.epidemiology.etiology.physiopathology.therapy
Aged
Critical Illness
Female
Hospital Mortality
Hospitals.classification.statistics & numerical data
Humans
Intensive Care Units.classification.statistics & numerical data
Male
Middle Aged
Outcome Assessment (Health Care)
Prevalence
Prospective Studies
Renal Replacement Therapy
Severity of Illness Index
Appears in Collections:Journal articles

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