Acute Renal Failure Renal Replacement Therapy & Outcome

Acute renal failure is present in 1 to 5 percent of patients at hospital admission and affects 15 to 20 percent of patients in intensive care units [2]. In a study in Madrid, pre-renal type of acute renal failure accounted for 21% of cases, post-renal type constituted 10% of cases and intrinsic-type accounted for 69% of cases [2]. Renal replacement therapy is the life saving procedure for patients with acute renal shut down. It came as a treatment option since the 1960s. Intermittent Haemodialysis, Continuous Venovenous Haemodialysis or Continuous Arteriovenous Haemodialysis and Peritoneal Dialysis are the frequently used treatment options. Outcome in acute renal failure is usually determined by the severity of the underlying diseases and other complications, rather than by renal shut down alone. The Madrid data showed that 60% of deaths were due to the primary disease and the remaining 40% were due to cardiopulmonary failure or infection. In Kerala, studies on acute renal failure and its outcome are rare. The clinicodemographic profile and determinants of outcome of acute renal failure patients varies in different parts of the world. In the context of developing countries, where the facilities for renal replacement therapy are limited, sometimes there is need for selecting patients on the basis of prognostic indices; even though these modalities of treatment should not be forbidden to anyone under any circumstances. In this era of highly sophisticated technology, there is also an ethical question of prolonging the artificial life support for patients with irreversible multi-organ failure with renal replacement therapy. By finding out the determinants of prognosis, we can prioritise the use of highly expensive dialysis modalities. Volume 2 Issue 5 2015