[Analysis of factors related to mortality of critical patients with acute renal dysfunction]

To investigate the high risk factors related to mortality rate of critical patients with acute renal dysfunction in intensive care unit (ICU).

The data of patients with acute renal dysfunction hospitalized in ICU of Peking union medical college hospital during August 1999 to May 2001 were retrospectively investigated and the high risk factors related to hospital mortality were analyzed. The statistical analysis methods were univariate and multivariate factors analysis.

Among 1 218 critical patients hospitalized during August 1999 to May 2001, there were 149 patients with acute renal dysfunction. One hundred and thirty-five patients were investigated completely. Fifty-five (41 percent) died during the hospital stay. By univariate analysis, risk factors related to hospital mortality included acute physiology and chronic health evaluationII (APACHEII) score, the systemic inflammatory response syndrome, sepsis, severe sepsis, septic shock, chronic respiratory dysfunction, sepsis-related organ failure assessment (SOFA) score, acute respiratory dysfunction, coagulation dysfunction, central nerves system dysfunction, cardiovascular dysfunction, management of noradrenaline and continuous venovenous hemofiltration (CVVH). By multivariate analysis, only APACHEII score and management of noradrenaline and CVVH were determined as risk factors of hospital mortality independently. If the three factors were excluded, sepsis, central nerves system dysfunction, oliguria became the risk factors of mortality (all P<0.05).

The prognosis of critical patients with the acute renal dysfunction correlate with degree of basic diseases. There include oliguresis, coagulation dysfunction, central nerves system dysfunction and sepsis. In spite of management of CVVH, acute renal dysfunction per se can affect the prognosis of the critical patients.