Risk Factors and Prognostic Factors of Acute Renal Failure in Patients Admitted to an Intensive Care Unit, Tehran-Iran

Acute renal failure (ARF) is defined as a sudden and continuous decrease of glomerular function associated with azotemia, and may be followed by decreased urinary output. There is a high incidence of ARF in ICU patients with a high mortality rate. Many factors can promote ARF development or influence its outcome. This study was done to assess the incidence, risk factors, outcome and treatment of patients who develop ARF in ICU. One hundred seventy five patients admitted to general ICU were studied. The impact of some factors such as age, sex, hypertension, length of stay in ICU, sepsis, oliguria, surgery, consumption of nephrotoxic drugs such as aminoglycosides and underlying chronic renal failure on development and prognosis of ARF was evaluated. ARF developed in 42(24%) patients with the mortality rate of 59.5%. Among factors studied, only use of aminoglycosides was statistically significant in relation to ARF development (P= 0.041 ), and the factors found to be associated with increasing mortality were hypertension (P=0.015) and prolonged stay in the ICU (P=0.012). In conclusion, among the prognostic factors, two were associated with a worse outcome of patients with ARF: hypertension and prolonged stay in the ICU. Unfortunately, the rapidly-changing clinical status of critically ill patients prohibits the clinician to make a clear decision on the prognosis of patients.