Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score

Mendonça, Arnaldo de; Vincent, Jean‐Louis; Pm, Suter; Moreno, Rui P.; Dearden, N. M.; Antonelli, Massimo; Takala, Jukka; Sprung, C. L.; Cantraine, Francis

doi:10.1007/s001340051281

Cited by 657 publications

(441 citation statements)

References 26 publications

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“…The studies show an association of a determined co-morbidity that may or may not affect the appearance of ARF in ICU (8,11,17) . In this study, the restrictive factor located was the small number of comorbidities that, when grouped, did not allow to identify them as a risk factor to ARF.…”

Section: Discussionmentioning

confidence: 89%

“…The ARF is defined, in most studies, as when there is elevation in the creatinine level between 1.3 mg/dl and 5.0 mg/dl, or when there is a need for dialysis treatment (8)(9)(12)(13)(14) . In this study, it was considered as serum creatinine levels greater than 1.5 mg/dl (11)(12) .…”

Section: Discussionmentioning

confidence: 99%

“…The main risk factors to the development of the ARF in ICU are: ischemic, nephrotoxic, infectious, and obstructive events, hypotension, shock (hypovolemic, cardiogenic, and septic), cardiovascular, hepatic and respiratory insufficiency, neoplasia and mean hospitalization time greater than seven days (7)(8) . The identification of the ARF development's risk factors directs the type of treatment , dialysis or non-dialysis (9) .…”

Section: Introductionmentioning

confidence: 99%

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Evolução clínica de pacientes com insuficiência renal aguda em unidade de terapia intensiva

et al. 2008

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Objective: To evaluate the clinical outcome of acute renal failure (ARF) patients when submitted to dialysis and non-dialysis treatments in ICU. Methods: this prospective study included patients over 18 years of age and serum creatinine of >1.5 mg/dl. The patients were included in dialysis and non-dialysis groups. Results: The study included 70 patients, 19 (27.1%) comprised the dialysis group and 51 (72.9%) the non-dialysis group. In the dialysis group, mortality rate was 42.1% and in the non-dialysis group was 33.3% (p<0.58). Conclusion: There were multifactors of ARF in ICU, but ARF is not the single cause for the high mortality rate in ICU patients. Keywords: Renal insufficiency, acute/therapy; Renal insufficiency, acute/epidemiology; Intensive care units; Nursing RESUMOObjetivo: Avaliar a evolução clínica de pacientes com insuficiência renal aguda (IRA) submetidos a tratamento dialítico e não-dialítico na UTI. Métodos: Estudo prospectivo onde foram incluídos pacientes com idade maior que 18 anos e com creatinina sérica > 1,5 mg/dl. Os pacientes foram divididos em grupo dialítico e não-dialítico. Resultados: Dos 70 pacientes incluídos 19 (27,1%) foram do grupo dialítico e 51 (72,9%) do grupo não-dialítico. A taxa de mortalidade foi de 42,1% no grupo dialítico e de 33,3% no grupo não-dialítico (p<0,58). Conclusão: Há multifatores determinando a IRA na UTI, porém, não é causa isolada das elevadas taxas de mortalidade dos pacientes na UTI. Descritores: Insuficiência renal aguda/terapia; Insuficiência renal aguda /epidemiologia; Unidades de terapia intensiva; Enfermagem RESUMEN Objetivo: Evaluar la evolución clínica de pacientes con insuficiencia renal aguda (IRA) sometidos a tratamiento dialítico y no-dialítico en la UCI. Métodos: Se trata de un estudio prospectivo donde fueron incluídos pacientes mayores de 18 años y con creatinina sérica > 1,5 mg/ dl. Los pacientes fueron divididos en grupo dialítico y no-dialítico. Resultados: De los 70 pacientes incluídos 19 (27,1%) fueron del grupo dialítico y 51 (72,9%) del grupo no-dialítico. La tasa de mortalidad fue del 42,1% en el grupo dialítico y del 33,3% en el grupo no-dialítico (p<0,58). Conclusion: Hay multifactores que determinan la IRA en la UCI, sin embargo, no es causa aislada de las elevadas tasas de mortalidad de los pacientes en la UCI.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evolução clínica de pacientes com insuficiência renal aguda em unidade de terapia intensiva

et al. 2008

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“…During the previous decades, the component of AKI had been proposed instead of the WRF, and AKI has also been reported to affect the outcome of patients admitted to ICUs 29, 30, 31. The RIFLE criteria have been established as the standard method for evaluating AKI in intensive care patients 5, 6.…”

Section: Discussionmentioning

confidence: 99%

Worsening renal function definition is insufficient for evaluating acute renal failure in acute heart failure

et al. 2018

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AimsWhether or not the definition of a worsening renal function (WRF) is adequate for the evaluation of acute renal failure in patients with acute heart failure is unclear.Methods and resultsOne thousand and eighty‐three patients with acute heart failure were analysed. A WRF, indicated by a change in serum creatinine ≥0.3 mg/mL during the first 5 days, occurred in 360 patients while no‐WRF, indicated by a change <0.3 mg/dL, in 723 patients. Acute kidney injury (AKI) upon admission was defined based on the ratio of the serum creatinine value recorded on admission to the baseline creatinine value and placed into groups based on the degree of AKI: no‐AKI (n = 751), Class R (risk; n = 193), Class I (injury; n = 41), or Class F (failure; n = 98). The patients were assigned to another set of four groups: no‐WRF/no‐AKI (n = 512), no‐WRF/AKI (n = 211), WRF/no‐AKI (n = 239), and WRF/AKI (n = 121). A multivariate logistic regression model found that no‐WRF/AKI and WRF/AKI were independently associated with 365 day mortality (hazard ratio: 1.916; 95% confidence interval: 1.234–2.974 and hazard ratio: 3.622; 95% confidence interval: 2.332–5.624). Kaplan–Meier survival curves showed that the rate of any‐cause death during 1 year was significantly poorer in the no‐WRF/AKI and WRF/AKI groups than in the WRF/no‐AKI and no‐WRF/no‐AKI groups and in Class I and Class F than in Class R and the no‐AKI group.ConclusionsThe presence of AKI on admission, especially Class I and Class F status, is associated with a poor prognosis despite the lack of a WRF within the first 5 days. The prognostic ability of AKI on admission may be superior to WRF within the first 5 days.

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“…[3][4][5][6] The high mortality rate of these pathologies, especially in ICU, brings out the need for attention for this disease. [1][2][3][4][5][6][7] Studies on chronic kidney diseases have shown the importance of ethnical, 8 environmental, 9,10 socioeconomical, [11][12][13][14][15] and psychic factors, modulating the disease, its complications and progonosis. 16 Many investigations have demonstrated that chronic stress conditions are associated with allostatic overload, 17,18 that is, the attempt of the body to find stability through stressful change, thus leading to changes in cortisol and insulin levels, in the hypothalamo-hypophyseal axis (HPA), kinins, and other proinflammatory elements, among other homeostatic changes.…”

Section: Introductionmentioning

confidence: 99%

Eventos vitais estressores e lesão renal aguda em centros de terapia semi-intensiva e intensiva

Diniz¹,

Marques²,

Blay

et al. 2012

J. Bras. Nefrol.

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Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score

Cited by 657 publications

References 26 publications

Evolução clínica de pacientes com insuficiência renal aguda em unidade de terapia intensiva

Evolução clínica de pacientes com insuficiência renal aguda em unidade de terapia intensiva

Worsening renal function definition is insufficient for evaluating acute renal failure in acute heart failure

Eventos vitais estressores e lesão renal aguda em centros de terapia semi-intensiva e intensiva

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