Patients with acute renal failure requiring hemodialysis and factors associated with mortality in Lamphoon Hospital
Keywords:
Acute Renal Failure, Hemodialysis, , Prognosis, Mortality. Risk FactorsAbstract
Background: Acute renal failure may occur in patients with multiple co-morbidity. Patients with acute renal failure requiring hemodialysis experienced a high mortality rate. The hemodialysis service in Lamphoon Hospital is limited by small unit numbers and health personnel. More efficient means of the unit administration will be needed. Objective: To explain the characteristics of patients with acute renal failure requiring hemodialysis and those associated with death. Design: Retrospective cohort study. Setting: Lamphoon Hospital Methods: Subjects were 67 patients with acute renal failure who required hemodialysis in Lamphoon Hospital between March 2001 and December 2004. Information was retrieved from the medical records. They included general and clinical characteristics of the patients and treatment outcomes. Descriptive statistics were used to explain these characteristics. The characteristics associated with death were analysed by exact probability tests and Wilcoxon’s rank sum tests. Results: Subjects were 31.3% male, aged 54.0 years on average (SD = 18.6). Co-morbidity were reported in 46.3%. Expected causes of acute renal failure included post-operative consequences (23.9%) septicemia (20.9%) and acute on top of chronic renal failure (10.5%). Pre-dialysis blood urea nitrogen was 109.9 mg/dl (SD = 52.4) and creatinine 8.6 mg/dl (SD = 3.5). Hypotension requiring vasopressive therapy was reported in 43.3%. The patients required, on average, 1.8 hemodialysis treatments. Renal recovering time was 6.0 days on average. Death occurred in 38.8% after hemodialysis. Patients with co-morbidity experienced more death than those without (80.7% and 2.8%, p<0.001). Patients treated with vasopressive drugs also experienced more death than those not treated (79.3% and 7.9%, p <0.001) . Conclusion: Patients with acute renal failure required, on average, 1.8 hemodialysis. Death rate was reported in 38.8%. Renal function recovering time was 6.0 days on average. Co-morbidity and hypotension requiring vasopressive therapy increased mortality. Mortality rate may be reduced by monitoring these characteristics, which can also serve as prognostic indicators in addition to other clinical profiles.
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