Costs of care, long-term prognosis and quality of life in patients requiring renal replacement therapy during intensive care

Objective: To assess (1) the long-term outcome of patients requiring renal replacement therapy (RRT) in terms of 6-month and 5-year mortality, (2) qua lity of life and (3) costs of the intensive care. Design: A retrospective observational cohort study. Setting: Twenty-three-bed multidisciplinary intensive care unit (ICU) in a tertiary care center. Patients and participants: Out of 3447 intensive care patients admitted, 62 patients with no end-stage renal failure required RRT, Interventions: None. Measurements and results: The incidence rate of acute renal failure (ARF) w as 8/100,000 inhabitants/year. The majority of patients (71 %) had ARF in c onjunction with multiple organ failure. The mortality in the ICU and in the hospital was 34 % and 45 %, respectively. Mortality was 55 % at 6 months a nd 65 % at 5 years. Renal function re-covered in 82 % of the survivors duri ng hospitalization. Loss of energy and limitations of physical mobility ass essed by Nottingham Health Profile were the most frequently reported compla ints at 6 months. Functional ability, as assessed by the activities of Dail y Living score was fairly good at 6 months. The cost per ARF 6-month surviv or was $80 000. Conclusions: There was only a minor increase in mortality after discharge f rom hospital among patients treated for ARF in intensive care. The costs re lated to ARF in intensive care are high, but the almost complete physical a nd functional recovery seen in ARF survivors should be noted in cost-effect ive analyses.