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. 2005;9(6):R700-9.
doi: 10.1186/cc3879. Epub 2005 Oct 25.

Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study

Sean M Bagshaw  1 , Kevin B Laupland, Christopher J Doig, Garth Mortis, Gordon H Fick, Melissa Mucenski, Tomas Godinez-Luna, Lawrence W Svenson, Tom Rosenal
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Free PMC article

Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study

Sean M Bagshaw et al. Crit Care. 2005.
Free PMC article

Abstract

Introduction: Severe acute renal failure (sARF) is associated with considerable morbidity, mortality and use of healthcare resources; however, its precise epidemiology and long-term outcomes have not been well described in a non-specified population.

Methods: Population-based surveillance was conducted among all adult residents of the Calgary Health Region (population 1 million) admitted to multidisciplinary and cardiovascular surgical intensive care units between May 1 1999 and April 30 2002. Clinical records were reviewed and outcome at 1 year was assessed.

Results: sARF occurred in 240 patients (11.0 per 100,000 population/year). Rates were highest in males and older patients (> or = 65 years of age). Risk factors for development of sARF included previous heart disease, stroke, pulmonary disease, diabetes mellitus, cancer, connective tissue disease, chronic renal dysfunction, and alcoholism. The annual mortality rate was 7.3 per 100,000 population with rates highest in males and those > or = 65 years. The 28-day, 90-day, and 1-year case-fatality rates were 51%, 60%, and 64%, respectively. Increased Charlson co-morbidity index, presence of liver disease, higher APACHE II score, septic shock, and need for continuous renal replacement therapy were independently associated with death at 1 year. Renal recovery occurred in 78% (68/87) of survivors at 1 year.

Conclusion: sARF is common and males, older patients, and those with underlying medical conditions are at greatest risk. Although the majority of patients with sARF will die, most survivors will become independent from renal replacement therapy within a year.

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Figures

Figure 1
Figure 1
Age and sex-specific incidence rates of severe acute renal failure among adult residents admitted to a Calgary Health Region intensive care unit.
Figure 2
Figure 2
Age and sex-specific mortality rates of severe acute renal failure among adult residents admitted to a Calgary Health Region intensive care unit.
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