Prognostic factors of postoperative acute renal failure

Fifty-one patients (39 males, 12 females) who developed postoperative acute renal failure (ARF) were retrospectively analyzed to identify factors that could be used to predict survival and renal function recovery. The mortali ty rate was 45.1% (23/51). The renal function recovery rate was 45.1% (23/5 1). The majority of operations performed were cardiovascular surgery (68.6% ), general surgery (19.6%), hepatobiliary surgery (7.8%), and neurosurgery (3.9%). The etiologies of postoperative ARF were cardiogenic shock (41.2%), hepatorenal syndrome (2.0%), aortic dissecting aneurysm with renal artery involvement (2.0%), and others (5.9%). The causes leading to mortality were septic shock (65.2%), hypovolemic shock (21.7%), cardiogenic shock (13.1%) , and hepatic failure (4.4%). Statistically significant differences were fo und among 8 clinical variables between the survivors and non-survivors. The y were: postoperative APACHE II scores, number of postoperative organ dysfu nctions, peak postoperative blood urea nitrogen and creatinine levels, sept ic shock, oliguria, necessity of dialytic support, and recovery of renal fu nction. The significant variables predicting renal function recovery of pos toperative ARF were postoperative APACHE II scores, number of postoperative organ dysfunctions, peak postoperative creatinine levels, postoperative se psis, oliguria, and dialytic support.