Thursday, April 30, 2009

Prognosis of acute renal failure

For specific information, visit http://www.kidneyatlas.org/book1/adk1_08.pdf, it's an extract of a textbook and it's just AMAZING! all these pretty tables that make sense (at least most of the time), and quite detailed info. Strongly recommended. (second half of the chapter is most applicable)

Anyway, basically acute kidney failure is quite a bad thing to have, and the prognosis is very reliant on the underlying cause of the kidney failure. Despite innovations in kidney treatment, mortality from ARF have actually increased, but this can be explained away by ageing populations, more diabetics, better treatments for other causes, but then again iatropic caused ACR have also increased. Mortality is approximately 50% in population studies, but on an individual level it varies greatly.

Some of the most important variables in determining prognosis are listed here:

Age
Jaundice
Sepsis
Burns
Trauma
NSAIDs
BUN increments
Coma
Oliguria
Obstetric origin
Malignancies
Cardiovascular disease
X-ray contrast agents
Acidosis
Hypotension
Catabolism
Hemolysis
Hepatic disease
Kind of surgery
Hyperkalemia
Need for dialysis
Assisted respiration
Site of war injuries
Disseminated intravascular coagulopathy
Pancreatitis
Antibiotics
Timing of treatment

After 30 days, 90% of people who are going to recover have recovered, or who are going to die, have died, so the longer they hang in there, the better their changes are.
Seriously. just read the chapter. it's really good :)

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