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Renal and respiratory failure in Scottish ICUs
J S Noble1, F N MacKirdy, S I Donaldson
1Department of Anaesthetics, Victoria Infirmary, Langside Road, Glasgow G42 9TY, UK.
Anaesthesia
|February 13, 2001
Summary
Critically ill patients needing kidney support and mechanical ventilation had a high mortality rate of 64.2%. End-stage renal failure was rare in survivors of acute kidney injury.
Area of Science:
- Nephrology
- Critical Care Medicine
- Intensive Care
Background:
- Patients requiring both renal replacement therapy (RRT) and mechanical ventilation in intensive care units (ICUs) represent a critically ill population.
- Outcomes for this patient group are often poor, necessitating further investigation into survival and long-term renal function.
Purpose of the Study:
- To determine the mortality and incidence of end-stage renal failure (ESRF) in patients receiving RRT and mechanical ventilation in Scottish ICUs.
- To compare current outcomes with previous studies.
Main Methods:
- Retrospective analysis of patients from 16 Scottish ICUs over a 2-year period.
- Data sourced from the Scottish Intensive Care Society's database.
- Identification of survivors with ESRF using the Scottish Renal Registry database.
Main Results:
- The overall mortality rate for patients receiving RRT and mechanical ventilation was 64.2% (392/612).
- ESRF developed in 1.6% (3/188) of survivors with acute renal failure (ARF).
- ESRF developed in 33% (4/11) of survivors with pre-existing chronic renal failure (CRF).
Conclusions:
- Mortality for critically ill patients on RRT and mechanical ventilation remains high and has not improved.
- ESRF rarely develops in survivors of ARF treated in the ICU.
- Patients with pre-existing CRF have a higher risk of developing ESRF after ICU survival.