Spectrum of Acute Renal Failure and Factors Predicting Its Outcome in an Intensive Care Unit in India

Mahajan, Sandeep; Bharani, Rajesh; Bhowmik, D; Saxena, Rahul; Agarwal, Sanjay Kumar; Tiwari, Sachchidanand

doi:10.1080/08860220500530395

Cited by 23 publications

(26 citation statements)

References 23 publications

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“…There are many studies that support the relationship between mortality and hypoalbuminemia. [7,8,[11][12][13] Our study also confirms these reports: in our study, mortality was significantly higher in patients with low albumin levels. In future studies, it may be worth investigating the hemodynamic effects of intradialytic or interdialytic albumin infusions in a low-albumin level group.…”

Section: Discussionsupporting

confidence: 82%

Outcomes of Acute Renal Failure Patients Requiring Intermittent Hemodialysis

Öztürk¹,

Arpacı²,

Yazıcı³

et al. 2007

Renal Failure

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The published studies on the prognosis of patients requiring intermittent hemodialysis (IHD) are scarce and have some conflicts. In this study, we retrospectively analyzed our data on ARF patients who were treated with IHD. A total of 192 (female: 85, 44.3%; male: 107, 55.7%) patients were included in the study. The mean age was 56.3 ± 17.1 years. In all, 48.9% of the patients were older than 60 years. The mean number of IHD sessions was 7.8 ± 8.0 per patient; 12.4% was due to prerenal causes, 76.8% was due to intrarenal causes, and 10.8% was due to postrenal causes. The leading indication of the IHD was uremic symptoms (46.8%). With the exclusion of hypertension, 72.4% of the patients had at least one systemic comorbidity. After treatment, 75.5% of the patients recovered, in contrast to 9.4% of patients who were transferred to chronic renal replacement programs and 15.1% who died during IHD period. Pre-dialytic serum creatinine (p = 0.003) and albumin levels (p = 0.016), total IHD session number per patient (p = 0.003), and age (p = 0.034) were the parameters that were related to high mortality in statistical analysis. Mortality was higher if the leading indication of IHD was biochemical disturbances (p = 0.013). Diabetes mellitus did not influence mortality. Consequently, predialytic serum creatinine and albumin levels may be very important predictors of mortality. Patients in high-risk groups (older age, female sex, and low pre-dialytic creatinine and albumin levels) should be considered to be treated with slow continuous renal replacement methods.

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Section: Discussionsupporting

confidence: 82%

Outcomes of Acute Renal Failure Patients Requiring Intermittent Hemodialysis

Öztürk¹,

Arpacı²,

Yazıcı³

et al. 2007

Renal Failure

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“…[24] A study by Sandeep et al ., which evaluated acute renal failure in ICU, found sepsis to be more common than nephrotoxic drugs. [25] Kaul et al ., in their study have reported acute diarrhea as the most common cause. [26] In our study drug induced AKI accounted for only 5.6% of the cases, which is lower than the previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Mahajan et al ., who evaluated ARF in ICU, reported that 71.1% required RRT and that intermittent RRT was the most common mode used. [25] These modes are associated with lower cost, lesser adverse effects when compared to the other RRT modes. However, patient outcomes of all three modalities have been shown to be comparable in several studies.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of acute kidney injury in critically ill patients: A single center study from South India

Eswarappa¹,

Gireesh²,

Ravi³

et al. 2014

Indian J Nephrol

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Acute kidney injury (AKI) is common in intensive care unit (ICU) and carries a high mortality rate. Reliable and comparable data about the clinical spectrum of AKI is necessary for optimizing management. The study was conducted to describe epidemiology, etiology, clinical characteristics and outcome of AKI in critically ill patients without pre-existing renal disease, diagnosed using RIFLE criteria. We retrospectively analyzed data of 500 adult patients admitted to ICU with AKI or who developed AKI in ICU. Patients with pre-existing renal disease, renal transplant recipients were excluded. AKI was predominantly encountered in older males. Diabetes, hypertension, coronary artery disease were the most commonly prevalent comorbidities. Sepsis was the most common cause of AKI, accounting for 38.6% of patients. 24.4% belonged to risk class, 37.0% to injury class, 35.0% to failure class, 3% to loss and 0.6% to ESRD class of the RIFLE criteria. Renal replacement therapy (RRT) was required in 37.2% (n = 186) of patients. About 60% recovered complete renal function. Chronic kidney disease (CKD) was a sequel in 2.4% (n = 12) of patients. Average duration of ICU stay was 5.6 days. Crude mortality rate was 37.6% (n = 188). In critically ill patients without pre-existing renal disease, elderly age, male sex, type 2 diabetes along with a primary diagnosis of sepsis were most commonly associated with AKI. Majority of the patients’ recovered complete renal function.

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“…Thus, in certain regions in Africa and India, boys are more than twice as likely as girls to be taken by their parents to see medical personnel (62)(63)(64)(65)(66). Gender disparity is also expressed in the development of AKI after septic abortion (41,67).…”

Section: Global Perspectivesmentioning

confidence: 99%

Epidemiology of Acute Kidney Injury

Cerdá¹,

Lameire²,

Eggers³

et al. 2008

Clinical Journal of the American Society of Nephrology

243

156

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Background and objectives: The worldwide incidence of acute kidney injury is poorly known because of underreporting, regional disparities, and differences in definition and case mix. New definitions call for revision of the problem with unified criteria.Design, setting, participants, & measurements: This article reports on the research recommendations of an international multidisciplinary committee, assembled to define a research agenda on acute kidney injury epidemiology using a modified three-step Delphi process.Results: Knowledge of incidence and risk factors is crucial because it drives local and international efforts on detection and treatment. Also, notable differences exist between developing and developed countries: Incidence seems higher in the former, but underreporting compounded by age and gender disparities makes available data unreliable. In developing countries, incidence varies seasonally; incidence peaks cause critical shortages in medical and nursing personnel. Finally, in developing countries, lack of systematic evaluation of the role of falciparum malaria, obstetric mechanisms, and hemolytic uremic syndrome on acute kidney injury hampers efforts to prevent acute kidney injury.Conclusions: The committee concluded that epidemiologic studies should include (1) prospective out-and inpatient studies that measure incidence of community and hospital acute kidney injury and post-acute kidney injury chronic kidney disease; (2) incidence measurements during seasonal peaks in developing and developed countries; and (3) whenever available, use of reliable existing administrative or institutional databases. Epidemiologic studies using standardized definitions in community and institutional settings in developing and underdeveloped countries are essential first steps to achieving early detection and intervention and improved patient outcomes.

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Spectrum of Acute Renal Failure and Factors Predicting Its Outcome in an Intensive Care Unit in India

Cited by 23 publications

References 23 publications

Outcomes of Acute Renal Failure Patients Requiring Intermittent Hemodialysis

Outcomes of Acute Renal Failure Patients Requiring Intermittent Hemodialysis

Spectrum of acute kidney injury in critically ill patients: A single center study from South India

Epidemiology of Acute Kidney Injury

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