Risk factors for death among critically ill patients with acute renal failure

Sao Paulo Medical Journal

Geraldo Bezerra Da Silva Júnior¹  Elizabeth De Francesco Daher¹  Rosa Maria Salani Mota¹  Francisco Albano Menezes¹ 

[1] ,Universidade Federal do Ceará School of Medicine Intensive Care Unit of Hospital Universitário Walter CantídioFortaleza Ceará ,Brazil

关键词: Acute kidney failure;    Risk factors;    Oliguria;    Sepsis;    Prognosis;    Insuficiência renal aguda;    Fatores de risco;    Oligúria;    Sepse;    Prognóstico;   

DOI  :  10.1590/S1516-31802006000500004

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.

【 授权许可】

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