The epidemiology of acute renal failure in the world

The aim of this article is to describe our current understanding of the epidemiology of acute renal failure, especially in severe cases requiring renal replacement therapy. Some data from an international observational study (the Beginning and Ending Supportive Therapy (BEST) for the kidney study) are also presented.

Multiple epidemiological studies for acute renal failure have been conducted in different populations using various criteria and reported a wide range of incidence and mortality. In several multicenter studies reporting the incidence of renal replacement therapy requirement in a general intensive care unit population, however, renal replacement therapy requirement and hospital mortality was quite similar among the studies, approximately 4% and 60%, respectively. In North and South America, nephrologists typically manage acute renal failure patients with intermittent renal replacement therapy. On the other hand, in Asia, Australia and Europe, intensivists are commonly responsible for managing these patients with continuous renal replacement therapy.

Although the epidemiology of acute renal failure is varied among regions and centers, the average incidence of renal replacement therapy requirement and hospital mortality in critical illness are similar in multicenter studies. Continuous renal replacement therapy is gaining popularity and intensivists are becoming responsible for managing patients with it. More studies are needed to understand acute renal failure epidemiology worldwide. To conduct such studies, consensus criteria for acute renal failure and a well performed acute renal failure-specific severity score will be required.