ACUTE-RENAL-FAILURE - CLINICAL OUTCOME AND CAUSES OF DEATH

Acute renal failure (ARF) is a frequent complication in hospitalized p atients and is strongly related to increase in mortality. In order to analyze the clinical outcome and the prognostic factors in hospital-ac quired ARF a prospective study was performed. Data from 200 patients w ith established ARF during the period of January 1987 through July 199 0 were collected. The incidence of ARF was 4.9/1000 admissions. Renal ischemia (50%) and nephrotoxic drugs (21%) were the main etiologic fac tors. The histologic study done in 43 patients showed: acute tubular n ecrosis (53%), tubular hydropic degeneration (16%), glomerulopathies ( 16%), and other lesions (15%). Dialysis therapy was performed in 101 p atients. The mortality rate was 46.5% and the most important causes of death were. sepsis (38%), respiratory failure (19%), and multiple org an failure (11%). Higher mortality was observed in oliguric patients ( 62.9%) than nonoliguric (34.5%) (p < 0.05) and in ischemic renal failu re (56.7%) when compared to nephrotoxic renal failure (14.7%) (p < 0.0 5). As primary cause of death was not associated to the acute renal fa ilure, conclude that acute renal failure is an important marker of the gravity of the underlying disease and not the cause of death.