Prognostic factors in acute renal failure due to sepsis. Results of a prospective multicentre study

Neveu, H.; Kleinknecht, D; Brivet, F.; Loirat, P; Landais, Paul

doi:10.1093/oxfordjournals.ndt.a027256

Cited by 302 publications

(221 citation statements)

References 0 publications

Supporting

Mentioning

193

Contrasting

Unclassified

Order By: Relevance

“…Various risk factors for increased mortality in ATN have been identified, including male sex, advanced age, comorbid illness, malignancy, oliguria, sepsis, mechanical ventilation, multiorgan failure, and severity-of-illness score (18,20). Traditional models of predicting death in critically ill patients, such as the Acute Physiology and Chronic Health Evaluation II (APACHE II) system, underestimate the risk for death in patients with ATN.…”

Section: Epidemiology and Outcomes Of Atnmentioning

confidence: 99%

Diagnosis and Treatment of Acute Tubular Necrosis

Esson

Schrier²

2002

Ann Intern Med

230

147

View full text Add to dashboard Cite

Section: Epidemiology and Outcomes Of Atnmentioning

confidence: 99%

Diagnosis and Treatment of Acute Tubular Necrosis

Esson

Schrier²

2002

Ann Intern Med

230

147

View full text Add to dashboard Cite

“…The incidence ranges from 15-50% [2][3][4], and is associated with a mortality rate of 30-75% [2][3][4][5]. This variation in reported incidence and outcome is partly due to heterogeneous patients and different definitions of kidney injury used in these studies.…”

Section: Introductionmentioning

confidence: 99%

The effects of vasopressin on acute kidney injury in septic shock

et al. 2009

View full text Add to dashboard Cite

Kidney injury was present in 464 patients (59.6%) at study entry. In patients in the RIFLE "Risk" category (n=106) vasopressin as compared with norepinephrine was associated with a trend to a lower rate of progression to renal "Failure" or "Loss" categories (20.8% v 39.6% respectively, p=0.03), and a lower rate of use of renal replacement therapy (17.0% v 37.7%, p=0.02). Mortality rates in the "Risk" category patients treated with vasopressin compared to norepinephrine were 30.8% v 54.7%, p=0.01, but this did not reach significance in a multiple logistic regression analysis (OR=0.33, 99%CI 0.10-1.09, p=0.02). The interaction of treatment group and RIFLE category was significant in predicting mortality. Conclusions:Vasopressin may reduce progression to renal failure and mortality in patients at risk of kidney injury who have septic shock.

show abstract

“…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 is considerably higher than in other subgroups of ARF (2,20,23).Despite these considerations, there are to the best of our knowledge hardly any data concerning risk factors associated with the development of ARF in patients with sepsis. Our own group found in 1993 that sepsis patients who developed ARF had more associated organ failure, more need for vasoactive therapy, and had a lower central venous pressure (CVP), despite more aggressive fluid therapy, compared with sepsis patients without ARF (31).…”

mentioning

confidence: 99%

Acute Renal Failure in Patients with Sepsis in a Surgical ICU

Hoste¹,

Lameire²,

Vanholder³

et al. 2003

Journal of the American Society of Nephrology

377

234

View full text Add to dashboard Cite

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...

show abstract

Prognostic factors in acute renal failure due to sepsis. Results of a prospective multicentre study

Cited by 302 publications

References 0 publications

Diagnosis and Treatment of Acute Tubular Necrosis

Diagnosis and Treatment of Acute Tubular Necrosis

The effects of vasopressin on acute kidney injury in septic shock

Acute Renal Failure in Patients with Sepsis in a Surgical ICU

Contact Info

Product

Resources

About