Determinants of Survival and Recovery in Acute Renal Failure Patients Dialyzed in Intensive-Care Units
作者:
David M. Spiegel,
Michael E. Ullian,
Gary O. Zerbe,
Tomas Berl,
期刊:
American Journal of Nephrology
(Karger Available online 1991)
卷期:
Volume 11,
issue 1
页码: 44-47
ISSN:0250-8095
年代: 1991
DOI:10.1159/000168271
出版商: S. Karger AG
关键词: Survival;Dialysis;Intensive-care units
数据来源: Karger
摘要:
The survival rate of critically ill patients who develop acute renal failure is extremely low, in spite of the sophisticated support systems, including dialysis. Therefore, it would be advantageous to identify, early in the disease course, those few survivors. We reviewed the clinical course of 43 consecutive critically ill patients who developed acute renal failure and were first dialyzed in an intensive-care unit setting to define comorbid conditions, present at the time of first dialysis, that were predictive of outcome. Mortality rate was 88%. Adult respiratory distress syndrome (p < 0.05), requirement for antibiotics (p < 0.01) and ventilatory failure (p < 0.01) impacted negatively on recovery of renal function. The most powerful predictor of mortality was the need for ventilatory support (p < 0.001). The presence of ventilatory failure at the initiation of dialysis predicted a 100% mortality (89–100%;,95% confidence limits). The initiation of dialysis in intensive-care unit patients with acute renal failure requiring ventilatory support did not alter the uniformly fatal outcom
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