The prognosti̇c factors of acute renal failure

Aim: The purpose of this study, in patients who have been hospitalized with acute renal failure diagnosis or who have been diagnosed during the hospitalization at Farabi Hospital, Faculty of Medicine, Karadeniz Technical Univercity by investigating retrospective datas such as demografic datas, comorbidities, infectious status, vital and laboratory findings, unne volume, need for dialysis, length of hospitalization to evaluate the prognosis and factors contributing to the prognosis in acute renal failure patients and help improve the treatment of such patients. Material and Method: Our study has include 18 years old and older 857 patients who were followed with acute renal railure diagnosis whose archieve files could be reached from 01.01.2007 to 31.12.2012 at Farabi Hospital, Faculty of Medicine, Karadeniz Technical Univercity. All data was obtained and recorded from at Farabi Hospital, Faculty of Medicine, Karadeniz Technical Univercity archieves Patient age, gender, the service that the patient was hospitalized, comorbidities (HT, DM, CHF, CHD, COPD, malignencies, CVE), etiology of ARF (hypovolemia, sepsis, cardiac failure, urinary obstruction, contrast agent exposure, nephrotoxic drug use), urine volume, blood pressure measurement, length of hospitalization, infectious diseases by time of or during the hospitalization, and laboratory findings [creatinin (mg/dL), BUN (mg/dL), sodium (mEq/L), potassium (mEq/L), calcium (mg/dL), phosphor (mg/dL), albümine (gr/dL), uric acid (mg/dL), lactic dehidrogenase (w/L) bilirubin (mg/dL), hemoglobin (gr/dL), C-reactive protein (mg/dL)] were recorded Patients were assigned to two groups; survivors and non-survivors. Results: 857 patients were included in the study and 66,6 of them were discharged from the hospital with full of partial recovery, %33,4 of them died during the hospitalization. The mean age of survivors were 63,6 ± 17,2 and non-survivors were 68,72 ±14,6 (p<0,001) The etiologies of ARF were hypovolemia (%22,7), infections (%21), cardiac failure (%19,9), urinary track obstruction (%7,8), nephrotoxic agents (%13,6), more than one reason (%5,2), and idiopatic (%8,4). The comorbidities were hypertension (%35,7), diabetes mellitus (%24,5), coronary artery disease (%20,8), congestive heart disease (%6,3), chronic obstructive pulmonary disease (%5,1), malignencies (%17) and cerebrovascular event (%3,9) Among these comorbidities coronary artery disease, congestive heart disease, and malignencies were determined affecting the mortality (p<0,001). In patients who were oliguric, hypotensive, and required dialysis mortality was statistically significant (p<0,001). Patients with infectious diseases were determined to be having high mortality (p<0.001). The C-reactive protein and albumine levels measured during the admission to the hospital were statistically significant with mortality (p<0,001). Discussion: According to our retrospective study and the logistic regression analysis result, older age, presence of infections, need for dialysis, low serum albumine levels, high C reaktive protein levels, presence and length of oliguria, and hypotension are associated with poor prognosis. From these contributing factors those that can be improved, such as infections, hemodynamic parameters, and nutritional status, must be evaluated for better outcomes and low mortality rates.