Nephron Clinical Practice
Original Paper
Relationship of Urine Output to Dialysis Initiation and Mortality in Acute Renal FailureLiangos O.a · Rao M.a · Balakrishnan V.S.a · Pereira B.J.G.a · Jaber B.L.bDivision of Nephrology, Department of Medicine,aTufts-New England Medical Center, and bCaritas-St. Elizabeth’s Medical Center, Boston, Mass., USA
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Subscribe
For eJournal Archive and eJournal Backfiles information please contact Karger service
Article / Publication Details
Received: July 21, 2004
Accepted: August 10, 2004
Published online: January 14, 2005
Issue release date: February 2005
Number of Print Pages: 1
Number of Figures: 1
Number of Tables: 3
eISSN: 1660-2110 (Online)
For additional information: https://www.karger.com/NEC
Abstract
Background: A non-oliguric state is considered a good prognostic indicator in acute renal failure (ARF), and may lead to withholding renal replacement therapy in anticipation of recovery. The present study explores the relationship between urine volume and the start of dialysis and hospital mortality in patients with ARF. Methods: In a non-concurrent cohort of patients with ARF treated exclusively with intermittent hemodialysis (IHD), demographic, clinical and laboratory characteristics were collected at the time of the first nephrology consultation and at the start of dialysis. Multiple linear and logistic regression analyses were used to identify factors associated with the time to initiation of dialysis and hospital mortality, respectively. Results: Urine volume correlated with the time from admission to start of dialysis (r = 0.60; p < 0.001). Higher urine volume, lower serum creatinine and lower APACHE II score were independently associated with increased time from admission to start of dialysis. Hospital mortality was independently associated with a higher urine volume (odds ratio, OR 3.8, 95% confidence interval, CI, 1.1–12.8, p = 0.03), a higher MOF score (OR 4.9, 95% CI 1.1–21.6, p = 0.03) and a higher number of dialysis treatments performed in the 1st week (OR 3.7, 95% CI 1.2–11.3, p = 0.03). Conclusions: Among patients with ARF requiring IHD, increased urine output is associated with higher mortality. This observation may reflect physician bias toward later initiation of dialysis in non-oliguric ARF. Further research is needed to help identify patients with non-oliguric ARF who require early dialytic support.
© 2005 S. Karger AG, Basel
Related Articles:
References
-
Brivet FG, Kleinknecht DJ, Loirat P, Landais PJ: Acute renal failure in intensive care units – Causes, outcome, and prognostic factors of hospital mortality; A prospective, multicenter study. French Study Group on Acute Renal Failure. Crit Care Med 1996;24:192–198.
External Resources
-
Liano F, Pascual J: Epidemiology of acute renal failure: A prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996;50:811–818.
External Resources
- Mehta RL, Pascual MT, Gruta CG, Zhuang S, Chertow GM: Refining predictive models in critically ill patients with acute renal failure. J Am Soc Nephrol 2002;13:1350–1357.
- Star RA: Treatment of acute renal failure. Kidney Int 1998;54:1817–1831.
- Mehta RL, Pascual MT, Soroko S, Chertow GM: Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA 2002;288:2547–2553.
- Mehta RL, McDonald B, Gabbai F, et al: Nephrology consultation in acute renal failure: Does timing matter? Am J Med 2002;113:456–461.
- Paganini EP, Halstenberg WK, Goormastic M: Risk modeling in acute renal failure requiring dialysis: The introduction of a new model. Clin Nephrol 1996;46:206–211.
- Briglia A, Paganini EP: Acute renal failure in the intensive care unit. Therapy overview, patient risk stratification, complications of renal replacement, and special circumstances. Clin Chest Med 1999;20:347–366.
- Mehta RL: Outcomes research in acute renal failure. Semin Nephrol 2003;23:283–294.
- Barretti P, Soares VA: Acute renal failure: Clinical outcome and causes of death. Ren Fail 1997;19:253–257.
- Cantarovich F, Verho MT: A simple prognostic index for patients with acute renal failure requiring dialysis. French Multicentric Prospective Study on Furosemide in Acute Renal Failure Requiring Dialysis. Ren Fail 1996;18:585–592.
- McLeish KR, Luft FC, Kleit SA: Factors affecting prognosis in acute renal failure following cardiac operations. Surg Gynecol Obstet 1977;145:28–32.
Article / Publication Details
Received: July 21, 2004
Accepted: August 10, 2004
Published online: January 14, 2005
Issue release date: February 2005
Number of Print Pages: 1
Number of Figures: 1
Number of Tables: 3
eISSN: 1660-2110 (Online)
For additional information: https://www.karger.com/NEC
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
