tailieunhanh - Báo cáo y học: "Renal failure in the intensive care unit: acute kidney injury compared to end-stage renal failure"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Renal failure in the intensive care unit: acute kidney injury compared to end-stage renal failure. | Available online http content 12 5 432 Letter Renal failure in the intensive care unit acute kidney injury compared to end-stage renal failure Marlies Ostermann1 and René Chang2 for the Riyadh ICU Program Users Group 1 Guy s St Thomas Hospital Departments of Critical Care and Nephrology London SE1 9RT UK 2St George s Hospital Department of Nephrology Transplantation London SW17 0QT UK Corresponding author Marlies Ostermann Published 31 October 2008 This article is online at http content 12 5 432 2008 BioMed Central Ltd Critical Care 2008 12 432 doi cc7085 Patients with advanced acute kidney injury AKI and endstage dialysis dependent renal failure ESRF are characterized by loss of renal function as well as significant associated co-morbidities. However prognosis appears to differ when they are admitted to the intensive care unit ICU . Patients with advanced AKI have a reported ICU mortality between 25 and 90 depending on the specific patient population and the definition of AKI 1 2 whereas ICU mortality in ESRF patients has been reported to be 9 to 26 3-5 . In contrast Uchino and coworkers 5 found no difference in outcome between 32 ESRF patients in an ICU and 32 diagnosis and severity score matched patients with AKI treated with renal replacement therapy RRT . We retrospectively analyzed the Riyadh Intensive Care Program database of 41 972 adult patients admitted to ICUs in 19 hospitals in the UK and three hospitals in Germany between 1989 to 1999 and we compared ESRF patients and patients with advanced AKI defined by serum creatinine 354 ựmol l treatment with RRT or a rise in serum creatinine by 300 from baseline . A total of 797 patients had preexisting ESRF and 2 782 patients had advanced AKI of Table 1 Characteristics of patients with AKI and ESRF Factor Advanced AKI without RRT n 935 AKI on RRT n 1 847 ESRF n 797 P AKI on RRT versus ESRF Male sex Mean age SD years .