J Korean Soc Emerg Med.  2009 Feb;20(1):58-64.

Acute Renal Failure in Comatose Survivors after Cardiopulmonary Resuscitation

• Kwon IA
• Choi SP
• Yim HW
• Yoon JS
• Choi KH
• Choi SM
• Park KN

Abstract

PURPOSE
The purpose of this study was to assess the incidence, survival rate and risk factors of acute renal failure (ARF) in patients following cardiac arrest.
METHODS
This was a retrospective analysis of 132 cases of comatose survival after cardiac arrest and these patients had received cardiopulmonary resuscitation (CPR) in a tertiary emergency department from April 1997 to May 2007. We analyzed the basic data and clinical data, and we compared the patients who had developed ARF (ARF group) following CPR with those who had not (the non-ARF group).
RESULTS
Out of the 132 comatose survivors, ARF occurred in 54 patients (40.9%). The survival rate was higher in the non-ARF group (52.6%) than that in the the ARF group (16.7%) (p<0.0001). Both baseline renal insufficiency (OR 5.721, 95% CI 2.42-13.51; p<0.0001) and a peak creatine kinase level > 5000 IU/L (OR 8.527, 95% CI 1.78-40.91; p=0.043) were independent predictors of ARF. However, a history of coronary artery disease was not independently associated with renal failure, although it was more frequently found in patients with ARF (the ARF group).
CONCLUSION
ARF occurred commonly in the post-resuscitation period. The survival rate was higher in the non-ARF group than that in the ARF group. The major factors contributing to ARF were both baseline renal insufficiency and a peak creatine kinase level > 5000 IU/L.

Keyword

Acute renal failure; Cardiopulmonary resuscitation; Incidence; Survival rate; Risk factors

MeSH Terms

Acute Kidney Injury
Cardiopulmonary Resuscitation
Coma
Coronary Artery Disease
Creatine Kinase
Emergencies
Heart Arrest
Humans
Incidence
Renal Insufficiency
Retrospective Studies
Risk Factors
Survival Rate
Survivors
Creatine Kinase