Acute Renal Failure and the Critically Ill Patient

2002 ◽  
Vol 15 (2) ◽  
pp. 158-166 ◽  
Author(s):  
Earnest Alexander ◽  
Bradley A. Boucher
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Current Knowledge ◽  
Treatment Options ◽  
Management Strategies ◽  
Critically Ill Patient ◽  
Drug Induced ◽  
Investigational Therapies

Acute renal failure (ARF) is a complication frequently observed in critically ill patients. This review provides details regarding the epidemiology and overall care of the ARF patient. ARF is defined and classified based on etiology. These classifications are prerenal azotemia, ischemic ARF, and postrenal azotemia. Examples of drug-induced nephrotoxicity are also outlined. Clinical presentation and diagnostic criteria of ARF are differentiated among the major ARF classes, and management strategies are outlined. These management strategies include preventive, supportive, pharmacologic, and nonpharmacologic interventions. Current standards of practice and investigational therapies are also discussed. Pharmacokinetic monitoring and dosing regimen adjustments in ARF patients with and without renal replacement therapy are reviewed. Finally, a prognostic evaluation of ARF in critically ill patients is provided based on current knowledge of the disease state and treatment options.

Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients*

2002 ◽  
Vol 30 (9) ◽  
pp. 2051-2058 ◽  
Author(s):  
Philipp G. H. Metnitz ◽  
Claus G. Krenn ◽  
Heinz Steltzer ◽  
Thomas Lang ◽  
Jürgen Ploder ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients

IMPROVING QUALITY OF ASSISTANCE AND OUTCOME IN CRITICALLY ILL PATIENTS WITH ACUTE RENAL FAILURE

2006 ◽  
Vol 32 (3) ◽  
pp. 167-170
Author(s):  
P. Sclauzero ◽  
S. Casarotto ◽  
M. Martingano ◽  
F. Morpurgo ◽  
I. Rocconi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Critically Ill ◽  
Critically Ill Patients

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

2006 ◽  
Vol 124 (5) ◽  
pp. 257-263 ◽  
Author(s):  
Geraldo Bezerra da Silva Júnior ◽  
Elizabeth De Francesco Daher ◽  
Rosa Maria Salani Mota ◽  
Francisco Albano Menezes
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Mechanical Ventilation ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Liver Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Urine Volume

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.

Acute Renal Failure in the Elderly Critically Ill Patient

2009 ◽  
pp. 1676-1680
Author(s):  
Monica Bonello ◽  
Dimitris Petras ◽  
Zaccaria Ricci ◽  
Nereo Zamperetti ◽  
Claudio Ronco
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Critically Ill ◽  
The Elderly ◽  
Critically Ill Patient
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