Critical Care and Shock

Outcomes of acute renal failure patients having received renal replacement therapy in the intensive care unit

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Objective: The aim of the present study was to investigate both the outcomes and prognostic factors of ARF patients requiring RRT in our Intensive Care Unit.

Design: It was a retrospective observational study.

Setting: Pamela Youde Nethersole Eastern Hospital, a 20-bed medico-surgical ICU.

Patients and participants: ARF patients who had received RRT from January 2005 to December 2006 were recruited.

Interventions: The primary outcome was hospital mortality. Secondary outcomes were: dialysis dependency at hospital discharge, ICU and hospital length of stay. Relationship between demographics, premorbidities and clinical parameters with primary outcome was studied.

Measurements and results: One hundred and thirty-five patients were included in the final analysis. Hospital mortality rate was 63.7%. The median survival was 24 days (IQR 7 to 746 days). Mechanical ventilation (HR 2.96, 95% CI 2.04 to 3.89) and hepatorenal syndrome (HR 2.29, 95% CI 1.63 to 2.95) were independently associated with hospital mortality. Dialysis dependency rate after hospital discharge as on day 60 was 4.1%.

Conclusion: ARF in ICU was associated with a high mortality rate which was correlated with hepatorenal syndrome and mechanical ventilation. Most of the hospital survivors were free from dialysis.