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Acute renal failure: six months pilot study in qatar.

A Rashed¹, O Abboud, A Addasi

¹Department of Medicine, Hamad General Hospital, Doha, Qatar.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia

|April 15, 2008

Summary

Acute renal failure (ARF) affected 0.49% of hospital patients. Renal ischemia was the primary cause, leading to higher mortality compared to nephrotoxic drug-induced ARF.

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Area of Science:

Nephrology
Critical Care Medicine

Background:

Acute renal failure (ARF) is a significant complication in hospitalized patients.
Identifying the primary causes and outcomes of ARF is crucial for improving patient management.

Purpose of the Study:

To investigate the incidence, etiologic factors, and outcomes of acute renal failure in a hospital setting.
To compare mortality rates between different causes of ARF and analyze the impact of oliguria.

Main Methods:

Retrospective analysis of 11,216 hospital admissions over six months.
Diagnosis of ARF based on elevated blood urea nitrogen and creatinine levels.
Categorization of ARF causes into renal ischemia and nephrotoxic drugs, with sub-classification of ischemic causes.

Main Results:

ARF developed in 0.49% of patients (55/11,216), with a mean age of 51.9 years.
Renal ischemia (69%) was the leading cause, followed by nephrotoxic drugs (16.3%). Septic shock and severe hypotension were major contributors to ischemic ARF.
ARF patients had a longer hospital stay (15.8 days vs. 5.1 days). Overall mortality was 21.8%, exclusively concentrated in the oliguric group, with significantly higher mortality in ischemic ARF compared to nephrotoxic ARF (p < 0.05).

Conclusions:

Renal ischemia, particularly due to septic shock and hypotension, is the predominant cause of ARF in hospitalized patients.
Oliguria is a critical indicator of poor prognosis in ARF, irrespective of age.
Prompt management of hypotension and judicious use of renal replacement therapies are essential, with a notable difference in survival based on ARF etiology.