Acute renal failure in intensive care unit

A retrospective study was done to analyse the incidence and outcome of acute renal failure among all patients admitted in intensive care unit (ICU) of Apollo Hospital, Secunderabad during the 12-month period from March 2003 to February 2004. Of the total 1100 patients admitted in ICU during the period, 75 patients were diagnosed with acute renal failure considering the primary markers as the levels of nitrogenous compounds in blood, i.e., blood urea nitrogen and serum creatinine. Sepsis in 24 (32%), hypoperfusion in 46 (61.3%), nephrotoxic drugs in 3, contrast induced in 1 and 20 patients with surgical ailments were the factors responsible for causing acute renal failure in various combinations. Thirty-three patients required dialytic support. Of the 75 patients, 29 died and of those who survived 9 had partial recovery. The overall mortality in ICU was 8.1% as compared to mortality among acute renal failure in ICU setting at 38.7%. Sepsis, oliguria and hypotension and scores over 120 on the Apache III scoring system were indicators of poor outcome. More than one pathogenetic factor playing a role in the development of acute renal failure in the majority. Acute renal failure can be prevented in several cases or the severity reduced by appropriate measures.