J Korean Soc Emerg Med.  2004 Aug;15(4):240-247.

Evaluation of Prognostic Factors in Acute Renal Failure at the Emergency Department

• Youm KI
• Han SC
• Yun YY
• Mun JM
• Chun BJ
• Heo T
• Min YI

Abstract

PURPOSE
This study intended to identify prognostic factors influencing recovery, progressing chronic renal failure (CRF) and mortality in acute renal failure (ARF) patients at the emergency department.
METHODS
We retrospectively analyzed 104 patients with ARF and with serum creatinine (Cr) level above 2 mg/dL and glomerular filtration rate (GFR) < 62.5 mL/min/ 1.73m2 (< 50%), who were treated at the emergency department fome Jan. 1998 to Aug. 2003. RESULT: Among the 104 patients, 71 patients were male and 33 patients were female. The overall mortality was 16.3%. Based on a univariate analysis, sex, age > 60 years, underlying disease, cause of ARF, urine volume, existence of oliguria, duration of oliguria, proteinuria, GFR, serum BUN, serum Cr, BUN/Cr ratio, arterial pH, PaO2, S a O2, serum Na+, serum K+, serum albumin, serum total bilirubin, serum osmolarity, serum AST, serum ALT, serum creatine kinase, and serum myoglobin were all significant factors discriminating between recovery patients and nonrecovery patients (progressing CRF, mortality). Based on a multivariate analysis, sex, existence of oliguria, duration of oliguria, GFR, BUN/Cr ratio, PaO2, serum K+, SaO2, serum bilirubin, and serum osmolarity were useful factors which might affected non-recovery.
CONCLUSION
In ARF, the prognostic factors were serum K+, S a O2, duration of oliguria, and BUN/Cr ratio. The higher serum K+, the lower SaO2, the longer the duration of oliguria, and the lower the BUN/Cr ratio are for ARF patients at the emergency department, the more the intensive care emergency physician must perform.

Keyword

Acute renal failure; Progression; Emergency

MeSH Terms

Acute Kidney Injury*
Bilirubin
Coriolaceae
Creatine Kinase
Creatinine
Emergencies*
Emergency Service, Hospital*
Female
Glomerular Filtration Rate
Humans
Hydrogen-Ion Concentration
Critical Care
Kidney Failure, Chronic
Male
Mortality
Multivariate Analysis
Myoglobin
Oliguria
Osmolar Concentration
Proteinuria
Retrospective Studies
Serum Albumin
Bilirubin
Creatine Kinase
Creatinine
Myoglobin
Serum Albumin