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Study examines global prevalence of kidney failure among critically ill patients
August 17, 2005A multinational study has found that 5 to 6 percent of patients in intensive care units experience acute kidney failure, and about 60 percent of these patients die in the hospital, according to an article in the August 17 issue of JAMA.
The epidemiology and outcome of acute renal (kidney) failure (ARF) in critically ill patients in different regions of the world have not been well understood, according to background information in the article.
Shigehiko Uchino, M.D., of Austin Hospital, Melbourne, Australia, and colleagues conducted a study to determine the prevalence of ARF in intensive care unit (ICU) patients at 54 hospitals in 23 countries. The ICU patients were either treated with renal replacement therapy (RRT), such as dialysis, or fulfilled at least 1 of the predefined criteria for ARF from September 2000 to December 2001.
Of 29,269 critically ill patients admitted during the study period, 1,738 (5.7 percent) had ARF during their ICU stay, including 1,260 who were treated with RRT. The most common contributing factor to ARF was septic shock (47.5 percent). Approximately 30 percent of patients had preadmission renal dysfunction. The overall hospital death rate was 60.3 percent. Dialysis dependence at hospital discharge was 13.8 percent for survivors. Independent risk factors for hospital death included use of vasopressors (drugs that produce a rise in blood pressure), mechanical ventilation, septic shock, cardiogenic shock, and hepatorenal syndrome (kidney failure combined with severe liver disease).
"In summary, we have conducted a multinational, multicenter, prospective, epidemiological study of ARF that includes the largest and most representative sample of ICUs and ARF patients so far," the authors write. "This information may be helpful in the design of future international interventional trials, which would apply to worldwide practice, in regard to the statistical power and choice of appropriate outcome measures."
JAMA and Archives Journals
Of 29,269 critically ill patients admitted during the study period, 1,738 (5.7 percent) had ARF during their ICU stay, including 1,260 who were treated with RRT. The most common contributing factor to ARF was septic shock (47.5 percent). Approximately 30 percent of patients had preadmission renal dysfunction. The overall hospital death rate was 60.3 percent. Dialysis dependence at hospital discharge was 13.8 percent for survivors. Independent risk factors for hospital death included use of vasopressors (drugs that produce a rise in blood pressure), mechanical ventilation, septic shock, cardiogenic shock, and hepatorenal syndrome (kidney failure combined with severe liver disease).
"In summary, we have conducted a multinational, multicenter, prospective, epidemiological study of ARF that includes the largest and most representative sample of ICUs and ARF patients so far," the authors write. "This information may be helpful in the design of future international interventional trials, which would apply to worldwide practice, in regard to the statistical power and choice of appropriate outcome measures."
JAMA and Archives Journals
Kidney Failure Current Events and Kidney Failure News RSSPreventing anemia is important to kidney disease patients' quality of life
Maintaining sufficient red blood cell levels is important to the physical and mental health of patients with chronic kidney disease (CKD), according to a study appearing in the January 2009 issue of the Clinical Journal of the American Society Nephrology (CJASN). The findings indicate that preventing anemia in kidney disease patients should be an integral part of their care.
African-American Canadians who receive kidney transplants fare better than those in US
African American kidney disease patients in both Canada and the United States are less likely than Caucasian Americans to have access to kidney transplants, but only African-Americans in the United States have worse health outcomes than Caucasians after a transplant is performed.
Scientists identify cell changes leading to impaired 'artificial kidney' function
Molecular targets identified by a Spanish research team may hold the key to freedom for some sufferers of kidney disease. A new study published in Disease Models & Mechanisms (DMM), dmm.biologists.org, reveals the cellular signals which cause one treatment for kidney failure to lose its usefulness over time.
Researchers propose new ultrasound screening criteria for diagnosing polycystic kidney disease
Modification of the current screening criteria are needed for diagnosing patients with autosomal dominant polycystic disease (ADPKD), according to a study appearing in the January 2009 issue of the Journal of the American Society Nephrology (JASN). The results suggest that some patients with a milder form of the disease may otherwise be misdiagnosed.
Hypertension disparity linked to environment
Social environment may play a greater role in the disparity between the numbers of African Americans living with hypertension compared to non-Hispanic whites with the disease.
Larger labs report kidney function routinely
Labs that conduct the highest number of routine blood tests are more likely than others to report estimated glomerular filtration rate (eGFR), an important measure of kidney function that can identify early kidney disease.
Late-breaking results of clinical trial on therapeutic endovascular cooling reported at TCT 2008
Late-breaking results from the COOL RCN (COOLing to Prevent Radio Contrast Nephropathy in Patients Undergoing Diagnostic or Interventional Catheterization) Trial were presented during the 20th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF).
New gene variant identified for nondiabetic end stage renal disease in African-Americans
Scientists at Johns Hopkins schools of Public Health and Medicine have, for the first time, identified variants in the gene MYH9 that are associated with increased risk for non-diabetic end stage renal disease (ESRD,) which is the near-loss of kidney function leading to either dialysis of transplant. MYH9, located on the 22 chromosome, is the first gene identified for common forms of kidney disease.
Newly found gene variants account for kidney diseases among African-Americans
For the first time, researchers have identified variations in a single gene that are strongly associated with kidney diseases disproportionately affecting African-Americans. This work was conducted by researchers at the National Institutes of Health (NIH) and by NIH-funded investigators at the Johns Hopkins University.
Battling Diabetes with Beta Cells
Affecting eight percent of America's population, diabetes can lead to blindness, kidney failure, strokes and heart disease. Thanks to Tel Aviv University researchers, a new cure -- based on advances in cell therapy -- may be within reach.
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