Incidence

Acute renal failure is increasingly common, particularly in elderly people, although reported incidences vary according to the definition used and the population studied. In 1993 a community based study found an incidence of severe acute renal failure (serum creatinine > 500 µmol/l) of 172 per million adults per year, of whom 72% were over 70. Age related incidence rose from 17 per million per year in adults under 50 to 949 per million per year in the 80-89 age group. More recent prospective studies report an overall incidence of acute renal failure of almost 500 per million per year and an incidence of acute renal failure needing dialysis of more than 200 per million per year. This is double the UK incidence of end stage renal disease needing dialysis5 and places high demands on healthcare resources.

Acute renal failure accounts for 1% of hospital admissions and complicates more than 7% of inpatient episodes, mostly in patients with underlying chronic kidney disease. When the condition is severe enough to need dialysis in-hospital mortality is around 50%, and it may exceed 75% in the context of sepsis or in critically ill patients